Heart Watch Blog

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

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

March 3, 2008, 8:33 PM CT

Depression And Heart Attack Patients

Depressed heart attack patients have a higher risk for sudden death in the months following a heart attack. Now a team led by scientists from Washington University School of Medicine in St. Louis has observed that the risk continues for a number of years.

"There's a two- to four-fold increase in a person's risk of dying following a heart attack if they also happen to be depressed," says Robert. M. Carney, Ph.D., lead author of the new study and professor of psychiatry at Washington University. "Previously we thought the impact of depression was strongest for the first three to six months following a heart attack and then gradually dropped off within a couple of years. Instead, we observed that the effect lasts for at least five years."

Carney, with colleagues from Duke University Medical Center, Harvard University, Yale University, the National Heart, Lung and Blood Institute (NIH) and the Mayo Clinic, followed more than 750 heart attack patients for five years. The findings will appear in an upcoming issue of the Journal of Affective Disorders and are currently available online.

Patients followed in the study had participated in the NIH-funded project Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD). A little less than half were diagnosed with depression......... Posted by: April      Read more         Source

March 2, 2008, 9:03 PM CT

Low-fat diets to reduce risk of heart disease

Low-fat diets are more effective in preserving and promoting a healthy cardiovascular system than low-carbohydrate, Atkins-like diets, as per a new study by scientists at the Medical College of Wisconsin in Milwaukee.

The study, reported in the February edition of the scientific journal Hypertension, was led by David D. Gutterman, M.D., Northwestern Mutual Professor of Cardiology, professor of medicine and physiology, and senior associate dean of research at the Medical College. Shane Phillips, M.D., a former Cardiology faculty member at the Medical College, and now assistant professor in the department of physical treatment at the University of Illinois - Chicago, was the lead author.

Public awareness of the obesity epidemic has resulted in various dietary weight loss strategies. In America, it is estimated that 45 percent of women and 30 percent of men diet to lose weight.

The nutrient-specific effects of these diets on cardiovascular health are largely unknown, says Dr. Gutterman.

Low-carbohydrate diets are significantly higher in total grams of fat, protein, dietary cholesterol and saturated fats than are low-fat diets. While a low-carbohydrate diet may result in weight loss and improvement in blood pressure, similar to a low-fat diet, the higher fat content is ultimately more detrimental to heart health than is the low-fat diet suggested by the American Heart Association, points out Dr. Phillips......... Posted by: April      Read more         Source

February 11, 2008, 8:29 PM CT

Swift System For Heart Attack Care Improves Treatment

Heart attack patients received lifesaving care up to an hour sooner after an Indiana hospital implemented a novel protocol to rapidly activate the cardiac catheterization lab, scientists reported in Circulation: Journal of the American Heart Association.

In comparison to the traditional protocol, patients arrived at the cardiac catheterization lab ("cath lab") sooner for artery-opening procedures, had less heart damage and shorter hospital stays. The new protocol also reduced the cost of care.

Patients in the study had a type of heart attack called ST-segment elevation myocardial infarction, or STEMI, which is caused by a completely blocked artery. The quicker a patient with this heart attack has the artery opened, the better the chances are for survival and less permanent damage to the heart.

Currently, the preferred therapy for this type of heart attack is emergency angioplasty, which is also called percutaneous coronary intervention (PCI). In this procedure, which is performed in a cath lab, a thin wire with a tiny balloon on the end is threaded through an artery to the blockage. When the balloon is inflated, it clears the blockage and restores blood flow to the heart. A number of times a wire mesh tube, called a stent, also is placed to help prop the artery open and prevent re-blockage......... Posted by: April      Read more         Source

February 11, 2008, 8:16 PM CT

Uncertain About Care for Heart Failure Patients

Less than one fourth of physicians specializing in geriatrics, internal or family medicine or cardiology believe they can accurately predict the whether patients with heart failure are at risk of dying, new Saint Louis University research found.

The ability to determine whether patients are within six months of death is crucial to clinical care, impacting key patient-care decisions such as therapeutic approaches and referral for palliative care, which is focused on symptom relief rather than cure.

"Our findings are important not only in light of the increasing prevalence of heart failure in the United States but because the data show that there are considerable gaps in knowledge regarding end-stage heart failure that ultimately affect a patient's experience with their illness," says Paul Hauptman, M.D., professor of internal medicine at Saint Louis University School of Medicine and the study's lead author.

"Palliative measures can be adopted to ease the pain of patients with terminal heart failure, but these measures are not always utilized because of uncertainty about the patient's prognosis. Unlike cancer, for example, predicting death is not always clear with end-stage heart failure."

Across the board, physicians reported that they were unlikely to refer a patient with end-stage heart failure for hospice care. Their reluctance was due in part to uncertainty about timing and patient acceptance of the recommendation......... Posted by: April      Read more         Source

February 7, 2008, 10:08 PM CT

Woman is first in region to receive new heart valve

A 78-year-old St. Louis woman was the first patient in this region to receive an experimental device to replace her defective aortic valve without opening the chest wall or using a heart-lung machine. This procedure waccording toformed by Washington University cardiologists at Barnes-Jewish Hospital on Jan. 15.

The woman is an initial participant in a national multicenter trial to evaluate the effectiveness of the new device. If proven effective, this new device holds enormous hope for patients who are unable to undergo the standard open-heart surgery for aortic valve replacement because they are too old or too sick to qualify for the surgery.

The patient, a retired registered nurse, longtime girl scout volunteer and mother of five, is expected to be discharged from the hospital as early as Friday.

Washington University School of Medicine/Barnes-Jewish Hospital is one of only 10 heart centers selected by the U.S. Food and Drug Administration (FDA) to evaluate this technique, which uses a catheter to thread a replacement aortic valve into the heart. Mounted on a catheter, the valve can be guided through the patient's circulatory system from the leg or inserted between the ribs into the heart and expanded at the site of the patient's diseased valve. The technique is called transcatheter valve replacement......... Posted by: April      Read more         Source

January 17, 2008, 10:23 PM CT

Increased risk of heart attack for who are resistant to aspirin

Being resistant to aspirin makes patients four times more likely to suffer a heart attack, stroke or even die from a pre-existing heart condition, as per a research studypublished on bmj.com today.

The study relates to patients who are prescribed aspirin long term as a way of preventing clots from forming in the blood.

Patients who are labelled aspirin resistant have blood cells (platelets) that are not affected in the same way as those of patients who are responsive to the drug, ie people who are aspirin sensitive.

There is currently no agreed method of accurately determining who is and isnt aspirin resistant and the reasons why someone might be aspirin resistant are currently a cause of controversy.

Relatively few studies have looked at whether aspirin resistance has any impact on clinical outcome so the Canadian authors carried out a review of all the available data to better understand the relationship between the two.

They identified 20 studies, involving 2,930 patients with cardiovascular disease, all of whom had been prescribed aspirin as a way of preventing clots from forming in the blood. 28% were classified as aspirin resistant.

They observed that all aspirin resistant patients, regardless of their underlying clinical condition, were at greater risk of suffering a heart attack, stroke or even dying. In particular they observed that 39% of aspirin resistant patients in comparison to 16% of aspirin sensitive patients suffered some sort of cardiovascular event......... Posted by: April      Read more         Source

January 10, 2008, 11:05 PM CT

High Blood Pressure In Older Adults

Researchers have identified the gene that sets off a sequence of events in the blood vessels of otherwise healthy adults that can lead to high blood pressure. The disease process eventually makes conditions in vessels ripe for the creation of blockages that can cause heart attacks, strokes and circulatory problems.

The finding in a study led by Ohio State University scientists might lead to new therapeutic options for high blood pressure, particularly high blood pressure linked to aging. Obesity and aging contribute to increasing cases of high blood pressure, which currently affects an estimated 50 million Americans.

Despite more intensive therapys available for hypertension, little has been done to prevent it. A change in the structure of the blood vessels, called vascular remodeling, increases with age and triggers the onset of the disease. When remodeling occurs, blood vessel walls increase in thickness, decreasing the diameter of the channel through which blood normally flows.

The gene, called profilin 1, has been traced to a series of interactions within the smooth muscle cells of blood vessels that causes those cells to increase in size. This in turn narrows the channel through which blood flows, causing stress on vessel walls, injuring the lining of the vessel walls and making it easier for blockages to develop. By identifying this pathway, scientists hope to pinpoint the most effective therapeutic target to interfere with the disease process......... Posted by: April      Read more         Source

January 8, 2008, 9:43 PM CT

A healthy smile may promote a healthy heart

Each year, cardiovascular disease kills more Americans than cancer. And while most people are aware that lifestyle choices such as eating right, getting enough exercise and quitting smoking can help prevent cardiovascular disease, they may not know that by just brushing and flossing their teeth each day, they might also be avoiding this potentially lethal condition.

An article reported in the recent issue of the Journal of Periodontology (JOP), the official publication of the American Academy of Periodontology (AAP), suggests that periodontal patients whose bodies show evidence of a reaction to the bacteria linked to periodontitis may have an increased risk of developing cardiovascular disease.

Eventhough there have been a number of studies associating gum disease with heart disease, what we have not known is exactly why this happens and under what circumstances, said JOP editor Kenneth Kornman, DDS, PhD. The findings of this new analysis of previously published studies suggest that the long-term effect of chronic periodontitis, such as extended bacterial exposure, may be what ultimately leads to cardiovascular disease.

Scientists at Howard University identified 11 studies that had previously examined clinically-diagnosed periodontal disease and cardiovascular disease. The team then analyzed the participants level of systemic bacterial exposure, specifically looking for the presence of the bacteria linked to periodontal disease, as well as measuring various biological indicators of bacterial exposure. They observed that individuals with periodontal disease whose biomarkers showed increased bacterial exposure were more likely to develop coronary heart disease or atherogenesis (plaque formation in the arteries)......... Posted by: April      Read more         Source

January 7, 2008, 11:08 PM CT

Congestive heart failure leads to greater disability

Medical breakthroughs in recent decades have allowed heart attack survivors and other heart-disease patients to live longer. But as their hearts decline into congestive heart failure, an increasing number will experience disability and the need for nursing-home care.

A new study from the University of Michigan Health System and the VA Ann Arbor Healthcare System sheds light on the degree of disability among people with CHF, as well as the implications for the health care system, community care facilities, families and the patients themselves.

In particular, the study observed that CHF patients were much more likely to be disabled than people without the condition. They were found to be much more likely to have difficulties with activities of daily living, such as grocery shopping and walking across the room. And they were more likely to require care from nursing homes and family members.

The prevalence of congestive heart failure imposes a substantial burden on patients, families and the long-term care system, says lead author Tanya Gure, M.D., a lecturer in the Division of Geriatric Medicine at the U-M Health System. The degree of disability in this group is quite high, and their caregiving needs are extensive. We need to make sure, in the medical community and society in general, that we are adequately meeting their health and social needs......... Posted by: April      Read more         Source

December 20, 2007, 9:55 PM CT

New insights into deadly heart rhythm disorder

Every year, 300,000 Americans die suddenly when, out of the blue, a storm of electrical activity arises within their heart muscle so violent and so abrupt that their hearts just stop beating. These tragic and dramatic sudden cardiac deaths strike people young and old, often without warning.

But despite this, researchers still dont understand just what causes a hearts electrical system to suddenly go so berserk. They have a name for the rhythm disturbance that causes most sudden cardiac deaths ventricular fibrillation, or VF but not a full understanding of what makes one person more vulnerable to it than another.

And eventhough research on VF in animals is yielding important clues, it hasnt been clear if lessons learned from the hearts of laboratory mice can be applied to people.

Now, a new paper by a group of scientists published online in the Proceedings of the National Academy of Sciences sheds new light on the origins of VF and the ability of research in animals to be translated into humans. The paper, and other research by the team, may help lead to better ways to identify which people are at risk of sudden cardiac death, and to develop therapys to help them reduce their risk.

The paper, which will be in the December 26 print edition of PNAS, is by a group of scientists from the United States, Canada and Spain. Most of them are from a State University of New York Upstate Medical University group that is in the process of moving its research laboratory to the University of Michigan Medical School......... Posted by: April      Read more         Source