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