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Depression And Heart Disease Death
In the first analysis of 22 studies, patients who were depressed after their heart attacks had a twofold increase in the risk of dying or suffering a new heart problem two years after their heart attack, according to Joost van Melle, M.D., and his colleagues of University Hospital Groningen in the Netherlands.
In the second analysis of 20 studies by Jürgen Barth, Ph.D., of University of Freiburg in Gera number of and his colleagues, the scientists concluded that depressed patients were twice as likely to die within two years after their first heart disease episode compared with non-depressed patients.
According to van Melle, post-heart attack depression is common, affecting nearly 20 percent of all heart attack patients.
The two research teams found that the relationship between depression and a higher risk of death and disease stayed consistent despite a variety of ways to measure depression.
The finding "may have important clinical implications for the identification of post-heart attack patients with poor prognosis, because questionnaires are easier, faster and cheaper than psychiatric interviews," van Melle says.
In their study, van Melle and his colleagues also noticed a stronger link between depression and higher risk of death in studies published before 1992.
"It may be possible that improvements in cardiac care for hospitalized and rehabilitating heart attack patients are responsible for this finding, but this would need further research," van Melle says.........
December 27, 2005
Daily Weighing Helps People Lose Weight
The research team evaluated self-weighing practices of more than 3,000 people participating in either a weight-loss or a weight-gain prevention program. The study's key finding: "Higher weighing frequency was associated with greater 24-month weight loss or less weight gain".
When people weigh themselves daily, "something is going on. It's independent of things such as diet and exercise, so it may be worth recommending," said lead researcher Jennifer Linde, an associate professor at the University of Minnesota. "If people see that their number has gone up they may realize it's time to do something. It's probably easier to make that small correction," Linde said, than to try to compensate after gaining a lot of weight.
The first study group consisted of 1,800 obese or overweight adults enrolled in a weight-loss program. Participants all had a body mass index (BMI) of at least 27. They were randomly divided into three groups: a telephone-based weight-loss intervention, a mail-based weight loss intervention or a usual-care control condition. The scientists weighed them every six months for two years.
"The average 12-month and 24-month weight losses of 1.3 and 2 BMI units respectively ..... were in the clinically significant range," reported the researchers.
The other group consisted of 1,226 overweight adults - BMI above 25 - enrolled in a weight-gain prevention program. They were randomly divided into either an educational weight-control intervention, the same educational intervention plus a reward for returning self-monitoring postcards or a minimal-contact control condition. The scientists weighed the participants at the study's outset and every year for three years.........
December 27, 2005
Lifestyle Changes Have Major Health Impact
The results of a two-year study involving the Department of Human Services (7,500 employees) of the State of Oklahoma conclude the answer is "yes". A lifestyle management program using step-by-step attainable goals was shown to successfully translate good intentions to live a healthier lifestyle into reality.
The study participants were enrolled in INTERVENTUSA, a scientifically-based lifestyle management program offered in the Atlanta area through the Emory Heart Center. Individualized programs to help participants implement and adhere to exercise, nutrition, weight management, stress management, and smoking cessation resolutions were implemented and administered via the telephone and the Internet.
Not only did a number of of the participants in the program, named OK Health, reach their goals but the health claim costs of the employees who completed one year of program participation were lowered by a staggering 31 percent, according to the Oklahoma Employees Benefits Council and Oklahoma Department of Human Services.
"In employees with abnormal risk factor values at the start of the study, one year of program participation resulted in impressive improvements in blood pressure and cholesterol levels, with increases in HDL ('good' cholesterol) and decreases in the 'bad' lipids (LDL cholesterol and triglycerides). In addition, on average, there was a weight loss of 11 pounds and a significant reduction of fasting blood glucose levels," says Neil F. Gordon, MD, PhD, clinical professor of medicine in the Emory University School of Medicine and INTERVENTUSA founder.........
December 27, 2005
How To Make Cox-2 Inhibitors Safer
In a paper published in the Dec. 23 issue of Science, a Johns Hopkins team led by Solomon H. Snyder, M.D., said the iNOS (inducible nitric oxide synthase)-based inflammation pathway has now been found to cross-link with the more well-known COX-2 pathway that is the target of COX-2 inhibitor drugs such as Vioxx. Until now, these two major inflammatory mechanisms were assumed to be unrelated and independent of each other, the scientists say.
"The fundamental significance of this work is that it demonstrates a totally unsuspected connection between the two most important inflammatory systems in the body," says Snyder, professor and director of neuroscience in Johns Hopkins' Institute for Basic Biomedical Sciences. "The therapeutic significance is that drugs which block the binding of iNOS and COX-2 might represent novel anti-inflammatory agents or reduce the dosage needed and side effects of this family of drugs".
COX-2 is an enzyme that makes prostaglandins, molecules that cause inflammation and pain. iNOS is an enzyme that makes NO (nitric oxide), a molecule that acts as a signal for a variety of cellular functions throughout the body, including the triggering of inflammation, dilating of blood vessels and penile erection.
The site on the iNOS protein that binds to COX-2 is close to the active or business end of the iNOS, the scientists found. As a result, it should be possible to design drugs that do double duty by inhibiting iNOS while also blocking iNOS binding to COX-2. This would decrease the formation of both NO and prostaglandins, Snyder said.........
December 26, 2005
Traditional Risk-factor Scoring And Women
"Our best means of preventing coronary heart disease is to identify those most likely to develop the condition, and intervene with changes in lifestyle and drug therapy before symptoms start to appear," says the senior author of both studies, cardiologist Roger Blumenthal, M.D., an associate professor and director of the Ciccarone Preventive Cardiology Center at The Johns Hopkins University School of Medicine and its Heart Institute. "The goal is to strongly consider therapies, such as aspirin, cholesterol-lowering medications and, possibly, blood pressure medications for individuals at higher risk, so that heart attacks will be less likely to occur in the future".
The Hopkins findings, the latest of which appear in the American Heart Journal online Dec. 16, is believed to be one of the first critical assessments of the Framingham Risk Estimate (FRE) as the principal test for early detection of heart disease. The scientists wanted to determine why a number of of these women at risk for heart disease are not identified earlier.
The FRE is a total estimate of how likely a person is to suffer a fatal or nonfatal heart attack within 10 years, and it is based on a summary estimate of major risk factors for coronary heart disease, such as age, blood pressure, blood cholesterol levels and smoking.
However, Blumenthal says, a number of women with cardiovascular problems go undetected despite use of the Framingham score. While the death rate for men from cardiovascular disease has steadily declined over the last 20 years, the rate has remained relatively the same for women, he says.........
December 25, 2005, 10:32 AM CT
Merry Christmas To All Our Readers
Oh, jingle bells, jingle bells
Jingle all the way
Oh, what fun it is to ride
In a one horse open sleigh
Jingle bells, jingle bells
Jingle all the way
Oh, what fun it is to ride
In a one horse open sleigh........
December 22, 2005
How Air Pollution
In a well-designed mouse study, where animals breathed air as polluted as the air in New York City, the researchers pinpointed specific mechanisms and showed that air pollution can be particularly damaging when coupled with a high-fat diet, according to new research published in the December 21 issue of JAMA.
"We established a causal link between air pollution and atherosclerosis," says Lung Chi Chen, Ph.D., Associate Professor of Environmental Medicine at NYU School of Medicine and a lead author of the study. Atherosclerosis-the hardening, narrowing, and clogging of the arteries-is an important component of cardiovascular disease.
The study, done in collaboration with the Mount Sinai School of Medicine and University of Michigan, looked at the effects of airborne particles measuring less than 2.5 microns, referred to as PM2.5, the size linked most strongly with cardiovascular disease. The emissions arise primarily from power plants and vehicle exhaust. The US Environmental Protection Agency (EPA) has regulated PM2.5 since 1997, limiting each person's average exposure per year to no more than 15 micrograms per cubic meter. These tiny particles of dust, soot, and smoke lead to an estimated 60,000 premature deaths every year in the United States.
Dr. Chen and his colleagues divided 28 mice, which were genetically prone to developing cardiovascular disease, into two groups eating either normal or high-fat diets. For the next six months, half of the mice in each feeding group breathed doses of either particle-free filtered air or concentrated air containing PM2.5 at levels that averaged out to 15.2 micrograms per cubic meter. This amount is within the range of annual EPA limits and equivalent to air quality in urban areas such as New York City.........
December 21, 2005
It's never too late to quit smoking
According to the American Cancer Society, smoking is the most preventable cause of death in the United States, accounting for 440,000 deaths, or nearly one of every five deaths, each year. It also causes more than 80 percent of all lung cancers and increases the risk for a number of other types of cancer, including oral, throat pancreatic, uterine, bladder, and kidney cancers.
"Our most effective tool for treating lung cancer is to prevent it from ever happening," explains Bruce E. Johnson, MD, director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute in Boston.
Johnson emphasizes that it is never too late to quit. People who stop and remain a nonsmoker for at least 10 to 20 years can cut their risk of developing lung cancer in half. Even those who quit smoking in their 60s, 70s, and 80s benefit by reducing their risk of dying from a heart attack or from developing lung or head and neck cancer, says Johnson.
Johnson offers the following tips to help people to quit smoking:
First, commit to quit
Tell friends and family
December 21, 2005
Links Between Kidney Function And Bone
Keith A. Hruska, MDMultitasking might seem like a modern invention, but in biology it's been an established technique for millennia.
The organs of the human body, for example, all have their well-known primary specialties, but a number of of them also play secondary roles in support of each other.
One such moonlighter is the human kidney, which purifies waste from the blood, but also has a more recently identified role as a contributor to the structural integrity of the human skeleton.
Keith A. Hruska, MD, professor of pediatrics, medicine and of cell biology and physiology at the School of Medicine and head of pediatric nephrology at St. Louis Children's Hospital, has developed several new insights into the connections between the kidney and the skeleton and hopes to put them to use soon in new therapys for kidney patients that will ease the harmful effects their condition inflicts on both the skeleton and the heart.
To recognize the connections between the kidney and the skeleton, doctors first had to understand that the skeleton isn't the dry and unchanging place it .
was once thought to be.
"In the past, the skeleton has been viewed as mostly a dead structure, but that's not the case at all," Hruska explains. "The adult skeleton is very active tissue that is continually remodeling, dismantling damaged bone and replacing it with new bone".
Cells inside the bone marrow accomplish this task, regularly destroying and rebuilding bone structure to adjust for wear, injury and changes in the mechanical loads and pressures placed on the bones.
Kidney disease's direct connection to bone health was initially masked by a complication of chronic kidney disease (CKD) known as secondary hyperparathyroidism. This complication, which afflicts about 100,000 new patients with kidney disease each year, raises bloodstream levels of the parathyroid hormone.........
December 21, 2005
Impediments For Overweight People From Exercising
A team of scientists studying nearly 1,000 men and women participating in a randomized trial evaluating three weight-loss programs in Minnesota found that associations between gastrointestinal symptoms, diet and exercise may have implications for the therapy of both obesity and gastrointestinal problems. The physiological mechanisms linking gastrointestinal symptoms, obesity and exercise still need to be determined, said psychology expert Rona Levy, lead author of the study and a University of Washington professor of social work whose research focuses on common gastrointestinal disorders such as irritable bowel syndrome in adults.
"Our main finding is that the amount of exercise people in a weight loss program do is related to gastrointestinal symptoms. In statistical terms, this means exercise is protective against gastrointestinal symptoms. This isn't surprising, but it has not been demonstrated before with this population. Science has now validated what people have been guessing," she said.
"But we don't know if this is a 'did the chicken or the egg come first' kind of a thing. We are not sure which is the key, exercise or gastrointestinal symptoms. It is plausible that if a doctor put a patient on an exercise program to lose weight the GI problems experienced might hamper the patient's ability to exercise".
People in the study reported experiencing a variety of problems: 19 percent said they had abdominal pain, 13 percent had irritable bowel syndrome, 25 percent had diarrhea and 20 percent had bloating.........
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Did you know?
An advanced study launched at Yale School of Medicine is evaluating the role of statin therapy in patients with heart failure, one of the leading causes of hospitalization in people over age 65.While statins-drugs that inhibit cholesterol production in the liver-are used primarily to lower cholesterol levels, there is evidence that these drugs may also have beneficial effects on blood vessel function independent of cholesterol levels. Heart failure patients are known to have vascular dysfunction, but are impaired and not routinely considered for statin therapy. The Yale trial, "Short Term Effects of Statin on Vascular Function in Heart Failure," will assess vascular function before and after a short course of statin therapy in heart failure patients with normal cholesterol levels. The randomized trial will include 30 patients with mild to moderate chronic heart failure.
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