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November 12, 2008, 10:20 PM CT

Exercise improves quality of life for heart failure patients

Exercise improves quality of life for heart failure patients
Heart failure patients who regularly exercise fare better and feel better about their lives than do similar patients who do not work out on a regular basis, say scientists at Duke University Medical Center.

The findings, reported today at the annual meeting of the American Heart Association's Scientific Sessions 2008, go a long way toward addressing concerns about the value of exercise for the nation's five million patients with heart failure. They also raise important policy questions for the country's Medicare program and other insurers.

"Past studies have sent mixed signals about the merit of exercise for patients with heart failure. The HF-ACTION study (A Controlled Trial Investigating Outcomes Exercise TraiNing) shows that exercise is not only safe for patients, but also helps to improve the quality of their lives, overall," says Kathryn Flynn, PhD, a health services researcher at Duke Clinical Research Institute (DCRI) and lead author of the study.

HF-ACTION is the largest clinical trial to date examining the value of exercise in the therapy of heart failure. Investigators enrolled 2331 patients with moderate to severe heart failure at 82 sites throughout the U.S., Canada and France from 2003 to 2008.

Funded by a $37 million grant from the National Heart, Blood, and Lung Institute, scientists randomized participants to receive either standard care or standard care plus an exercise program. The exercise regimen consisted of three months of supervised aerobic training on a bicycle or treadmill, followed by instruction for continued home-based training. Scientists set the exercise goal at five, 40-minute workouts, or 200 minutes of exercise per week. Participants reached about 60 percent of that goal at one year.........

Posted by: Daniel      Read more         Source


November 11, 2008, 9:46 PM CT

Ties Between Cholesterol Drugs, Muscle Problems

Ties Between Cholesterol Drugs, Muscle Problems
Assistant Professor Jill Slade, Radiology Osteopathic Medicine
and Osteopathic Manipulative Medicine

A Michigan State University researcher is studying whether the most popular class of cholesterol-lowering drugs may cause muscle problems in users.

There is accumulating evidence that the effect statins can have on skeletal muscle - including muscle weakness, fatigue and deterioration - is underestimated, said Jill Slade, assistant professor of radiology and osteopathic manipulative medicine at MSU.

"Statins work by preventing cholesterol from forming," said Slade, whose study is funded by a two-year, $230,000 grant from the National Institutes of Health. "While this is a good thing inside structures such as liver cells, it can be problematic in places such as muscle cells".

About 50 percent of all Americans over the age of 50 are prescribed a statin medication, including Lipitor, Crestor and Torvast, and their use has tripled in the past seven years. Side effects affecting skeletal muscles have been reported in up to 7 percent of users, though Slade thinks that number could be higher.

In August 2001, the Food and Drug Administration pulled the statin Baycol off the market after it appeared to be responsible for 31 deaths through a potentially fatal breakdown of muscle tissue known as rhabdomyolysis. The FDA at the time said the muscle breakdown occurred more frequently in patients taking Baycol than in patients on other statins. The National Lipid Association in 2006 published recommendations on investigating statin-induced muscle problems, and Slade's research will directly address several of those.........

Posted by: Daniel      Read more         Source


November 9, 2008, 10:15 PM CT

Low-dose aspirin may not reduce risk of CV in diabetics

Low-dose aspirin may not reduce risk of CV in diabetics
Low-dose aspirin as primary prevention did not appear to significantly reduce the risk of a combined end point of coronary, cerebrovascular and peripheral vascular events in patients with type 2 diabetes, as per a new study in JAMA However, aspirin did significantly reduce the combination of fatal coronary and fatal cerebrovascular events. The article is being released early online Sunday, November 9 to coincide with its scientific presentation at the American Heart Association meeting. The study will appear in the November 12 print issue of JAMA

"Diabetes mellitus is a powerful risk factor for cardiovascular events," the authors write. "Individuals with diabetes have a two- to four-fold increased risk of developing cardiovascular events than those without diabetes." The authors note that the "American Diabetes Association recommends use of aspirin as a primary prevention strategy in patients with diabetes who are at increased cardiovascular risk," including those who are older than 40 years or who have additional risk factors, such as family history, high blood pressure or smoking.

In this study conducted by Hisao Ogawa, M.D., Ph.D., from the Graduate School of Medical Sciences, Kumamoto University, Japan and his colleagues from the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) Trial Investigators, the scientists examined whether low-dose aspirin would be beneficial for primary prevention of atherosclerotic (atherosclerosis, which involves narrowing or hardening of the arteries because of plaque build-up) events in patients with type 2 diabetes. From Dec. 2002 through April 2008, 2,539 patients with type 2 diabetes and no history of atherosclerotic disease from 163 institutions from throughout Japan were enrolled in the study. Patients were randomly assigned to the low-dose aspirin group receiving 81 or 100 mg per day (n = 1,262) or the nonaspirin (n = 1,277) group. The average age was 65 and 55 percent of the patients were men. The median (midpoint) follow-up period was 4.37 years. The main outcome measures were atherosclerotic events, including fatal or nonfatal ischemic heart disease, fatal or nonfatal stroke, and peripheral arterial disease.........

Posted by: Daniel      Read more         Source


November 9, 2008, 10:13 PM CT

Early-warning blood test before heart attack strikes

Early-warning blood test before heart attack strikes
A team of Johns Hopkins biochemists has identified a mixed bag of five key proteins out of thousands secreted into blood draining from the heart's blood vessels that may together or in certain quantities form the basis of a far more accurate early warning test than currently in use of impending heart attack in people with severely reduced blood flow, or ischemia.

The work, involving more than a dozen researchers and taking more than a year to perform, is thought to bethe largest protein analysis ever done at Hopkins. It was based on 76 arterial blood samples from 19 men and women taken immediately before and after a period of medically induced ischemia lasting as long as 45 minutes.

All had ischemia induced through accelerated pacing of the heart's main chambers. Blood samples were provided by heart specialists at the University of Texas Southwestern.

Key to the researchers' selection criteria for which proteins to analyze from among tens of thousands in the blood was what they call "a pipeline approach." .

"From the start, we knew that we were looking for rare, almost unique biomarkers that bore some direct relationship with ischemia," says study senior investigator Jennifer Van Eyk, Ph.D., whose first step was to remove from the analysis common blood proteins, such as albumin and globulins. That left batches of 400 proteins for in-depth measure of any changes before and after ischemia.........

Posted by: Daniel      Read more         Source


November 9, 2008, 2:09 PM CT

Statins prevent heart attacks in people with normal cholesterol levels

Statins prevent heart attacks in people with normal cholesterol levels
Cholesterol-lowering statins can also reduce inflammation that causes heart disease and have the potential to prevent tens of thousands of heart attacks each year in patients with normal cholesterol levels, scientists reported Sunday.

In a study of nearly 18,000 people with normal cholesterol levels, the drug rosuvastatin produced a 54% reduction in heart attacks, a 48% reduction in strokes, a 46% reduction in the need for angioplasty or bypass surgery and a 20% reduction in deaths compared with a placebo, scientists said at a New Orleans meeting of the American Heart Assn.

The effects were so dramatic that the planned four-year study was halted after nearly two years.

The findings "really change what we are going to do in the future," said Dr. W. Douglas Weaver of Henry Ford Hospital in Detroit, president of the American College of Cardiology. "This targets a patient group that normally would not be screened or treated to prevent cardiovascular disease".

About half of heart attacks occur in patients who do not have high cholesterol levels.........

Posted by: Daniel      Read more


October 31, 2008, 5:37 AM CT

Friend or foe? Body's clot-busting system and atherosclerosis

Friend or foe? Body's clot-busting system and atherosclerosis
Sometimes it's hard to tell friends from foes, biologically speaking. Naturally produced in the body, urokinase plasminogen activator and plasminogen interact to break up blood clots and recruit clean-up cells to clear away debris correlation to inflammation. In fact, urokinase manufactured as a drug effectively clears clogged arteries by generating clot-busting plasmin from blood-derived plasminogen.

However, despite the efficacy of urokinase and plasmin in clearing blood clots, evidence has shown that humans with a high baseline level of blood plasmin are at increased risk for heart attacks and for fast-developing forms of atherosclerosis. In addition, human arteries affected by atherosclerosis have an abundance of urokinase. These associations between plasmin, urokinase and increased atherosclerosis counter the notion that urokinase and plasmin protect against heart attacks by removing dangerous blood clots.

At first vascular biologists didn't know how to interpret these findings. Specifically, they wondered whether the high level of urokinase in atherosclerotic artery walls was contributing to atherosclerosis or was evidence of the body's efforts to fight it.

To try to resolve this puzzle, Dr. David A. Dichek, the John Locke Jr. Family Endowed Professor of Cardiology and associate director for research in the Division of Cardiology at the University of Washington (UW), and his team generated mice that were genetically engineered to produce more urokinase in their artery walls. These mice developed arteries with worse atherosclerosis, including thicker walls, narrower interiors, and limited blood flow. The mice died suddenly with clogged arteries and evidence of heart attacks.........

Posted by: Daniel      Read more         Source


October 29, 2008, 10:14 PM CT

Grapes may aid a bunch of heart risk factors

Grapes may aid a bunch of heart risk factors
Could eating grapes help fight hypertension correlation to a salty diet? And could grapes calm other factors that are also correlation to heart diseases such as heart failure? A new University of Michigan Cardiovascular Center study suggests so.

The new study, reported in the recent issue of the Journal of Gerontology: Biological Sciences, gives tantalizing clues to the potential of grapes in reducing cardiovascular risk. The effect is believed to be due to the high level of phytochemicals naturally occurring antioxidants that grapes contain.

The study waccording toformed in laboratory rats. The scientists noted that while these study results are extremely encouraging, more research needs to be done.

The scientists studied the effect of regular table grapes (a blend of green, red, and black grapes) that were mixed into the rat diet in a powdered form, as part of either a high- or low-salt diet. They performed a number of comparisons between the rats consuming the test diet and the control rats receiving no grape powder including some that received a mild dose of a common blood-pressure drug. All the rats were from a research breed that develops hypertension when fed a salty diet.

In all, after 18 weeks, the rats that received the grape-enriched diet powder had lower blood pressure, better heart function, reduced inflammation throughout their bodies, and fewer signs of heart muscle damage than the rats that ate the same salty diet but didn't receive grapes. The rats that received the blood-pressure medicine, hydrazine, along with a salty diet also had lower blood pressure, but their hearts were not protected from damage as they were in the grape-fed group.........

Posted by: Daniel      Read more         Source


October 27, 2008, 10:40 PM CT

Statins associated with lower risk of death from pneumonia

Statins associated with lower risk of death from pneumonia
Individuals who take cholesterol-lowering statins before being hospitalized with pneumonia appear less likely to die within 90 days afterward, as per a report in the October 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

In the United States and Europe, pneumonia hospitalization rates have increased 20 percent to 50 percent over the past decade, as per background information in the article. About 10 percent to 15 percent of those with pneumonia die from the disease. A recent review article indicated that statins may benefit patients with sepsis (infection of the bloodstream) or bacteremia (presence of bacteria in the bloodstream), possibly due to the medications' anti-clotting, anti-inflammatory or immune-modifying properties.

Reimar W. Thomsen, M.D., Ph.D., of Aarhus University and Aalborg Hospital, Aalborg, Denmark, and his colleagues evaluated data from 29,900 adults hospitalized with pneumonia between 1997 and 2004. Of these, 1,371 (4.6 percent) were taking statins at the time.

"Mortality [death] among statin users was lower than among non-users: 10.3 percent vs. 15.7 percent after 30 days and 16.8 percent vs. 22.4 percent after 90 days," the authors write. The lowest relative death rate linked to statins was observed in patients older than 80 and in those with bacteremia. "The differences became apparent during the first few weeks of hospitalization, a period linked to a high number of pneumonia-related deaths, and they increased only minimally between 30 and 90 days after admission, which suggests that statin use is beneficial primarily in the early phase of infection".........

Posted by: Scott      Read more         Source


October 22, 2008, 10:36 PM CT

Developing depression after a heart attack

Developing depression after a heart attack
Science has found a number of links between depression and other serious medical illnesses, such as cancer, stroke, diabetes, and heart disease. For example, people who develop depression following a heart attack (myocardial infarction) or chest pain (angina) have an elevated risk of cardiac death or hospital readmission over the following year. In a new study scheduled for publication in the October 15th issue of Biological Psychiatry, scientists report that only episodes of depression that commenced after the coronary event were linked to increased cardiac-related morbidity and mortality, but that this increased risk was substantial.

The authors recruited patients hospitalized for ACS, and reviewed them for both lifetime and current depression. Patients were then followed for one year, with additional assessments of depression and cardiac health. Specifically, they discovered that cardiovascular outcome was not linked to previous or existing depression at the time of hospitalization. In contrast, even after controlling for traditional cardiac risk factors such as age, gender, and smoking status, depression that developed in the month after the ACS event increased the odds of cardiac readmission or death by 7 times.

John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, comments, "Depression may be a 'canary in the coal mine,' a relatively early sign of an inflammatory disease process that contributes to coronary artery disease and other medical illnesses." He adds, "The current study suggests that depression may be heterogeneous with respect to its association with inflammatory disease processes, so it will be very important to develop biomarkers, i.e., objective and quantitative tests that can identify the subtype of depression that is a component of systemic disease processes." Senior authors Gordon Parker and Catherine Owen further discuss: "If confirmed, [this finding] has the potential to greatly enhance the ability of health professionals to identify and allocate resources to those patients who are at the greatest risk. This finding also has the potential to shed light on the mechanisms by which post-ACS depression is linked to reduced survival; an area that is still very poorly understood." .........

Posted by: Daniel      Read more         Source


October 16, 2008, 10:49 PM CT

Aspirin does not prevent heart attacks in patients with diabetes

Aspirin does not prevent heart attacks in patients with diabetes
Taking regular aspirin and antioxidant supplements does not prevent heart attacks even in high risk groups with diabetes and asymptomatic arterial disease, and aspirin should only be given to patients with established heart disease, stroke or limb arterial disease, as per a research studypublished recently on bmj.com.

In light of these findings, and the evidence from six other well controlled trials, the prescribing practice of doctors and international guidelines should be evaluated so that aspirin is only prescribed to patients with established heart and stroke disease, argues the author of an accompanying editorial.

Patients with diabetes are two to five times more likely to suffer from heart disease than the general population and heart disease is a major cause of death in patients with type 1 and 2 diabetes. Eventhough there is considerable evidence showing no protective benefit of aspirin in high risk patients without heart disease, guidelines are inconsistent and aspirin is usually prescribed for the primary prevention of heart disease in patients with diabetes and with peripheral arterial disease.

But aspirin is one of the top 10 causes of adverse drug events reported to the Commission on Human Medicines. It causes gastrointestinal bleeding and the risk of bleeding increases with age and prolonged use.........

Posted by: Daniel      Read more         Source



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Heart disease
About 13 million Americans (about 7 percent of the total population) suffer from coronary artery disease. Coronary artery disease is the leading cause of death in American men and women amounting a staggering 20 percent of all causes of death. About half of all deaths related to cardiovascular diseases occur from coronary artery disease. Through this heart watch blog we will have our humble contribution towards making men and women aware of the risks of heart diseases.

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