Heart disease news archives

April - June 2009

Heart disease news summaries:

Low to moderate drinking – especially of red wine – appears to reduce all causes of mortality, while too much drinking causes multiple organ damage. "Reports on the benefits of red wine are almost two centuries old," said Lindsay Brown, associate professor in the School of Biomedical Sciences at The University of Queensland and corresponding author for the study. "However, studies on the actions of resveratrol, one of the active non-alcoholic ingredients, were uncommon until research around 1997 showed prevention of cancers. This led to a dramatic interest in this compound."

Red wine contains a complex mixture of bioactive compounds, including flavonols, monomeric and polymeric flavan-3-ols, highly colored anthocyanins, as well as phenolic acids and the stilbene polyphenol, resveratrol. Brown said that some of these compounds, particularly resveratrol, appear to have health benefits.

"The breadth of benefits is remarkable – cancer prevention, protection of the heart and brain from damage, reducing age-related diseases such as inflammation, reversing diabetes and obesity, and many more," said Brown. "It has long been a question as to how such a simple compound could have these effects but now the puzzle is becoming clearer with the discovery of the pathways, especially the sirtuins, a family of enzymes that regulate the production of cellular components by the nucleus. 'Is resveratrol the only compound with these properties?' This would seem unlikely, with similar effects reported for other components of wine and for other natural products such as curcumin. However, we know much more about resveratrol relative to these other compounds."

ScienceDaily (June 12, 2009)

Sleeping less than 7 or 8 hours a night as a routine puts people at risk for high blood pressure, study found.

The less the adults participating in the research slept, the more likely they were to see their blood pressure rise, according to research published in the Archives of Internal Medicine. For every hour of missed sleep, odds of developing the condition rose an average 37 percent over five years, said Kristen Knutson, the lead author. Skipping two hours sleep raised the blood pressure risk 86 percent.

More than 73 million American adults have high blood pressure and about 70 million suffer from chronic sleep problems, according to the US Centers for Disease Control and Prevention. Uncontrolled high blood pressure can lead to heart attack, stroke, heart failure, or kidney failure, according to the American Heart Association.

The study at the University of Chicago followed 578 adults who had their blood pressure and other health signs measured between 2000 and 2001. At the start of the study,participants were aged 33 to 45. After five years, each participant’s blood pressure was checked again and each was asked about their sleep. The adults in the study slept an average of six hours each night. Only seven participants averaged eight or more hours of sleep, researchers found.

Chronic lack of sleep or sleep problems may have a long-term effect on the cardiovascular system, increasing high blood pressure. Not getting enough sleep is also related to obesity and diabetes, affecting overall heart health. Future studies need to examine whether improving sleep reduces a person’s risk of developing high blood pressure.

Bloomberg (June 9)

Overweight male teens may have elevated hormone known to increase blood pressure and early signs of heart damage. Medical College of Georgia researchers looked at 126 healthy 15 to 17 year-olds in Augusta, Ga., and found the hormone aldosterone highest among overweight males.

Aldosterone, produced by the adrenal gland, is known to increase blood pressure by increasing sodium and water retention. Despite normal blood pressures, the overweight males had thickened heart walls and an increase in the size of the pumping chamber of the heart. Structural changes in the young hearts can be linked to a lesser-known aldosterone fact: it also promotes inflammation and formation of fibrous tissue in the heart muscle.

Overweight females in the group did not have elevated aldosterone levels or the associated heart damage, Dr. Dayal D. Raja says, noting estrogen's cardioprotective effect may have made the difference.

“Our failure to halt the progression of heart damage is attributed to late detection, because early heart damage is usually asymptomatic," Dr. Raja says. "We have evidence that we could identify individuals early and stop or even reverse that damage. We need more study to confirm our findings and a plan for whom and how to screen."

"We are trying weight loss but we are failing miserably," Dr. Raja says, noting the worldwide obesity epidemic. In fact, losing weight will decrease aldosterone levels.

ScienceDaily (June 5, 2009)

Implantation of patient's own stem cells regenerates heart and improves cardiac performance. The Area of Cell Therapy of Cordoba hospital, led by haematologist Dr. Concha Herrera, conducted a clinical test with adult stem cells in patients with heart-related problems. This therapy is not a service the hospital offers yet.

The test consisted of treating 30 people in three groups of ten each at random. The first group received standard treatment for heart attack; the second group was treated with stem cells directly implanted into the coronary artery affected using a catheterization; the third group was treated with a medicine called G-CSF, which makes cells move from the marrow to the blood, so that they get to the heart in a natural way, without having to do so through a catheter.

The results revealed that the first and third groups treated without cells improved slightly, whereas patients transplanted with stem cells through the coronary arteries (the second group) did improve their ventricular function much more.

The stem cells transplanted from the marrow into the heart muscle have a double function: on the one hand they regenerate the heart cells. In addition, they segregate a series of proangiogenic factors that produce blood vessels (angiogenesis) and can also produce the recruitment of stem cells that are in the myocardium itself.

The Area of Cell Therapy, led by Dr. Herrera, is currently developing other trials.

ScienceDaily (May 29, 2009)

Diabetics' heart attack risk can be reduced. People with diabetes who maintain intensive, low blood sugar levels are significantly less likely to suffer heart attacks and heart disease, new research published in The Lancet has shown.

Pooling information from five large trials, researchers at the University of Cambridge were able to provide reliable evidence linking intensive blood sugar level (or glucose) control with fewer heart attacks.

The research, funded by the British Heart Foundation, pointed to a 17 % reduction in heart attacks and a 15 % reduction in heart disease.

It's well documented that diabetics have increased risk of heart disease. Even though patients can reduce their risk by maintaining healthy blood pressure levels and cholesterol reduction, the risk remains high.

The five trials involved more than 33,000 individuals, including 1497 heart attack cases, 2,318 cases of coronary heart disease, and 1227 strokes. Dr. Kausik Ray of the University of Cambridge, lead author of the study, and his team analyzed the data collected on the glucose levels in blood, specifically a long-term marker of glucose control called HbA1c. In healthy individuals, HbA1c levels average between 4-5%. However, diabetics often have levels above 6.5%.

In the present study, those taking a standard treatment maintained a HbA1c level of 7.5%. Individuals who underwent intensive treatment to lower their blood sugar level were 0.9% lower than those who underwent standard treatment (average 6.6%), thereby dramatically reducing their risk of disease in large blood vessels.

ScienceDaily (May 25, 2009)

Cheerios not so wholesome as maker General Mills Inc. claims say US regulators.

Packaging and internet advertising for the toasted oats violate federal law with promises to lower cholesterol and reduce the risk of heart disease and cancer, according to a warning letter posted on the Food and Drug Administration’s (FDA) web site on May 12, 2009.

The FDA took issue with Cheerios boxes that say the cereal can lower cholesterol. That statement qualifies Cheerios under US regulations as an unapproved new drug, the FDA said. While the agency allows a health claim linking soluble fiber from whole grain oats to a reduced risk of heart disease by means of lowering cholesterol, Cheerios boxes have cholesterol as a prominent, stand-alone claim, the FDA said in its letter, dated May 5.

Cheerios’ online marketing of heart disease and cancer benefits also fails to include language the FDA requires about other foods that help reduce risks, according to the agency.

“The claim on your web site leaves out any reference to fruits, vegetables, and fiber content,” the FDA letter said. “Therefore, your claim does not convey that all these factors together help to reduce the risk of heart disease and does not enable the public to understand the significance of the claim in the context of the total daily diet.”

“We certainly don’t have any issues with the safety of Cheerios,” Stephen Sundlof, director of the FDA’s Center for Food Safety and Applied Nutrition, said. “We just believe that the labeling on this particular product has gone beyond what the science supports.”

The FDA started its Cheerios review after the National Consumers League, a Washington-based advocacy group, complained that the cereal’s health claims made it out to be a drug.

Cheerios was introduced in 1941 as the world’s first ready- to-eat oat cereal, according to the product’s web site. The cereal box has said for more than two years that the product can “lower your cholesterol 4 percent in 6 weeks.”

Bloomberg (May 12, 2009)

Study shows AstraZeneca’s experimental blood thinner Brilinta prevented heart attacks, strokes, and death from heart disease better than Plavix.

AstraZeneca plans to use the results of the 18,624-patient trial to seek approval of Brilinta, one of its most important products in development.

The findings from the study, called Plato, should set Brilinta apart from Plavix, Savvas Neophytou, an analyst at Panmure Gordon & Co. in London, said in a note to investors. Plavix is one of the world’s best-selling drugs, generating $7.8 billion in 2008. Other companies, including Eli Lilly & Co. and Daiichi Sankyo Co., also are developing medicines that work by preventing platelets in the blood from clumping together.

Neophytou, who currently estimates Brilinta could generate $1.7 billion in annual sales by 2014, said he may raise his forecast if the study doesn’t turn up any safety concerns.

The study, which focused on heart attacks, strokes, and death from cardiovascular problems in people with existing heart disease, is still being analyzed. Overall, the safety risks were similar to those seen in earlier trials, AstraZeneca said.

The company said it plans to present final results at the European Society of Cardiology meeting in August and publish the findings in a major medical journal.

Bloomberg (May 11, 2009)

New research concludes rise in obesity in the US since the 1970s is due to excess calorie intake. Scientists tested 1,399 adults and 963 children to determine how many calories their bodies burn in in real-life situations. Once they determined each person's calorie burning rate, researchers calculated how much adults needed to eat to maintain a stable weight and how much children needed to eat to maintain a normal growth curve.

They then worked out how much Americans were actually eating, using national food supply data from the 1970s and the early 2000s.

Researchers used their findings to predict how much weight they would expect Americans to have gained over the 30-year period if food intake were the only influence. They used data from a nationally representative survey (NHANES) that recorded the weight of Americans in the 1970s and early 2000s to determine the actual weight gain over that period.

Researchers found that in children, the predicted and actual weight increase matched exactly, indicating that the increases in food intake alone over the 30 years studied could explain the weight increase.

"For adults, we predicted that they would be 10.8 kg heavier, but in fact they were 8.6 kg heavier. That suggests that excess food intake still explains the weight gain, but that there may have been increases in physical activity over the 30 years that blunted what would otherwise have been a higher weight gain," Professor Boyd Swinburn, chair of population health and director of the World Health Organization Collaborating Centre for Obesity Prevention at Deakin University in Australia said.

"To return to the average weights of the 1970s, we would need to reverse the increased food intake by about 350 calories a day for children (about 1 can of pop and a small portion of French fries) and 500 calories a day for adults (about 1 large hamburger)," Swinburn said. "We could achieve similar results by increasing physical activity by about 150 minutes a day of extra walking for children and 110 minutes for adults, but realistically, although a combination of both is needed, the focus would have to be on reducing calorie intake."

ScienceDaily (May 8, 2009)

Drug-eluting cardiovascular stents superior. The Cardiovascular Research Foundation (CRF) announced its study comparing the safety and efficacy of drug-eluting stents and bare-metal stents was published in The New England Journal of Medicine. The study, HORIZONS-AMI, showed that in heart attack patients undergoing angioplasty, the use of drug-eluting stents reduces rates of target lesion revascularization (TLR) and binary angiographic restenosis when compared to the use of bare-metal stents after one year.

The study, was led by Gregg W. Stone, M.D., of the Cardiovascular Research Foundation and professor of medicine at Columbia University Medical Center/New York-Presbyterian Hospital.

In the trial, the use of drug-eluting stents resulted in a significant reduction of re-narrowing of the arteries (4.5% vs. 7.5%).

The use of drug-eluting stents also resulted in a significant reduction in restenoisis after 13 months, which is the rate at which the artery re-narrows at least 50% following implantation of the stent. The drug-eluting stent had a rate of 10.0% while the bare metal stent had a rate of 22.9%.

“These results now provide definitive evidence that paclitaxel-eluting stents are superior in efficacy to bare metal stents and have a comparable safety profile at 1 year,” said Dr. Stone.

All the patients in this trial will be followed to ensure that these favorable results are maintained.”

The HORIZONS-AMI trial enrolled 3,602 heart attack patients at 123 centers in 11 countries, 3,006 of whom were randomized to paclitaxel-eluting stents versus otherwise identical bare metal stents.

Newswise (May 6, 2009)

Half a glass of wine a day may add 5 years to your life a new study suggests. Drink beer, and you’ll live only 2 1/2 years longer.

Dutch researchers followed 1,373 men for more than four decades, noting their eating and drinking habits. Men who had about 20 grams of alcohol daily - equivalent to a half a glass of wine - had 2 1/2 years added to their life expectancy at age 50, compared with men who didn’t drink at all, according to the research published in the Journal of Epidemiology and Community Health. Men who consumed only wine had twice as much added longevity.

Researchers had known that moderate drinking is tied to a lower risk of heart disease, possibly because of an increase in high density lipoprotein or so-called good cholesterol as well as a reduction in platelet clumping, making it more unlikely for clots to form. It is the first study to show that one kind of alcohol is superior to others in prolonging life, the researchers said.

“In this study, 70 percent of all wine consumed was red wine,” the researchers, led by Marinette Streppel of the University of Wageningen in the Netherlands, said. “This suggests that the cardioprotective effect of wine could be due to a protective effect of polyphenol compounds in red wine, but other explanations cannot be ruled out.”

Bloomberg (April 30, 2009)

Eating fatty fish and marine omega-3 fatty acids seems to protect men from heart failure according to one of the largest studies to investigate the association.

Researchers in the US and Sweden followed 39,367 Swedish men, aged between 45-79, from 1998 to 2004. During this period, 597 men without a history of heart disease or diabetes developed heart failure, of which 34 died.

Researchers found that men who eat fatty fish, such as herring, mackerel, salmon, whitefish and char, once a week were 12% less likely to develop heart failure compared to men who never eat fatty fish. Eating more did not give a greater benefit and, in fact, returned the chances of heart failure to the same level as that seen in men who never consume fatty fish or fish oils.

The study (published in the European Heart Journal) provided no evidence that taking food supplements containing marine omega-3 fatty acids made any difference. The men in this study obtained most of their marine omega-3 fatty acids from the food they ate.

Previous studies have shown that fatty fish and omega-3 fatty acids help to combat risk factors for a range of heart-related conditions such as lowering levels of triglycerides (fats in the blood), blood pressure, heart rate and heart rate variability. This may explain the association with a reduced risk of heart failure found in this current study.

ScienceDaily (April 28, 2009)

Silent heart attacks may be far more common, and more deadly, than suspected. Studies estimate that these often painless heart attacks affect 200,000 people in the US each year. But Dr. Han Kim of Duke University suspects the numbers may be far higher.

Doctors usually can tell whether a patient has had a recent heart attack by looking for signature changes on a test of the heart's electrical activity (electrocardiogram) and by checking for certain enzymes in the blood.

For a heart attack that occurred in the past, doctors look for changes on an electrocardiogram called a Q-wave, a marker for damaged tissue.

But not all silent heart attacks result in Q-waves.

To spot these, Kim and colleagues used a new type of magnetic resonance imaging technology called delayed enhancement cardiovascular magnetic resonance, which is especially adept at finding damaged heart tissue.

They studied 185 patients with coronary artery disease but no record of heart attacks who were scheduled to have a test to look for possible blockages in their heart arteries.

They found that 35 percent of the patients had evidence of a prior heart attack. And that these so-called non-Q-wave heart attacks were three times more common than silent heart attacks with Q-waves.

They also found that after two years of follow up, people who had suffered a silent, non-Q-wave heart attack had a 17-fold higher risk of death due to heart problems, when compared to patients who did not have any heart damage.

Kim said people who have had silent heart attacks are treated like other patients with heart disease. But given the findings, he said new studies should look at the best way to care for these patients.

Reuters (April 26, 2009)

Being fat bad is for the environment. Overweight people eat more than thin people and are more likely to travel by car, making excess body weight doubly bad for the environment, according to a study from the London School of Hygiene & Tropical Medicine.

"When it comes to food consumption, moving about in a heavy body is like driving around in a gas guzzler," and food production is a major source of greenhouse gases, researchers Phil Edwards and Ian Roberts wrote in the International Journal of Epidemiology.

"We need to be doing a lot more to reverse the global trend toward fatness, and recognize it as a key factor in the battle to reduce (carbon) emissions and slow climate change," the British scientists said.

They estimated each fat person accounts for about one tonne of carbon dioxide emissions a year more on average than each thin person, adding up to an extra one billion tonnes of CO2 a year in a population of one billion fat people.

The European Union estimates each EU citizen is responsible for 11 tonnes of greenhouse gas emissions a year.

LONDON Reuters (April 19, 2009)

Both BMI and waist size influence risk of being hospitalized with heart failure or dying of the condition, new research shows. "This study reinforces the importance of maintaining a healthy body weight through diet and exercise," said Dr. Emily B. Levitan of Beth Israel Deaconess Medical Center in Boston, a researcher on the study.

In heart failure, the organ becomes too weak to pump blood efficiently through a person's body, leading to fatigue, swelling of the legs, and difficulty breathing. Heart failure is the top cause of hospitalization among Americans 65 and older, Levitan and her colleagues note in the American Heart Association's journal Circulation.

Levitan's team looked at 36,873 women aged 48 to 83 and 43,487 men 45 to 79 years old who were participating in long-term studies of the general Swedish population. During 6 years of follow up, 382 of the women and 718 of the men were hospitalized for heart failure or died from the disease.

For every additional BMI point, the risk of heart failure hospitalization or death increased by 3% in women and 7% in men, while a 10-centimeter increase in waist size boosted risk by 19% in women and 30% in men.

"Obesity has effect on blood pressure and lipids and all of the other things that we know increase the risk of heart disease, but it also will just increase the workload on the heart," she added. "The bigger someone's body, the harder the heart has to work to pump the blood around."

Reuters Health (April 9, 2009)

Hope For A Natural Pacemaker Heart pacemakers have saved and extended the lives of thousands, but they have their shortcomings. Could a permanent biological solution be possible?

Richard Robinson and colleagues at Columbia and Stony Brook Universities think so, and their work is published in The Journal of Physiology.

The body's natural pacemaker, called the sinoatrial (SA) node, is vulnerable to damage during a heart attack, often leaving the patient with a weak, slow, or unreliable heartbeat. The conventional approach is to fit an electronic pacemaker to monitor and control the heart beat.

Therapies to help raise the heart rate biologically could be a better solution, but the way electrical signals are generated in the SA node – and hence the heart rate – are far from simple. There are three separate electrical pathways between cells, called HCN or 'funny' channels (because of their complex behavior).

Robinson's work helps shed light on the secrets of the HCN channels, but more importantly describes a cell culture they have developed that accurately mimics HCN function in mammalian hearts.

The researchers used their new cellular model to genetically rewire two of the HCN channels. It is early yet – but Dr Robinson commented that the new developments “will facilitate the development of practical biological pacemakers by allowing more complete and rapid assessment of individual channel mutations through combined culture and simulation studies prior to full testing in animal models.”

ScienceDaily (April 10, 2009)

Zoll Issues Defibrillator Alert After Two Deaths Zoll Medical Corp. said some of its AED Plus external defibrillators, used in public settings such as airports, have defective batteries and software, leading to failures to deliver a shock and two patient deaths.

About 80,000 units that have been installed for at least three years are at the highest risk, said the Chelmsford, Massachusetts-based company.

The two patient deaths were among four reported cases Zoll reviewed in which a shock was not delivered to a patient.

“We did an extensive and thorough investigation,” said Ward Hamilton, Zoll’s senior vice president of marketing. “We’re still investigating but there’s a point where you have to let people know.”

Each year 250,000 to 450,000 Americans suffer a cardiac arrest due to a rhythm disturbance or silent coronary artery disease, according to the National Heart Lung and Blood Institute. About 95 percent of such patients die, according to the agency. Defibrillators deliver a shock aimed at restoring a normal heart rhythm.

The AED Plus devices are located in health clubs, airports, schools and other public places, and used by emergency medical services personnel, Hamilton said. The malfunctions include batteries that don’t work and self-test software that fails to detect battery problems, according to the company’s statement.

Bloomberg (April 2, 2009)

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