Heart Watch Blog

May 8, 2009, 5:25 AM CT

What caused the massive decline in coronary death in Iceland?

In the 25 years between 1981 and 2006 mortality rates from coronary heart disease (CHD) in Iceland decreased by a remarkable 80% in men and women aged between 25 and 74 years. How could such a huge decline be explained? Were the health services of Iceland so much better, or were its citizens reducing their risks?1.

To find out Dr Thor Aspelund and his colleagues from the Icelandic Heart Association and the University of Iceland applied a validated CHD analysis model (the IMPACT mortality model) to official Icelandic death statistics, national quality registers, published trials and meta-analyses, clinical audits and a series of national population surveys.2.

Results of the study are presented at EuroPRevent 2009 and show that approximately three-quarters of the mortality decrease in Iceland was attributable to reductions in risk factors throughout the general population. These were principally (36%) in the reduction of cholesterol levels, smoking (20%) and systolic blood pressure (26%) and in the greater uptake of physical activity (5%).

In addition, approximately one quarter of the decrease in CHD deaths in Iceland was attributable to therapy in individuals - 7% to secondary prevention (ie, medical therapy or surgery following a heart attack or other CHD event), 6% to therapys for heart failure, 5% to initial therapys of acute coronary syndrome, and 1% to treating hypertension......... Posted by: April      Read more         Source

April 27, 2009, 5:25 AM CT

How new heart cells are created?

Researchers at the Gladstone Institute of Cardiovascular Disease have identified for the first time key genetic factors that drive the process of generating new heart cells. The discovery, published in the current issue of the journal Nature, provides important new directions on how stem cells appears to be used to repair damaged hearts.

For decades, researchers were unable to identify a single factor that could turn nonmuscle cells into beating heart cells. Using a clever approach, the research team led by Benoit Bruneau, Ph.D., observed that a combination of three genes could do the trick. This is the first time any combination of factors has been found to activate cardiac differentiation in mammalian cells or tissues.

"The heart has very little regenerative capacity after it has been damaged," said Dr. Bruneau. "With heart disease the leading cause of death in the Western world, this is a significant first step in understanding how we might create new cells to repair a damaged heart".

Two of the three genes encode proteins called transcription factors, which are master regulators that bind to DNA and determine which genes get activated or shut off. The two transcription factors, GATA4 and TBX5, cause human heart disease when mutated and also cooperate with each other to control other genes. When Dr. Bruneau and postdoctoral fellow Jun K. Takeuchi added different combinations of transcription factors to mouse cells, these two seemed important for pushing cells into heart cellsbut they were not enough......... Posted by: April      Read more         Source

April 8, 2009, 5:04 AM CT

Exercise for patients with chronic heart failure

Regular exercise is safe for heart failure patients and may slightly lower their risk of death or hospitalization, as per results from the largest and most comprehensive clinical trial to examine the effects of exercise in chronic heart failure patients. Supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, the study also observed that heart failure patients who add regular, moderate physical activity to standard medical treatment report a higher quality of life in comparison to similar patients who receive medical treatment only.

Scientists with HF-ACTION (Heart Failure A Controlled Trial Investigating Outcomes of exercise TraiNing) have published two papers in the April 8, 2009, issue of the Journal of the American Medical Association The study was conducted at 82 centers in the United States, Canada, and France.

"A number of patients and health care providers have continued to be concerned about the safety of aerobic exercise for heart failure," said NHLBI Director Elizabeth G. Nabel, M.D. "With the results of this robust clinical trial, we can now reassure heart failure patients that, with appropriate medical supervision, regular aerobic exercise is not only safe but it can also improve their lives in really meaningful ways."........ Posted by: April      Read more         Source

April 7, 2009, 5:20 AM CT

Reduce depression after heart surgery

Two non-pharmacological interventionscognitive behavior treatment and supportive stress managementappear more effective than usual care for treating depression after coronary artery bypass surgery, as per a report in the recent issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

About one in every five patients experiences a major depressive episode following coronary artery bypass graft (CABG) surgery and at least that a number of develop milder forms of depression, as per background information in the article. "Depression around the time of surgery predicts postoperative complications, longer physical and emotional recovery, worse quality of life and increased rates of cardiac events and mortality [death]," the authors write, and may also be associated with problems with thinking, learning and memory.

Kenneth E. Freedland, Ph.D., of the Washington University School of Medicine, St. Louis, and his colleagues conducted a randomized clinical trial involving 123 patients who had major or minor depression within one year after CABG surgery. Of these, 40 were randomly assigned to usual care as determined by primary care or other physicians and the other patients were assigned to one of two therapy groups.

This included 41 patients who underwent 12 weeks of cognitive behavior treatment, shown to be an effective therapy for depression in other populations. The individual, 50- to 60-minute sessions with a psychology expert or social worker involved identifying problems and developing cognitive techniques for overcoming them, including challenging distressing automatic thoughts and changing dysfunctional attitudes. The other 42 patients received 12 weeks of supportive stress management, in which a social worker or psychology expert counseled the patient about improving his or her ability to cope with stressful life events. Depressive symptoms were assessed at the beginning of the study and again after three, six and nine months......... Posted by: April      Read more         Source

March 31, 2009, 3:40 PM CT

Why that patient is in heart failure

A failing heart makes a lot of a hormone needed to eliminate the excess salt and water bloating the body but not enough of the enzyme needed to activate it, scientists say.

Using novel assays they developed, Medical College of Georgia scientists found people in heart failure have less of the enzyme corin needed to activate pro-ANP, or pro-atrial natriuretic peptide, a hormone made by heart muscle cells that, when active, helps reduce extra sodium and fluid that tax the cardiovascular system.

Low corin levels help explain why the heart's natural attempt to save itself is often thwarted in heart failure and scientists hope the new tests they developed can help identify those people.

"The question is always: If you have so much of this hormone that is supposed to increase diuresis, why are patients still in heart failure with all this fluid in their lungs?" says Dr. Uzoma Ibebuogu, cardiology fellow at the Medical College of Georgia.

Dr. Ibebuogu presented the findings at the American College of Cardiology Congress March 28-31 in Orlando where he was among five finalists for the Young Investigator Award.

When he and his colleagues Drs. Guy Reed and Inna Gladysheva compared 14 patients in heart failure to 16 people with healthy hearts, they found those in heart failure had about 80 percent less corin. Their assays enabled measurement of corin as well as active ANP levels instead of only the total pro-ANP levels measured by current technology......... Posted by: April      Read more         Source

March 22, 2009, 9:39 PM CT

Genes associated with sudden cardiac death

You're sitting at your desk and suddenly your heart is beating in overdrive or worse, lurching along like a car on fumes. It is a shocking, uncomfortable and frightening sensation.

Irregular heart rhythms are a common cause of sudden cardiac death or SCD, a condition that accounts for 450,000 deaths annually in the United States. Researchers are now closer to understanding what causes SCD and who it may strike, said Gonalo Abecasis, associate professor of biostatistics at the University of Michigan School of Public Health.

Abecasis co-led on an international study aiming to identify genetic defects linked to sudden cardiac death. Aravinda Chakravarti of Johns Hopkins and Arne Pfeufer of the Institute for Human Genetics in Gera number of also co-led the study. Serena Sanna, formerly at the U-M School of Public Health and now a researcher at the National Research Center in Cagliari, Italy, was joint first author.

The team identified 10 genes linked to changes in the so-called QT interval duration. The QT interval duration measures the length of time the heart takes to contract. A QT interval that's too long or too short can cause serious problems, including arrhythmias and sudden cardiac death. The QT interval can be seen on an electrocardiogram monitor; it's a certain portion of the line that waves or spikes up and down when the heart contracts......... Posted by: April      Read more         Source

February 9, 2009, 6:21 AM CT

Gene associated with early heart attack

The largest study ever completed of genetic factors linked to heart attacks has identified nine genetic regions three not previously described that appear to increase the risk for early-onset myocardial infarction. The report from the Myocardial Infarction Genetics Consortium, based on information from a total of 26,000 inviduals in 10 countries, will appear in Nature Genetics and is receiving early online release.

"For several decades, it has been known that the risk for heart attack the leading cause of death and disability in the U.S. clusters in families and that some of this familial clustering is due to differences in DNA sequence," says Sekar Kathiresan, MD, director of Preventive Cardiology at Massachusetts General Hospital (MGH) and corresponding author of the Nature Genetics report. "We set out to find specific, single-letter differences in the genome, what are called single-nucleotide polomorphisms (SNPs), that appears to be responsible for an increased familial risk for heart attack."

Groundwork for the current study was laid more than 10 years ago when co-author Christopher O'Donnell, MD, now based at the Framingham Heart Study, began to gather data on patients treated at the MGH for early-onset heart attack men under 50 and women under 60. Kathiresan soon joined the project, and in 2006 they formed the Myocardial Infarction Genetics Consortium along with David Altshuler, MD, PhD, of the MGH Center for Human Genetic Research and the Broad Institute of MIT and Harvard, eventually involving six groups around the world that had collected samples on a total of about 3,000 early-onset heart attack patients and 3,000 healthy controls......... Posted by: April      Read more         Source

January 6, 2009, 7:01 PM CT

New risk assessment tools need to predict Coronary Heart Disease

The Framingham and National Cholesterol Education Program tools, NCEP, do not accurately predict coronary heart disease, according to a study performed at the Yale University School of Medicine in New Haven, CT.

The study included 1,653 patients who had no history of coronary heart disease; although 738 patients were taking statins (cholesterol lowering drugs like Lipitor) because of increased risk of developing coronary heart disease. All 1,653 patients underwent a coronary CT angiogram and doctors compared their risk of coronary heart disease, determined by the Framingham and NCEP risk assessment tools, to the amount of plaque actually found in their arteries as a result of the scan. Results showed that 21% of the patients who were thought to need statin drugs before the scan (because of the Framingham and NCEP assessment tools) did not require them; "26% of the patients who were already taking statins (because of the risk factor assessment tools) had no detectable plaque at all," said Kevin M. Johnson, MD, lead author of the study.

"Risk assessment tools are used by physicians implicitly. Physicians use them as a way to separate and treat patients accordingly. Ultimately, the Framingham influences what every doctor does, but I feel it is not good enough to show what is happening with each individual patient," said Dr. Johnson......... Posted by: April      Read more         Source

December 6, 2008, 4:34 PM CT

A little wine boosts omega-3 in the body

Results from the European study IMMIDIET show that moderate wine intake is associated with higher levels of omega-3 fatty acids considered as protective against coronary heart disease.

Moderate alcohol intake is associated with higher levels of omega-3 fatty acids in plasma and red blood cells. This is the major finding of the European study IMMIDIET that would be published in the recent issue of the American Journal of Clinical Nutrition, an official publication of the American Society for Nutrition and is already available on line (www.ajcn.org ). The study suggests that wine does better than other alcoholic drinks. This effect could be ascribed to compounds other than alcohol itself, representing a key to understand the mechanism lying behind the heart protection observed in moderate wine drinkers.

The IMMIDIET study examined 1,604 citizens from three geographical areas: south-west London in England, Limburg in Belgium and Abruzzo in Italy. Thanks to a close cooperation with General Practitioners of these areas, all participants underwent a comprehensive medical examination, including a one year recall food frequency questionnaire to assess their dietary intake, alcohol consumption included.

Omega-3 fatty acids, mainly derived from fish, are considered as protective against coronary heart disease and sudden cardiac death, thus their high blood concentration is definitely good for our health......... Posted by: April      Read more         Source

November 24, 2008, 9:32 PM CT

Gasping helps cardiac arrest victims survive

People who witness an individual collapse suddenly and unexpectedly should perform uninterrupted chest compressions even if the patient gasps or breathes in a funny way, research from the Resuscitation Research Group at The University of Arizona Sarver Heart Center shows. The study is set to publish in the Nov. 24 online issue of Circulation, the official journal of the American Heart Association, http://circ.ahajournals.org.

When an individual breathes abnormally or gasps after collapsing from sudden cardiac arrest there is a greater chance of surviving, the scientists report. Gasping can be thought of as a survival reflex triggered by the brain.

Each day, about 500 Americans collapse because their hearts suddenly stop beating. Data collected by Sarver Heart Center scientists show that in more than half of witnessed cardiac arrest cases, the patient gasped.

"Gasping is an indication that the brain is still alive, and it tells you that if you start and continue uninterrupted chest compressions, the person has a high chance of surviving," said Gordon A. Ewy, MD, corresponding author of the study, professor and chief of cardiology at the UA and director of its Sarver Heart Center. "We need people to promptly recognize sudden cardiac arrest, to call 9-1-1 and to start chest compressions right away"......... Posted by: April      Read more         Source

November 12, 2008, 10:39 PM CT

Sex differences narrow in death after heart attack

In recent years, women, especially younger women, experienced larger improvements in hospital mortality after myocardial infarction than men, as per a new study.

Over the last decade some studies showed that younger women, but not older ones, are more likely to die in the hospital after MI than age-matched men. A team of scientists led by Emory University examined whether such mortality differences have declined in recent years.

"We observed that the number of younger women who die in the hospital after a heart attack, compared with men has narrowed over the last few years," says study leader Viola Vaccarino, MD, PhD, professor of medicine (cardiology), Emory University School of Medicine.

Vaccarino says changes in patient characteristics and therapys over time accounted in part for the changing mortality trends. The findings were presented Nov. 12 at the American Heart Association Scientific Sessions conference in New Orleans.

Often referred to as a heart attack, MI occurs when the blood supply to part of the heart is interrupted. This decreased blood supply is usually due to blockage of a coronary artery and if left untreated can cause damage and/or death (infarction) of heart muscle tissue.

The scientists investigated MI mortality trends as per sex and age in five age groups during a 12-year period from 1994 to 2006. The study population included 916,380 MI patients from the National Registry of Myocardial Infarction (NRMI) who had a confirmed diagnosis of MI......... Posted by: April      Read more         Source

November 12, 2008, 10:35 PM CT

New theory that may lead to effective heart failure treatments

Do the biological underpinnings of heart failure share more in common with malignant tumors than other cardiovascular diseases?

Research presented at American Heart Association meeting may show why heart failure therapys fail.

A team of Medical University of South Carolina (MUSC) scientists and heart specialists are presenting many studies at the American Heart Association conference that point toward new therapys for heart failure patients.

As per the American Heart Association, more than 5 million Americans are living with heart failure, and 550,000 new cases are diagnosed each year. It is a chronic disease that has no cure and typically worsens rapidly.

Dr. Francis G. Spinale and several other scientists from MUSC have put together scientific clues resulting in more than a dozen research studies on patients and mice that strongly suggest that a family of proteins called matrix metalloprotienase (MMP) play a crucial role in why the supporting tissue surrounding the heart, called the myocardium, goes through significant and deleterious effects in heart failure patients.

The conclusions reached by the team have already led to the development of a blood test for these MMPs. But more significantly, as per MUSC cardiac specialist Francis G. Spinale, MD, PhD, this research may demonstrate why current therapys for heart failure are failing and point to novel therapy methods for heart failure patients, reduce the number of people on the heart transplant list and help prioritize those heart failure patients currently on the list......... Posted by: April      Read more         Source

November 11, 2008, 9:43 PM CT

Damage inflicted during cardiac attacks more widespread

Cholesterol crystals released in the bloodstream during a cardiac attack or stroke can damage artery linings much further away from the site of the attack, leaving survivors at greater risk than previously thought.

George Abela, a doctor in Michigan State University's College of Human Medicine and chief of the Department of Medicine's cardiology section, is leading innovative research into the role that the crystallization and expansion of cholesterol play in heart attacks, strokes and other cardiovascular events in humans.

He presented his latest research this week at the American Heart Association's Scientific Sessions meeting in New Orleans.

In recent medical trials, Abela and his team of scientists tested carotid arteries in a laboratory by injecting cholesterol crystals into them.

"Cholesterol has been shown to expand when crystallizing and then be released into the circulation following a cardiac event," Abela said. "We observed that the flow of sharp-ended crystals in arteries damage the lining of arteries and decrease the ability of arteries to dilate properly at intervals far away from the site of the attack".

Abela compared the process to a tree, with the trunk as the site of the cardiac event and the branches representing arteries where damage is afflicted far away from the trunk......... Posted by: April      Read more         Source

November 9, 2008, 10:23 PM CT

Vitamins E and C supplements andcardiovascular disease

Neither vitamin E nor vitamin C supplements reduced the risk of major cardiovascular events in a large, long-term study of male physicians, as per a research studyin the November 12 issue of JAMA The article is being released early online November 9 to coincide with the scientific presentation of the study findings at the American Heart Association meeting.

Most adults in the United States have taken vitamin supplements in the past year, as per background information provided by the authors. "Basic research studies suggest that vitamin E, vitamin C, and other antioxidants reduce cardiovascular disease by trapping organic free radicals, by deactivating excited oxygen molecules, or both, to prevent tissue damage." Some prior findings based on observation have supported a role for vitamin E in cardiovascular disease prevention. Some prior findings based on observation have also shown a role for vitamin C in reducing coronary heart disease risk.

In this study, known as the Physicians' Health Study II, Howard D. Sesso, Sc.D, M.P.H., and his colleagues from Brigham and Women's Hospital, Harvard Medical School and School of Public Health and VA Boston Healthcare System, Boston, assessed the effects of vitamin E and vitamin C supplements on the risk of major cardiovascular disease events among 14,641 male physicians. These physicians were 50 years or older and at low risk of cardiovascular disease at the beginning of the study in 1997, and 754 (5.1 percent) had prevalent cardiovascular disease. The study participants were randomized to receive 400 IU of vitamin E every other day or a placebo and 500 mg of vitamin C daily or a placebo......... Posted by: April      Read more         Source

November 9, 2008, 10:00 PM CT

New risk factor for cardiovascular disease

This release is available in French.

Montreal, November 9th 2008 - A team of international scientists including researchers from the McGill University Health Centre (MUHC) and McGill University have discovered that having high levels of particular protein puts patients at increased risk of developing cardiovascular disease. The results of the study were so conclusive that the clinical trial had to be stopped before its scheduled completion date.

Scientists linked to the international JUPITER Project have demonstrated that high levels of high-sensitivity C-reactive protein (hs-CRP) leads to increased risk of cardiovascular disease. This risk decreases by up to 44% if the patients are treated with statin medications.

Dr. Jacques Genest, of the Research Institute of the MUHC and McGill's Faculty of Medicine led the Canadian component of the JUPITER clinical study, which was initiated by Dr. Paul Ridker of the Harvard University Faculty of Medicine.

"The risk of cardiovascular disease due to increased hs-CRP levels has been greatly underestimated until now," as per Dr Genest. "Our results show that this is an extremely important indicator that doctors will have to consider in the future".

"We hope that this study will prompt a review of current clinical practices, particularly in terms of screening and prevention in adults," he added. "However, we still need to do more research to establish specific standards"......... Posted by: April      Read more         Source

November 6, 2008, 6:23 PM CT

Factors that influence carotid-surgery success

Advanced age and race are among the factors that can affect whether a patient dies or suffers a stroke after carotid-artery surgery, a UT Southwestern doctor involved in a multicenter study has observed.

"This study identified 11 readily available, clinical risk factors that can help referring physicians, neurologists, surgeons and anesthesiologists better weigh the risks and benefits of carotid surgery for an individual patient," said Dr. Ethan Halm, new chief of the William T. and Gay F. Solomon Division of General Internal Medicine at UT Southwestern and the study's lead author. "You don't want to cause a stroke to prevent a stroke".

The new findings are reported in the current online version of the journal Stroke.

Dr. Halm and his colleagues used data from the New York Carotid Artery Surgery (NYCAS) study, which reviewed the outcomes of 9,308 carotid surgeries performed on elderly patients by 482 surgeons in 167 hospitals in New York state. It is the largest study of its kind to use clinically detailed data on a population-based study of carotid-surgery outcomes and risk factors in community practice. Dr. Halm recently left Mt. Sinai School of Medicine in New York to lead UT Southwestern's general internal medicine division.

Carotid-artery surgery, one of the most common types of vascular surgeries performed in the U.S., involves opening the carotid artery in the neck and removing harmful plaque to restore blood flow to the brain. Eventhough prior controlled trials have shown carotid surgery reduces the long-term risk of death or stroke in some patients, there is a chance the procedure could cause death or stroke......... Posted by: April      Read more         Source

October 27, 2008, 10:34 PM CT

Cardiovascular effects of diabetes medications

The diabetes medicine metformin may be linked to a lower risk of death from cardiovascular disease, as per a meta-analysis of previously published studies in the October 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. No associations were found between other diabetes medications and beneficial or harmful cardiovascular effects, in part because of insufficient data, the authors note.

"A wide variety of oral diabetes medications are currently available for the therapy of type 2 diabetes mellitus," they write as background information in the article. "With the addition of newer oral therapies to the market in the late 1990s (e.g., thiazolidinediones and meglitinides), it is critical to evaluate how these agents compare with older medications. This is especially important in light of the expense of a number of of the newer therapies." The specific effects of these medications on cardiovascular health remains unclear, and recent controversy has surrounded possible cardiac risks linked to one newer drug, rosiglitazone.

Elizabeth Selvin, Ph.D., M.P.H., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and his colleagues performed a meta-analysis of data from 40 clinical trials published on or before Jan. 19, 2006. All the trials assessed the benefits or harms of oral diabetes medications approved for use in the United States, including combinations of therapies usually prescribed by physicians, and included information about heart attack, stroke or other cardiovascular events. The average age of participants ranged from 52 to 69 and 27 of the studies (68 percent) were less than one year in duration......... Posted by: April      Read more         Source

September 10, 2008, 10:15 PM CT

Bleeding gums linked to heart disease

Bleeding gums and poor dental hygiene can end up causing heart disease, scientists heard today (Thursday 11 September2008) at the Society for General Microbiology's Autumn meeting being held this week at Trinity College, Dublin.

People with poor dental hygiene and those who don't brush their teeth regularly end up with bleeding gums, which provide an entry to the bloodstream for up to 700 different types of bacteria found in our mouths. This increases the risk of having a heart attack, according to microbiologists from the University of Bristol and the Royal College of Surgeons in Ireland.

"The mouth is probably the dirtiest place in the human body," said Dr Steve Kerrigan from the Royal College of Surgeons in Dublin, Ireland. "If you have an open blood vessel from bleeding gums, bacteria will gain entry to your bloodstream. When bacteria get into the bloodstream they encounter tiny fragments called platelets that clot blood when you get a cut. By sticking to the platelets bacteria cause them to clot inside the blood vessel, partially blocking it. This prevents the blood flow back to the heart and we run the risk of suffering a heart attack".

The only treatment for this type of disease is aggressive antibiotic therapy, but with the increasing problem of multiple drug resistant bacteria, this option is becoming short lived......... Posted by: April      Read more         Source

July 19, 2008, 9:56 AM CT

Elderly with coronary artery disease

A new study from Duke University Medical Center finds that patients treated solely with medications after suffering from chest pain, heart attack or coronary artery disease are more likely to die during the first year following their initial hospitalization.

"Patients managed medically without stenting or bypass surgery tend to be elderly and frail, and in some sense we feel they have been overlooked," says Matthew Roe, a heart specialist at Duke and the senior author of the study appearing in the recent issue of the Journal of the American College of Cardiology: Cardiovascular Intervention "We wanted to find out what clinical factors were funneling them into a medicine-only group and what happened to them, when in comparison to patients who received stents and bypass procedures".

Roe led a team of scientists in examining a subset of 8,225 patients from a prior study (the SYNERGY trial) which compared the effects of two different anti-clotting drugs in heart patients. For the current study, scientists included only patients who had undergone cardiac catheterization and who had been found to have at least one significant blockage in a coronary artery. A majority of these patients (52 percent) underwent coronary stent implantation to open their arteries, while 32 percent were medically managed, and 16 percent underwent coronary bypass surgery......... Posted by: April      Read more         Source

July 14, 2008, 9:52 PM CT

Young adults with prehypertension and atherosclerosis

Prehigh blood pressure during young adulthood is common and is linked to subsequent coronary atherosclerosis, as per a research studypublished in today's issue of Annals of Internal Medicine

Scientists from the University of California, San Francisco, analyzed blood pressure measurements of 3,560 adults aged 18 to 30 from seven examinations over the course of 20 years. Nearly 20 percent (635) of the study participants developed prehigh blood pressure (systolic blood pressure 120 to 139 mmHg or diastolic blood pressure 80 to 89 mmHg) before the age of 35.

Eventhough these blood pressure levels are below the cutoff for hypertension, the young adults with prehigh blood pressure were more likely than those with lower blood pressure to have calcium in their coronary arteries during the later part of life. Coronary calcium is a marker of atherosclerosis and a predictor of future heart attacks and strokes.

"Our findings suggest the possibility that prehigh blood pressure itself is harmful, and not just because it is linked to subsequent hypertension," said Mark J. Pletcher, MD, MPH, the study's lead author. "People with a lot of calcium in their coronary arteries are more likely to have heart attacks and strokes, and these outcomes might be avoidable by keeping blood pressure low when you're young"......... Posted by: April      Read more         Source

July 10, 2008, 9:37 PM CT

Alaskan Eskimos' high rates of artery plaque

Alaskan Eskimos' significantly higher rates of fatty artery plaque than the general U.S. population may be due to unhealthy lifestyle habits, scientists report in Stroke: Journal of the American Heart Association.

Scientists observed that more than half of Alaskan Eskimo adults smoke, their level of physical activity has decreased from traditional levels, and their intake of saturated and trans fats, rather than heart-healthy omega 3 fatty acids (found in fish), has increased.

"Traditionally, American Eskimos have not had much cardiovascular disease, but more recent population surveys have shown that cardiovascular disease is increasing in this population," said Mary J. Roman, M.D., lead author of the study. "We sought to confirm this increase and determine whether it was correlation to the things that cause coronary heart disease in other populations or something else."

In the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study, scientists examined extensive medical histories, dietary surveys, blood analyses and ultrasound images of carotid arteries of more than 1,200 Eskimo adults (average age 42) in Alaskan villages to determine if signs of atherosclerosis - fatty plaque buildup - were present before symptoms occurred.

"Carotid arteries are the major arteries taking blood up to the brain," said Roman, a professor of medicine in the cardiology division at Weill Cornell Medical College in New York, N.Y. "We looked for thickening of the lining of the arteries, called intimal-medial thickness, and whether there was evidence of plaque or fatty buildup, known as atherosclerosis......... Posted by: April      Read more         Source

July 3, 2008, 9:06 PM CT

Screening for heart disorders in competitive athletes

Athletes who take part in competitive sport should be screened for potentially fatal heart problems before they compete, as per a research studypublished on BMJ.com today.

The findings show that a pre-participation screening programme, which involves checking the activity of the heart during exercise, would detect more athletes at risk of sudden cardiac death and save lives, say the authors.

One young competitive athlete dies every three days from an unrecognised cardiovascular disorder in the United States alone.

In the majority of cases the athletes appear healthy and there is no prior clinical sign of heart problems. The clinical usefulness of pre-screening programmes to identify people at high risk has been hotly debated. Whether or not to include an electrocardiogram (ECG) as part of pre-screening has been especially controversial because of concerns over cost-effectiveness and the number of false-positive test results.

In America and Europe authorities have recommended a pre-participation evaluation which includes taking a detailed patient and family history as well as a physical examination.

However, in Italy for the past 25 years, athletes wishing to enter competitive sport have also had to have two ECGs (a test to measure the electrical activity of the heart), one at rest and one while exercising. Scientists from the University of Florence set out to evaluate the clinical usefulness of this programme......... Posted by: April      Read more         Source