theHeart.org - Prevention

Cardiovascular effects of air pollution, even in the comfort of home

Fri, 14 Nov 2008 16:45:06 EST

Researchers who fitted study subjects with "air-pollution vests" to continuously monitor exposure to both indoor and outdoor air pollutants say that people are probably exposed to much higher levels of pollutants than community monitoring stations typically indicate and that this exposure affects both endothelial function and systolic blood pressure. (American Heart Association 2008 Scientific Sessions.)

FIT HEART: Novel family-based intervention a good idea, but better methods needed

Wed, 12 Nov 2008 15:00:18 EST

A new study in which the family members of patients hospitalized for cardiovascular disease were given CVD risk screening and lifestyle advice has shown that it is useful to take advantage of such "motivational moments." But the results could be improved upon, illustrating that it is difficult to change behavior in the "toxic environment" of the US, said the discussant. She stressed that better interventions—such as adopting the Mediterranean diet—are urgently needed. (Mosca L et al. Circ Cardiovasc Qual Outcomes; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)

New meta-analysis of beta blockers in noncardiac surgery: Time to abandon their use, or not?

Wed, 12 Nov 2008 14:00:45 EST

The use of beta blockers perioperatively to prevent cardiovascular events in patients undergoing noncardiac surgery is not justified by current evidence, according to the authors of a new meta-analysis. An update to the guidelines on this issue is under way, says one member of the writing committee, who incidentally does not agree with this overall conclusion. (Bangalore S et al. Lancet; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)

JPAD: No effect of aspirin primary-CV-event prevention in diabetics

Sun, 09 Nov 2008 21:30:47 EST

Low-dose aspirin didn't cut the risk of cardiovascular events but may have reduced CV mortality, a secondary end point, in the randomized but open-label trial conducted in Japan; clinical events were unexpectedly few, compromising the study's statistical power. (Ogawa H et al. JAMA 2008; 300:2180-2181. American Heart Association 2008 Scientific Sessions.)

SEARCH me: Null trial "morphed" into positive meta-analysis

Sun, 09 Nov 2008 20:30:15 EST

The SEARCH trial showed no effect on major vascular events with either an intensive 80-mg dose of simvastatin compared with a 20-mg dose or with homocysteine lowering using folic acid and vitamin B₁₂. But the statin data fit with other trials in the field, showing a "clear picture" emerging when it comes to the more-vs-less data on statins, say the UK investigators. (American Heart Association 2008 Scientific Sessions.)

JUPITER casts a large shadow: Moving from efficacy data to the big picture

Sun, 09 Nov 2008 19:30:00 EST

Some back-of-the-envelope analyses suggest that the public-health implications of using statins in primary prevention, especially among individuals considered "healthy" by conventional definitions, is weighing heavily on the minds of some cardiologists. heartwire spoke with many experts to get their take on the new JUPITER data. (American Heart Association 2008 Scientific Sessions.)

No benefit of vitamin C or E for prevention of major cardiovascular events: Physicians' Health Study II

Sun, 09 Nov 2008 17:45:12 EST

Randomized results from the Physicians' Health Study II found no effect of either supplement on a composite of nonfatal MI, nonfatal stroke, or cardiovascular death after eight years of treatment. (Sesso HD et al. JAMA 2008; 300:2123-2133. American Heart Association 2008 Scientific Sessions.)

Flu shot linked to reduced risk of VTE

Sun, 09 Nov 2008 17:45:00 EST

The link between influenza vaccination and reduced pulmonary embolism or deep vein thrombosis was particularly marked in younger subjects, researchers say. (American Heart Association 2008 Scientific Sessions.)

JUPITER hits New Orleans: Landmark study shows statins benefit healthy individuals with high CRP levels

Sun, 09 Nov 2008 09:00:00 EST

There are a number of adjectives being thrown at the JUPITER study—groundbreaking and paradigm shifting are just two—but many experts believe the study, which showed significant cardiovascular risk reduction among healthy individuals with elevated CRP levels, is likely going to shake up the field of primary prevention. (Ridker PM et al. New Engl J Med; published online before print November 9, 2008. American Heart Association 2008 Scientific Sessions.)

Eliminating inequalities in CHD: Focus on classic risk factors

Thu, 06 Nov 2008 18:30:00 EST

Focusing on the classic risk factors for coronary heart disease and ensuring that best-practice interventions to reduce absolute risk are implemented across the board could largely eliminate socioeconomic differences in CHD deaths, a new British study predicts (Kivimäki M et al. Lancet 2008; 372:1648-1654.)

Sanofi-Aventis scraps ongoing rimonabant research

Wed, 05 Nov 2008 17:30:50 EST

The company announced its decision after regulatory agencies asked for a discontinuation of the company's clinical trials.

Mixed findings cast doubt on HRT timing hypothesis

Wed, 05 Nov 2008 12:45:02 EST

A new study has shown mixed results with regard to the effects of hormone-replacement therapy on lipids in women around the time of menopause and also shows that HRT unfavorably affects inflammatory markers. The results muddy the waters somewhat for the so-called "time window" for the use of HRT, say the researchers. (Sowers MR et al. Arch Int Med 2008; 168:2146-2153.)

Doctors and lawyers butt heads over statins for primary prevention in women

Mon, 03 Nov 2008 17:00:00 EST

The data do not support statin use in primary prevention of cardiovascular events for women, and any advertising claims made by drugmakers are vulnerable to legal action, according to one legal expert. Cardiologists, however, argue that the absence of information doesn't mean the drugs don't work in women, and they continue to prescribe them. (Eisenberg T et al. J Empir Leg Stud 2008; 5:507-550.)

Endothelial dysfunction seen in "minimally symptomatic" obstructive sleep apnea

Fri, 31 Oct 2008 18:15:00 EDT

OSA not accompanied by daytime symptoms might still suggest increased cardiovascular risk, according to researchers. (Kohler M et al. Am J Respir Crit Care Med 2008; 178:984-988.)

MESA ties diabetes, HTN to new heart-failure risk in African Americans

Thu, 30 Oct 2008 18:00:24 EDT

Race per se shouldn't be a barrier to lowering the risk of new heart failure in African Americans, because the main causes are treatable, according to investigators for the longitudinal cohort study. (Bahrami H et al. Arch Intern Med 2008; 168:2138-2145.)

Endocarditis twice as likely to kill the elderly

Wed, 29 Oct 2008 18:30:18 EDT

The largest prospective multicenter study of infective endocarditis ever conducted has found that elderly patients with the disease have distinctive characteristics compared with their younger counterparts and that they are twice as likely to die from it. (Durante-Mangoni E et al. Arch Intern Med 2008; 168:2095-2103.)

Genetic study undermines case for CRP as cause of vascular disease

Wed, 29 Oct 2008 17:00:00 EDT

Genetically elevated CRP levels were associated with but probably didn't influence cardiovascular and cerebrovascular risk in a huge combined analysis of four Danish cohort studies, researchers say. (Zacho J et al. N Engl J Med 2008; 359:1897-1908.)

MIs linked to daylight saving time may also help explain MI spikes on Mondays

Wed, 29 Oct 2008 17:00:00 EDT

Rest easy for now: MI rates appear to increase in the spring but dip marginally with the end of DST in autumn, due likely to the extra hour of sleep. (Janszky et al. N Engl J Med 2008; 359:1966-1967.)

FDA warns Bayer about "unlawful" marketing of aspirin-supplement combinations

Tue, 28 Oct 2008 16:15:34 EDT

An aspirin-calcium combination marketed for women and an aspirin-phytosterol combination that purports to reduce heart-disease risk are illegal, the FDA says. Bayer, in response, says it "stands behind" its claims but is working with the FDA.

Metformin top oral antidiabetic for CV-risk reduction, says meta-analysis

Mon, 27 Oct 2008 16:00:00 EDT

Of all such agents used in 40 select clinical trials, only metformin significantly reduced cardiovascular mortality. An accompanying editorial highlights limitations of meta-analyses and the shortfalls in knowledge about the CV effects of these agents. (Selvin E et al. Arch Intern Med 2008; 168:2070-2080.)

Statin use reduces mortality after hospitalization for pneumonia

Mon, 27 Oct 2008 16:00:00 EDT

The decreased mortality rates among those pretreated with statin therapy became evident during the first weeks of hospitalization for pneumonia and persisted to at least 90 days, report investigators. (Thomsen R et al. Arch Intern Med 2008; 168:2081-2087.)

Drug maker agrees to suspend rimonabant marketing in Europe

Thu, 23 Oct 2008 15:30:29 EDT

European regulators say rimonabant's benefits no longer outweigh its risks. Its manufacturer, however, says it remains committed to the drug and hopes to provide evidence to support its reevaluation in the future.

"Western" diet increases MI risk worldwide

Tue, 21 Oct 2008 15:00:27 EDT

The simple message that a "Western" diet, high in fried foods and meat products, increases the risk of heart attack and that a diet rich in fruits and vegetables is protective is applicable in all regions of the world, a new analysis of the INTERHEART study finds. (Iqbal R et al. Circulation; published online before print October 20, 2008.)

Is prophylaxis for endocarditis essential, or just a habit that's hard to break?

Fri, 17 Oct 2008 14:30:18 EDT

The issue of when, or even if, antibiotics should be given for the prevention of infective endocarditis has been hotly debated of late. heartwire interviewed one expert on the subject, Dr Bernard Prendergast, to gauge his views.

Aspirin: Should it be used for primary prevention in diabetics?

Fri, 17 Oct 2008 13:45:26 EDT

A new study, POPADAD, has found no evidence that aspirin or antioxidants are of any benefit in the primary prevention of cardiovascular events in diabetic patients with asymptomatic peripheral arterial disease. The authors and accompanying editorialist say guidelines should be changed; others say more evidence is needed. (Belch Jet al. BMJ; published online before print October 16, 2008.)

Smoking cessation must not be an afterthought, new studies say

Tue, 14 Oct 2008 14:15:12 EDT

Two new studies suggest that smoking-cessation advice within hospitals needs to be much more structured to achieve better results. A related article finds that not only does smoking in midlife shorten life expectancy, but that the quality of that life is much reduced. (Dawood N et al. Rigotti NA et al. Strandberg AY et al. Arch Intern Med 2008; 168:1961-1967, 1950-1960, 1968-1974.)

New rofecoxib data will help inform treatment decisions with other coxibs, NSAIDs

Mon, 13 Oct 2008 18:30:00 EDT

New results from the extended follow-up of the APPROVE trial provide a more complete assessment of the cardiovascular toxicity of the COX-2 inhibitor rofecoxib than previously reported. The findings are still very relevant, because this is a class effect, say the researchers and editorialists. (Baron JA et al. Lancet; published online before print October 13, 2008.)

Good and bad news on hypertension in US

Mon, 13 Oct 2008 16:00:00 EDT

A new report shows that more US adults have hypertension than ever before, and the increase is primarily due to the rising rates of obesity in recent times, say the NHLBI researchers. However, awareness, treatment, and control of blood pressure have also improved. Nevertheless, much work remains, specifically with certain subgroups, they say. (Cutler JA et al. Hypertension; published online October 13, 2008.)

NOMAS: Just a 2% overlap for PFO and migraine; St Jude shuts down ESCAPE trial

Thu, 09 Oct 2008 14:30:12 EDT

While both migraine and PFO occurred in roughly 15% of the NOMAS participants, the two were rarely found together. Experts agree: hopes are dimming that PFO closure may help migraineurs. Indeed, only one company is still testing this hypothesis in randomized trials. (Rundek T et al. Circulation 2008; 118:1419-1424.)

CT angiography predicts mortality from coronary disease, EBT scans show

Wed, 08 Oct 2008 17:15:39 EDT

The study, using EBT scans taken as long as 12 years ago, provides some of the first data suggesting that noninvasive angiography using CT can provide prognostic information. Similar outcome data for the newer CT scanners are likely many years away. (Ostrom M et al. J Am Coll Cardiol 2008; 52:1335-1343.)

Ultrasound-based strategies comparable for DVT diagnosis, treatment guidance

Tue, 07 Oct 2008 17:30:00 EDT

A randomized trial found that two ultrasound-based strategies were similarly effective at determining the need for anticoagulation in symptomatic patients with suspected deep-vein thrombosis; both have strengths and weaknesses. (Bernardi E et al. JAMA 2008; 300:1653-1659.)

Societies confront GI risks of antiplatelets, NSAIDs in consensus document

Tue, 07 Oct 2008 10:00:38 EDT

It addresses a common clinical problem for which there is little clinical-trial-quality data for guidance and gives a starring role to proton-pump inhibitors in treating GI ulcers and bleeding and, in high-risk groups, in their prevention. (Bhatt DL et al. J Am Coll Cardiol; Circulation; published online before print October 3, 2008.)

India attempts to impose world's biggest smoking ban

Fri, 03 Oct 2008 11:30:39 EDT

The Indian government appears to have heeded the warnings of medical experts highlighting the immense problem of smoking in the country, with the introduction this week of a nationwide ban on smoking in public places.

Pfizer to drop development of drugs for hyperlipidemia, atherosclerosis, and heart failure

Thu, 02 Oct 2008 17:00:34 EDT

UPDATED // Forbes reported the news online after obtaining an internal Pfizer memo.

FDA finds no link between statin use and ALS

Wed, 01 Oct 2008 16:00:00 EDT

The meta-analysis, which included 41 clinical trials, revealed similar rates of ALS in the statin-treated and placebo-treated patients. The agency said further monitoring is still needed, however, because of the expansive use of the drugs and the dire consequences of this neurodegenerative disorder. (Colman E et al. Pharmacolepidemiol Drug Saf; published online September 29, 2008.)

Eating dark chocolate reduces CRP

Mon, 29 Sep 2008 13:30:32 EDT

A new Italian study has shown, for the first time, that consuming moderate amounts of dark chocolate can significantly reduce CRP levels. (di Giuseppe R et al. J Nutr 2008; 138:1939-1945.)

Inhaled anticholinergics for COPD raise CV-event risk in meta-analysis

Tue, 23 Sep 2008 16:00:00 EDT

Chronic use of inhaled ipratropium or tiotropium bromide independently increased the risk of CV death by 80%; patients who took them for at least six months appeared the most vulnerable. A forthcoming randomized trial may provide more authoritative guidance on the issue. (Singh S et al. JAMA 2008; 300:1439-1450.)

Live what you advocate: The exercise habits of busy cardiologists

Tue, 23 Sep 2008 10:15:00 EDT

Sure, it's easy to throw the book at a patient, telling them to eat better and to get active, but are cardiologists practicing what they preach? And if they are, just what are they doing to stay in shape? heartwire has a look at the athletic lives of some cardiologists.

Passive smoking ups risk of PAD by 50%

Mon, 22 Sep 2008 16:00:00 EDT

Chinese researchers have reported, for the first time, a link between exposure to passive smoke and peripheral arterial disease in a cohort of women who have never smoked. They call for urgent public-health measures to protect individuals from secondhand smoke. (He Y et al. Circulation: published online before print September 22, 2008.)