June 18, 2006, 6:06 PM CT

Vegetables May Reduce Hardening Of Arteries

New research suggests one reason vegetables may be so good for us - a study in mice found that a mixture of five common vegetables reduced hardening of the arteries by 38 percent compared to animals eating a non-vegetable diet. Conducted by Wake Forest University School of Medicine, the research is published in the current issue of the Journal of Nutrition.

"While everyone knows that eating more vegetables is supposed to be good for you, no one had shown before that it can actually inhibit the development of atherosclerosis," said Michael Adams, D.V.M., lead researcher. "This suggests how a diet high in vegetables may help prevent heart attacks and strokes."

The study used specially bred mice that rapidly develop atherosclerosis, the formation on blood vessel walls of fatty plaques that eventually protrude into the vessel's opening and can reduce blood flow. The mice have elevated low-density lipoprotein ( LDL), or "bad" cholesterol, which is also a risk factor for atherosclerosis in humans.

Half of the mice in the study were fed a vegetable-free diet and half got 30 percent of their calories from a mixture of freeze-dried broccoli, green beans, corn, peas and carrots. These five vegetables are among the top-10 vegetables in the United States based on frequency of consumption.........

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June 18, 2006, 0:14 AM CT

Coffee and Blood Pressure

In a long-term study of more than 1,000 men, drinking a daily cup of regular coffee raised systolic pressure (the upper number) by 0.19 mmHg and diastolic blood pressure (the lower number) by 0.27 mmHg. Coffee drinkers also had a greater incidence of high blood pressure (28 percent) than their non-coffee drinking counterparts (19 percent) Ref 1.

There is some evidence from prior studies to suggest that caffeine consumption (present in coffee) increases cortisol stimulation. This may be the cause of increased blood pressure that was seen in coffee drinkers. Caffeine also increases adrenaline levels, which in turn may contribute to the development of high blood pressure Ref 2, 3.

Results of the study, reported in the March 25 issue of the Archives of Internal Medicine, also showed that those who drank five or more cups of coffee a day were up to 1.6 times more likely to develop high blood pressure than non-coffee drinkers, eventhough these associations were less significant after the scientists took into account alcohol intake, smoking and other characteristics associated with coffee drinking.

"Overall, coffee drinkers had higher blood pressures than people who did not drink coffee, but there was no set 'dose-response' relationship," says Michael J. Klag, M.D., M.P.H., lead author of the study and director of the Division of General Internal Medicine at Hopkins. Still, Klag says people who already have hypertension should reduce their coffee intake because other studies have clearly shown that avoiding caffeine-containing drinks can lower blood pressure.........

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June 15, 2006, 10:42 PM CT

Growth Factor Triggers Growth Of New Blood Vessels In The Heart

The newest concept for treating coronary artery disease is to induce hearts to grow their own new blood vessels to bypass damaged tissue or clogged arteries. Unfortunately, clinical trials of two important blood-vessel growth factors -- fibroblast growth factor 2 (FGF2) and vascular endothelial growth factor (VEGF) -- have not produced stellar results.

Now scientists at Washington University School of Medicine in St. Louis have investigated a third signaling molecule -- called Sonic hedgehog -- that could overcome problems associated with FGF2 and VEGF treatment.

In a report appearing in the June 15 issue of Genes and Development, the team showed that activating hedgehog signals in adult mouse hearts led to an increase in the density of blood vessels in the heart.

Their findings suggest that a drug therapy that turned on or increased hedgehog signals could provide substantial benefit to patients suffering from ischemic heart disease and myocardial infarctions and offer an alternative to invasive procedures like surgery or angioplasty.

About 12 percent of heart patients are not eligible for bypass surgery, which redirects blood around clogged arteries, or for other procedures routinely used to open clogged vessels. That means each year in the United States, 100,000 to 200,000 patients could benefit from having another option for improving blood flow in the heart, as per the study's authors.........

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June 13, 2006, 11:50 PM CT

Using Device To Give CPR

Scientists looking for methods to improve survival from cardiac arrest were surprised by the results of a study comparing manual CPR compressions with those given by an FDA-approved mechanical device.

The randomized study, conducted in five North American cities including Columbus, showed that victims of sudden cardiac arrest were more likely to be discharged alive from the hospital if they received manual cardio-pulmonary resuscitation (CPR) rather than CPR administered by the mechanical device.

Results of the study are reported in the June 14 issue of the Journal of the American Medical Association.

Lynn White, clinical research manager in emergency medicine at Ohio State University Medical Center, coordinated the 34 medic crews involved in the Columbus study. "Everyone thought the device was a great idea and that its ability to provide compressions of much higher quality than those administered by humans would be lifesaving," said White. "The results are certainly not what we anticipated at the onset of the study."

The study involved 1,071 people who experienced out-of-hospital cardiac arrest in Columbus, Seattle, Pittsburgh, and Vancouver and Calgary, Canada. The study, originally planned to last 12-18 months, was halted in March 2005, nine months after it began, when it became apparent that the study device was not improving long-term outcomes.........

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June 8, 2006, 0:00 AM CT

Assessing Risk Of Heart Disease In Ethnic Groups

A new web-based calculator will better assess the risk of heart disease in British black and minority ethnic groups. These groups are often wrongly assessed.

ETHRISK is for everyday use in the doctor's surgery and other primary care settings. It has been developed by scientists at the University of Bristol to improve prediction of the heart disease risks of seven British black and minority ethnic groups.

Ethnic groups within Britain have a different risk of coronary heart disease (CHD) and cardiovascular disease (CVD), when compared with the general population in Britain. However, their risks are not being correctly assessed, due to the outdated method of calculation.

Dr Peter Brindle, lead author on the paper published online today in the BMJ journal Heart, said: "The ETHRISK calculator adjusts for ethnic groups and is based on a re-calibration of the Framingham risk equations. It provides a much more realistic assessment of the risk of having heart disease and stroke within a 10-year period, faced by an individual from one of these groups.

"Once the blood pressure and cholesterol measurements have been taken, the nurse or doctor can go online and plug in the numbers to get a more accurate risk score for that individual. ".

The recommended way of preventing heart disease involves using the Framingham risk score to identify high-risk patients. Patients above an agreed threshold are prescribed preventive therapys. However, the relevance of the Framingham score to the British population is uncertain, especially when applied to ethnic groups, because the US data on which Framingham is based, are over 20 years old.........

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May 23, 2006, 11:39 PM CT

Lowering Blood Pressure Doesn't Prevent Dementia

Lowering blood pressure does not appear to prevent cognitive or dementia-related disorders, a desired effect in light of the large number of older adults who suffer from both cognitive impairment and hypertension.

Authors of a new systematic review analyzed three studies comprising 12,091 patients with high blood pressure who were treated with either medicine or lifestyle strategies for at least six months while undergoing testing to assess their cognitive function. All were followed for five years.

"There is no convincing evidence that lowering blood pressure prevents the development of dementia or cognitive impairment in hypertensive patients without apparent previous cerebrovascular disease," write co-authors including A. Peter Passmore, M.D., of the department of Public Health Medicine and Primary Care at Queen's University in Belfast, Ireland.

One blood-pressure medication, Nitrendipine, did appear to reduce dementia in one of the studies reviewed, but when combined with all data, this effect was not significant.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.........

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May 8, 2006, 11:54 PM CT

Smokers Seven Times More Likely To Receive Jolt From Heart Devices

If some patients with heart disease don't take their doctor's advice to quit smoking, they are probably going to get "shocking" reminders. A study conducted at Washington University School of Medicine in St. Louis found that heart patients who had implanted defibrillators and also smoked were seven times more likely to have the devices jolt their hearts back into normal rhythm than nonsmokers with the devices. When the devices fire, it can feel like a thump or even a strong kick to the chest.

"Eleven percent of cardiovascular deaths are correlation to smoking, and prior studies have shown that decreasing or quitting smoking is in itself a very effective treatment for patients with heart disease," says J. Mauricio Sánchez, M.D., lead author of the study, which was reported in the April 2006 issue of Heart Rhythm.

"But if having heart disease isn't enough to make patients want to stop smoking," continues Sánchez, a cardiology fellow in the cardiovascular division, "the evidence from our study should definitely add a strong argument to quit."

Implantable cardioverter-defibrillators (ICDs) are self-contained units that are placed within the chest to monitor heart rhythms and deliver electrical charges directly to heart muscle to correct abnormal rhythms. Abnormal rhythms can occur without warning, and some can cause death rapidly if no action is taken. A recent study demonstrated that ICDs decreased the risk of death by 23 percent in patients with congestive heart failure.........

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May 7, 2006, 10:56 PM CT

Gene That Increases Type 2 Diabetes

In a painstaking set of experiments in overweight mice, researchers from the University of Wisconsin-Madison have discovered a gene that appears to play an important role in the onset of type 2 diabetes.

The finding is important because it provides evidence that the same gene in humans could provide clinicians with a powerful tool to determine the likelihood that some individuals will acquire the condition. Moreover, the finding that the gene works through a pathway not generally studied in the context of diabetes, suggests new avenues to explore in the search for new drugs to treat or prevent the disease, says Alan Attie, a UW-Madison professor of biochemistry and the senior author of the study published this week (May 7) in the journal Nature Genetics.

Type 2 diabetes is the most common form of the condition in the United States, with an estimated 16 million Americans afflicted with the disease. It is caused by an inability of the pancreas to produce enough insulin, or by the body's reduced ability to respond to insulin, or both. Insulin is necessary for the body to properly utilize sugar.

Often, the development of type 2 diabetes is caused by obesity. Obese individuals tend to have insulin resistance; that is, it takes more insulin for the body to respond normally. Type 2 diabetes occurs when the pancreas is unable to manufacture enough insulin to compensate for the body's increased demand for the hormone, which it does by growing more insulin-producing beta cells or by ramping up insulin secretion.........

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May 3, 2006, 0:37 AM CT

Diuretic May Not Be Best Way To Reduce Chf

Scientists believe they may have identified a new agent to reduce the excess fluid build-up in patients with congestive heart failure, one that avoids the relative sodium-depleting effects of diuretics, now the most usually used drugs for this purpose.

The drug under investigation, called lixivaptan, appears to be just as effective as a diuretic in helping patients get rid of excess water and has the added benefit of retaining proper levels of sodium in the body, said Dr. William Abraham, director of cardiovascular medicine at Ohio State University Medical Center and lead author of a study of this drug.

The study results are reported in the April 18 issue of the Journal of the American College of Cardiology. Abraham will also serve as the international principal investigator of an upcoming multicenter Phase 3 trial to further evaluate the effectiveness of the drug.

Diuretics become part of life for a number of patients with congestive heart failure, a disease characterized by fluid retention that can lead to shortness of breath, swollen legs and ankles, and progressive weakening of the heart. Though they are key to reducing fluid, diuretics can cause the kidneys to excrete more sodium than water, which can have damaging effects. An abnormally low concentration of sodium in the blood leads to another chronic condition called hyponatremia, which can slow thinking and cause memory problems, and indicates a poor prognosis for patients with heart failure.........

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April 25, 2006, 7:37 PM CT

Selenium Offers No Heart-Disease Protection

Selenium does not protect against cardiovascular disease, despite its documented antioxidant and chemopreventive properties, analysis of a randomized placebo-controlled clinical trial covering 13 years has shown.

The selenium-CVD association was a secondary endpoint in the Nutritional Prevention of Cancer Trial, which was designed primarily to determine if selenium supplementation could prevent the recurrence of non-melanoma skin cancer.

Results of the trial, the only large randomized clinical trial to date to examine selenium supplementation alone in the prevention of CVD, appear in the April 15 issue of the American Journal of Epidemiology. Saverio Stranges, M.D., Ph.D., assistant professor of social and preventive medicine in the School of Public Health and Health Professions, University at Buffalo, is first author.

"Our results extend prior research based on smaller intervention trials focusing on cardiovascular risk factors," said Stranges. "Our findings are consistent with those from prior studies that have shown no beneficial effect of selenium supplementation in combination with other antioxidants on the primary prevention of cardiovascular disease".

Several antioxidants, vitamins C and E in particular, that were thought to play a role in preventing heart disease based on findings based on observation have turned out not to be protective in randomized clinical trials, and selenium now has joined this group.........

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