Eliquis more effective at preventing strokes in patients with atrial fibrillation

The experimental anticlotting pill Eliquis beat out the standard drug, warfarin, at preventing strokes in people with a heart condition that puts them at high risk of blood clots and stroke, researchers report. The new drug, also known as apixaban, cut the risk of stroke by 21% compared with warfarin in people with atrial fibrillation (AF). It lowered the risk of dying by 11%. The side effect of serious internal bleeding, the key safety concern of anticlotting medication, was reduced by 31% with Eliquis compared to warfarin - WebMD

Diabetes in Saskatoon Health Region Report (Canada)

Saskatoon Health Region's Public Health Observatory has released its Diabetes in Saskatoon Health Region report. The report of the Medical Health Officer profiles diabetes in both urban and rural settings

Bad sleep ups blood pressure risk

Elderly men who spend little time in deep sleep could be at risk of developing high blood pressure, according to US scientists. A study on 784 patients, in the journal Hypertension, showed those getting the least deep sleep were at 83% greater risk than those getting the most. Researchers say they would expect a similar effect in women. The British Heart Foundation said it was important for everyone to prioritise sleep. High blood pressure - also known as hypertension - increases the risk of heart attack, stroke and other health problems. Researchers measured the "sleep quality" of 784 men over the age of 65 between 2007 and 2009. At the start none had hypertension, while 243 had the condition by the end of the study

Heart Rehabilitation Exercise (UK)

Heart Rehabilitation Exercise is dedicated to giving you all the relevant information regarding how to make and maintain lifestyle changes after a cardiac event. at Heart Rehabilitation Exercise, are Heart rehabilitation exercise workouts posted for you to try at home along with information articles regarding lifestyle changes to support you on your road to recovery

Global governments 'must get tough on obesity'

Tougher action - including taxing junk food - is needed by all governments if the obesity crisis is going to be tackled, experts say. The international group of researchers, who have published a series of articles in The Lancet, said no country had yet got to grips with the problem. They said changes in society meant it was getting harder for people to live healthy lives. And they warned without state action, health systems could become swamped. Obesity-related problems, such as diabetes, were now accounting for between 2% and 6% of health care costs in most countries - BBC

Aerobic exercise bests resistance training at burning belly fat

Aerobic exercise is your best bet when it comes to losing that dreaded belly fat, a new study finds. When Duke University Medical Center researchers conducted a head-to-head comparison of aerobic exercise, resistance training, and a combination of the two, they found aerobic exercise to be the most efficient and most effective way to lose the belly fat that's most damaging to your health. This isn't the fat that lies just under your skin and causes the dreaded muffin top. Belly or abdominal fat – known in scientific communities as visceral fat and liver fat - is located deep within the abdominal cavity and fills the spaces between internal organs. It's been associated with increased risk for heart disease, diabetes, and certain kinds of cancer. "When it comes to increased health risks, where fat is deposited in the body is more important than how much fat you have," says Duke exercise physiologist Cris Slentz, Ph.D., lead author of the study published in the American Journal of Physiology. "Our study sought to identify the most effective form of exercise to get rid of that unhealthy fat." The Duke study showed aerobic training significantly reduced visceral fat and liver fat, the culprit in nonalcoholic fatty liver disease. Aerobic exercise also did a better job than resistance training at improving fasting insulin resistance, and reducing liver enzymes and fasting triglyceride levels. All are known risk factors for diabetes and heart disease. Resistance training achieved no significant reductions in visceral fat, liver fat, liver enzyme levels or improvements in insulin resistance. The combination of aerobic with resistance training achieved results similar to aerobic training alone. "Resistance training is great for improving strength and increasing lean body mass," says Slentz. "But if you are overweight, which two thirds of the population is, and you want to lose belly fat, aerobic exercise is the better choice because it burns more calories." Aerobic training burned 67% more calories in the study when compared to resistance training

Maintaining exercise when the cardiac rehab is complete

Researchers from The Miriam Hospital have found that patients who have completed cardiac rehabilitation and who receive telephone counseling that supports exercise are more likely to adhere to an exercise program. Results of the study, funded by the National Heart, Lung and Blood Institute, are published in the American Journal of Preventive Medicine. Traditionally, patients who complete Phase II cardiac rehabilitation often have low rates of maintaining exercise after program completion. If patients who have completed cardiac rehabilitation do not maintain regular exercise, they are at risk for repeated cardiac events and hospitalizations. Lifestyle changes such as staying regularly active, along with prescribed medications, are important for preventing future hospitalizations in this high risk population. With that in mind, researchers at The Miriam Hospital developed a randomized controlled trial to determine the efficacy of a home-based intervention to support exercise maintenance. Patients who completed cardiac rehabilitation were randomly chosen to receive phone interventions with exercise counseling (maintenance counseling group) or to receive only telephone support (contact control group) that did not focus on exercise. Data was collected over a period of five years and included 130 patients

Too much salt, too little exercise bad for brain

Too much salt and too little exercise is hard on the heart, but new research suggests it can be hard on the brain, too. A three-year study of more than 1,200 people has linked a salty diet and sedentary lifestyle to cognitive decline in old age. "It's important for people to know there are things you can do to help protect your brains as you're aging," said study author Carol Greenwood, a nutrition scientist and interim director of the Baycrest Kunin-Lunenfeld Applied and Evaluative Research in Toronto. "You do have some control, and lifestyle is key." Using data from the Longitudinal Study on Nutrition and Successful Aging, a study of people between the ages of 67 and 84, Greenwood and colleagues found that men and women with the highest daily sodium intake and the lowest level of exercise performed poorer over time on cognitive tests than those with low sodium intake and an active lifestyle. The findings held up even when the researchers controlled for such factors as education, waist circumference, diabetes and overall diet

FDA warns that antidepressant can interfere with heart pumping action at high doses (USA)

Federal health regulators are warning doctors not to prescribe high doses of the antidepressant Celexa, because of the risk of fatal heart complications. The Food and Drug Administration said in an online posting that the drug can interfere with the heart's electrical activity at doses above 40 milligrams. The label for Celexa previously stated that some patients should receive 60 milligrams, but the FDA has eliminated that language. "Studies did not show a benefit in treatment of depression at doses higher than 40 mg per day," the FDA states. The new label will emphasize that Celexa should not be used in patients with congestive heart failure and other conditions that affect the heart's pumping action. Drugmaker Forest Laboratories sells Celexa in doses of 10, 20 and 40 milligrams

Blood pressure guidelines revised in England and Wales

Patients thought to have high blood pressure should have the diagnosis confirmed at home, according to new guidelines. Patients in England and Wales will be offered extra checks using a mobile device that records blood pressure over 24 hours, says the watchdog NICE. A quarter of patients may find visiting a GP stressful, leading to misdiagnosis and being given drugs they do not need. The move could save the NHS £10.5m a year, predictions suggest. High blood pressure (blood pressure of 140/90mmHg or more) affects about a quarter of all adults in the UK. It is a leading risk factor for heart disease or stroke and costs the NHS about £1bn a year in drugs alone. Currently, most patients found to have high blood pressure for the first time are given a formal diagnosis if their blood pressure is raised at two subsequent visits to the doctor. They may then be prescribed medication to lower their blood pressure

Call to measure duration of obesity

Experts say the health hazards of obesity may have been grossly underestimated because we are not measuring the condition adequately. Risk calculations have focused on severity of weight gain alone and not how long it persists. Latest research suggests every additional decade of being obese more than doubles death risk. The researchers told the International Journal of Epidemiology a new measure is needed - the "obese-year". Similar to the "pack-year" used for smoking, it gives a further quantification that can be used to help estimate the associated health risks.

Future heart health 'shaped by diet'

Growing up starved of calories may give you a higher risk of heart disease 50 years on, research suggests. Researchers in The Netherlands tracked the heart health of Dutch women who lived through the famine at the end of World War II. Those living on rations of 400-800 calories a day had a 27% higher risk of heart disease in later life. It's the first direct evidence early nutrition shapes future health, they report in the European Heart Journal. The Dutch famine of 1944-45 gave researchers in Holland a unique opportunity to study the long-term effects of severe malnutrition in childhood and adolescence

CARG Newsletter - September 2011

The CARG Newsletter - September 2011 is now available online

Top 10 myths about cardiovascular disease (AHA)

How much do you really know about your heart's health? It's easy to be fooled by misconceptions. After all, heart disease only happens to your elderly neighbor or to your fried food-loving uncle, right? Or do you know the real truth - that heart disease can affect people of any age, even those who eat right? Relying on false assumptions can be dangerous to your heart. Cardiovascular disease kills more Americans each year than any other disease. But you can boost your heart smarts by separating fact from fiction. The American Heart Association sets the record straight on some common myths

October 2011 conference focuses on the role of gender in cardiovascular disease (USA)

Heart disease has sometimes been considered a men's health issue, but the statistics prove otherwise. In the US alone, more than 42 million women live with the problem. Heart disease is responsible for more than one-third of deaths among American women each year, making it the number one killer of females older than 20. What's more, the signs of heart attack in women differ from those in men, tending toward vomiting, throat discomfort, anxiety and a feeling of pressure in the chest as opposed to the crushing, right-side chest pain more often reported in men. Indeed, the physiology of heart disease differs between men and women in ways that scientists have only begun to understand. Experts will present the latest research about these differences at the Physiology of Cardiovascular Disease: Gender Disparities conference, October 12, 2011 at the University of Mississippi in Jackson. The conference, sponsored by the American Physiological Society with additional support from the American Heart Association, will coincide with the grand opening of the Women's Health Research Center at the university's medical center. Presentations will cover gender differences in heart disease, vascular function, kidney disease and metabolism as well as provide insight on how perimenopause and menopause affect women's heart health

Over-the-counter Lipitor? That's risky (Consumer Reports)

Pfizer hopes consumers will soon be able to get its cholesterol-lowering drug Lipitor (atorvastatin) without a prescription, according to two news reports. But our medical advisors say that's a bad idea because Lipitor and other statins are potent medications that can cause dangerous side effects, and should only be taken with a doctor's supervision. The company is likely looking for ways to make up lost sales - the drug racked up nearly $11 billion last year according to figures from IMS Health - when the patent expires in November. The Food and Drug Administration would have to grant permission for the switch, but that seems unlikely because it has previously said no to over-the-counter sales of two other statins - Mevacor (lovastatin) and Pravachol (pravastatin) - in part due to concerns about safety and that people who don't actually need the medications might take them - Consumer Reports

ICU cardiac arrest circumstances might predict survival (Canada)

The circumstances of cardiac arrest suffered by patients in ICUs may predict their long-term survival rate, according to a study in the Canadian Medical Association Journal. Researchers with the University of Alberta sought to understand survival rates for people who suffer cardiac arrest in the ICU. They looked at data covering January 2000 to April 2005 from four Alberta hospitals with coronary care units and general ICUs, including survival rates at one and five years as well as short-term rates. The study included 517 patients, with 62% male participants and an average age of 67. Of these, 27% survived to hospital discharge, 24% to one year and 16% to five years.

Omecamtiv mecarbil provides new hope for heart failure patients

A new drug which helps the heart pump more easily could improve the lives of thousands of people afflicted by debilitating heart failure, research suggests. Omecamtiv mecarbil is the first of a new class of drugs, called myosin activators, targeting proteins that make the heart contract. Rather than forcing the heart to beat more often, the drug causes heart muscles to contract for longer, increasing the volume of blood pumped out with each stroke. A British trial reported in The Lancet medical journal showed that omecamtiv mecarbil significantly improved the heart function of 45 heart failure patients.

US cigarette makers sue over graphic warning labels

Five tobacco companies have sued the US Food and Drug Administration over a new law that would force them to place graphic health warnings on their cigarette packets. The firms argue the plan violates their constitutional right to free speech, as it requires firms to promote the government's anti-smoking message. The FDA has not commented on the lawsuit. The new warnings will be required on cigarette packs from September 2012 - BBC

Saskatoon transplant pioneer celebrates 19 years of health

A Saskatoon woman has reason to celebrate. It was 19 years ago that Sherry Duncan Paterson underwent a double-lung heart transplant, making her a pioneer in the Canadian transplant world. 19 years ago, after the birth of her second daughter, Paterson was diagnosed with a rare disease called primary pulmonary hypertension. It's a serious condition of the lungs that forces the heart to work harder and can lead to heart failure and even death. "All of my symptoms of the disease had been masked by my pregnancy," says Paterson. "So it really hit me out of nowhere, so the news was really devastating to my whole family." At the time, doctors told Paterson her only hope was to undergo a double lung heart transplant. She was placed at the top of the wait list, and three months later received word a donor match had become available. Paterson was flown to London, Ontario, where she was given a new heart and set of lungs and was told to expect another five years out of life. "We just tried to cram so many memories and happy times into the five years," says Paterson. "I was thinking I wore myself out." But luckily for her family, five years became 10 and then 15. Now, 19 years later, Paterson is considered a pioneer in the transplant world. She's one of only a few to have done so well for so long after undergoing a multiple organ transplant - CTV

Fat 'disrupts sugar sensors causing type 2 diabetes'

US researchers say they have identified how a high-fat diet can trigger type 2 diabetes, in experiments on mice and human tissue. Writing in the journal Nature Medicine, they say that fat interferes with the body's sugar sensors. The authors argue that a deeper understanding of the processes involved could help them develop a cure. Diabetes UK said the study was interesting and a "theory worth investigating further". One of the main risk factors for type 2 diabetes is being overweight - rising obesity levels have contributed to a doubling of diabetes cases in the last 30 years

15-minute daily exercise is 'bare minimum for health'

Just 15 minutes of exercise a day can boost life expectancy by three years and cut death risk by 14%, research from Taiwan suggests. Experts in The Lancet say this is the least amount of activity an adult can do to gain any health benefit. This is about half the quantity currently recommended in the UK. Meanwhile, work in the British Journal of Sports Medicine suggests a couch potato lifestyle with six hours of TV a day cuts lifespan by five years. The UK government recently updated its exercise advice to have a more flexible approach, recommending adults get 150 minutes of activity a week. This could be a couple of 10-minute bouts of activity every day or 30-minute exercise sessions, five times a week, for example. Experts say this advice still stands, but that a minimum of 15 minutes a day is a good place to start for those who currently do little or no exercise. The Lancet study, based on a review of more than 400,000 people in Taiwan, showed 15 minutes per day or 90 minutes per week of moderate exercise, such as brisk walking, can add three years to your life

Second Primary Health Bus benefits from golfing great, Sir Nick Faldo (Saskatoon)

SYNERGY 8 Community Builders and matching partner PotashCorp, with the help of six-time major championship winning golfer Nick Faldo, are joining forces to support St. Paul's Hospital Foundation and Saskatoon Health Region to purchase a new $360,000 Primary Health Bus for the community. The event will be held September 7-8 in Saskatoon and includes a Gala evening at Prairieland Park and a charity scramble at Moon Lake Golf & Country Club. For more information, please visit www.synergycommunitybuilders.ca or call 306-931-7544

Heart Healthy Children & Youth - Saskatchewan

Heart Healthy Children & Youth is the Heart and Stroke Foundation's response to the growing epidemic of childhood obesity, inactivity and other lifestyle choices that are putting Saskatchewan children at risk. This is a province-wide initiative aiming to inspire individuals, families, communities, businesses and governments to take collective action to help children become more physically active, eat healthier foods and be smoke-free. Canadian children may be among the first generation to have a shorter less healthy lifespan than their parents. Childhood obesity has tripled in the past 25 years and 29.1 per cent of Saskatchewan children are considered overweight or obese. At the same time, children are less active. According to Active Healthy Kids Canada, only 15 per cent of Saskatchewan children meet recommended levels for physical activity. And smoking rates among Saskatchewan youth are significantly higher than elsewhere in Canada, even among children as young as grade six.

To get involved, contact the Community Action Coordinator in your area at 1-888-473-4636 (toll-free):

* Candace Bloomquist, Central Saskatchewan bloomquistc@hsf.sk.ca
* Bill Ursel, South Saskatchewan urselb@hsf.sk.ca

Seniors in Canada overmedicalized, experts say

Seniors in Canada are overdrugged and overtested, to the detriment of both their health and the health care system, as billions of dollars are being spent that could more productively be spent elsewhere, several experts say. An array of factors is contributing to the overmedicalization of seniors, the experts add, including a simple desire of many patients for pharmaceutical solutions to prolong life or improve sexual performance; drugging seniors to make them manageable in health facilities; overuse of preventive medication; aggressive pharmaceutical industry marketing techniques; questionable clinical guidelines; and prescriptions to offset the effects of other prescriptions. Pharmacists filled an average 74 prescriptions per year for people aged 80 or over in 2005, as compared to 14 prescriptions per year for all other age groups, according to the latest available Statistics Canada data. The Canadian Institute for Health Information (CIHI) says that in 2010, about 13% of seniors who took five or more prescription medications experienced a side effect that caused them to seek further health care services - CMAJ

Smoking increases heart risk more in women than men

Women who start smoking increase their risk of a heart attack by more than men who take up the habit, according to a review of more than 30 years of research. A study of 2.4 million people, published in the Lancet, showed a 25% difference in increased risk. The reasons are unclear, say researchers. The British Heart Foundation said the findings were "alarming" especially as women tended to smoke fewer cigarettes. The World Health Organization lists heart disease as the world's biggest killer, affecting more than seven million people each year

Cutting salt 'should be global priority'

The UN must make reducing salt intake a global health priority, say UK scientists. Writing in the British Medical Journal they say a 15% cut in consumption could save 8.5 million lives around the world over the next decade. The report says practical steps to reduce consumption should be drawn up without delay. If voluntary measures do not work, the food industry should be compelled to cut salt levels, it says. The report - by researchers at the Universities of Warwick and Liverpool - says that after cutting tobacco consumption, getting people to eat less salt would be the most cost effective way to improve global health. The researchers say there is a "consistent, direct relation between salt intake and blood pressure". High blood pressure in turn is linked to heart disease, stroke and kidney problems

Poverty hurts cardiac rehab (USA)

Broken-up sidewalks, scary dogs in unfenced yards and heavy traffic can ruin a walk around the neighborhood. For heart attack survivors who need to exercise, such conditions can interfere with an important part of their rehabilitation. In a report published this week, researchers said they found that heart attack survivors who lived in low-income neighborhoods exercised less than heart attack survivors from wealthier neighborhoods. The findings weren't a surprise to Shireen Rajaram, the director of the University of Nebraska Medical Center's Center for Reducing Health Disparities. "We constantly hear complaints from our low-income communities that our neighborhoods are not supportive of walking, biking, just basically moving around," Rajaram said. Neighbors' behavior also can affect one's exercise habits, she said. "If nobody else is walking out on the street, if everybody else is suspicious of each other, you're less likely to go out," Rajaram said. The study of heart attack survivors' exercise habits was published in the September issue of the American Journal of Preventive Medicine

Wrist-worn device may detect cardiac arrest

A watch-sized device worn on the wrist successfully detected loss of pulse in an early-stage trial, a key step in developing a practical, noninvasive way to monitor patients at risk for sudden cardiac death, researchers said. In most patients participating in the phase I trial, the investigational device correctly signaled artificially induced pulselessness, though it had a false-positive rate of about 10%, according to John Rickard, MD, of the Cleveland Clinic, and colleagues online in Heart Rhythm. Called the Wriskwatch, the device incorporates a piezoelectric disk strapped snugly against the wrist, such that it detects the arterial swelling at the radial pulse point. It can therefore identify episodes of pulselessness or ventricular fibrillation - MedPage Today

Bear chemical brings heart hope (UK)

A synthesised compound also found in bear bile may help the recovery of some people who have had a heart attack. Ursodeoxycholic acid (UDCA) is already used to reduce cholesterol production, and to dissolve gallstones. Now a study by London's Imperial College has shown it could also treat potentially dangerous abnormal heart rhythms. Bear bile is used in many traditional Chinese medicines, but critics say the way it is collected is cruel - BBC

Canadian health system more efficient than U.S.: Study

The Canadian health-care system may be plagued by countless stories of lengthy wait times and crowded emergency rooms, but a new study shows the amount of time and money spent on administrative duties is a fraction of that required by the U.S. system. The study from the University of Toronto and New York's Cornell University says U.S. doctors pay an average of nearly $83,000 each for administrative costs associated with insurance documents. In Canada, for doctors based in Ontario that cost is significantly less at just over $22,200. In addition, nurses, medical assistants and other hospital staff dedicate nearly 21 hours per week to filing insurance papers and other duties required to push insurance claims through. For the same duties in Ontario, just 2.5 hours are spent each week. The findings of the study, published in the August edition of the journal Health Affairs, show that the "single payer" health-insurance system in Canada is largely responsible for the difference between countries

Simple device helps detect baby heart defects (UK)

Experts are calling for a simple piece of equipment that has been in most hospitals for years to be used on all newborn babies to help detect life-threatening heart defects. A major trial conducted in British hospitals has discovered that using pulse oximeters, a device which measures blood oxygen levels, dramatically increases the chance of identifying major heart faults. The simple, pain-free test has a detection rate of 92% when combined with traditional baby checks. Every year in Britain more than 5,000 babies are born with heart defects and, in the developed world, they are one of the leading causes of infant deaths - Sky News

Man with the plastic heart: dying Londoner saved by breakthrough

A London man will make medical history when he goes home after being given a plastic heart, it was revealed. The device, powered by a 13.5lb portable driver in a backpack, replaced 40-year-old Matthew Green's diseased heart to pump blood through his body. Mr Green, a father of one, was dying from "end-stage" failure of both chambers of his heart until the six-hour operation to put in the artificial heart at Papworth Hospital in Cambridge