theHeart.org - Prevention

Medicaid access to smoking cessation falls short

Thu, 05 Nov 2009 17:30:46 EST

A national survey shows that although the majority of state Medicaid programs offer coverage for some form of tobacco-dependence treatment, most fall far short of a stated mandate to provide unrestricted access to approved therapies.

Low-cholesterol/cancer studies should "dispel lingering doubts" of causal link

Thu, 05 Nov 2009 14:15:24 EST

Two new papers should help put to rest concerns that low serum cholesterol levels may increase cancer risk.

Not all metabolic syndrome is created equal: Framingham Offspring analysis

Thu, 05 Nov 2009 11:45:03 EST

The syndrome (defined by ATP III criteria) can predict increased cardiovascular and mortality risk or not, depending on which three of five risk factors contributed to the diagnosis, a cohort study suggests; its investigators caution that their observations are only preliminary.

Adding fuel to the J-curve fire; debate is reignited

Wed, 04 Nov 2009 14:30:56 EST

More discussion about the J-curve in hypertension is published this week; one expert believes the undue attention being paid to this subject might discourage doctors from treating high blood pressure aggressively.

No CV risk reduction with B vitamins posttransplant

Wed, 04 Nov 2009 13:15:27 EST

In keeping with all the other evidence showing no effects of homocysteine-lowering with B vitamins, the FAVORIT study now confirms that this lack of benefit is also seen in renal-transplant recipients.

Another in-hospital CV risk marker: 24-hour shifts with overnight on-call duty

Wed, 04 Nov 2009 09:45:43 EST

Long work shifts with nighttime on-call duty, with the inevitable interruptions of sleep, are associated with ECG, blood-pressure, and biochemical changes associated with increased cardiovascular risk, suggests a randomized crossover study that hints at a sustained effect on the risk markers if the 24-hour shifts happen too frequently.

CAC scoring plus SPECT provide long and short view of cardiac risk

Tue, 03 Nov 2009 17:00:51 EST

UPDATED // An 1126-patient trial shows that SPECT and CAC scoring imaging tests are independent and complementary predictors of short- and long-term cardiac risk, respectively.

Combined home/GP hypertension control program successful in Pakistan

Mon, 02 Nov 2009 17:00:00 EST

A synergistic approach of educating general practitioners about hypertension control together with a program to send lay workers into people's homes to educate them about the management of high blood pressure has proven successful in low- to middle-income households in Pakistan.

Advocates build support for Canadian Heart Health Strategy in a difficult environment

Mon, 02 Nov 2009 11:15:59 EST

Supporters of the Canadian Heart Health Strategy and Action Plan continue to solicit support from physicians and the public for a comprehensive strategy for improving Canadian's heart health at both the provincial and federal level.

Imaging study shows plaque regression with niacin vs placebo

Fri, 30 Oct 2009 16:00:00 EDT

Just weeks before ARBITER-HALTS�6 results come out at AHA 2009, an MRI study suggests that niacin is better than placebo in statin-treated patients with low HDL, at least for reducing carotid wall area. Experts say they'd also like to see insights into niacin effects on lipid-rich plaque volumes—the more commonly seen end point with MRI.

Lifestyle-based diabetes prevention seen to endure for at least a decade

Fri, 30 Oct 2009 10:00:00 EDT

The protective effects of diet modification, exercise, and other lifestyle changes against new-onset diabetes showcased in the three-year Diabetes Prevention Program continued out to 10 years in a follow-up analysis.

Sex differences in changing MI prevalence, mortality challenge conventional wisdom

Thu, 29 Oct 2009 10:30:28 EDT

Two well-known observational registries highlight such changes in women and men over a decade or more: Do women younger than 55 still have an advantage over men in the same age group?

Bariatric surgery fails to reduce risk of MI long term

Wed, 28 Oct 2009 14:30:14 EDT

After a median follow-up of 12 years, MI rates were essentially the same among those treated with surgery and those who received conventional care for weight loss.

Lorcaserin passes weight-loss and valvular hurdles in BLOSSOM study

Tue, 27 Oct 2009 16:15:27 EDT

Among overweight patients, including those with preexisting echocardiographic valvulopathy, the average weight loss was approximately 5 kg with lorcaserin. Importantly, there were no concerns raised about new or worsening cardiac valve problems with the 5HT2C-receptor agonist.

Experts weigh in on calorie lists on menus, despite "mixed" science

Mon, 26 Oct 2009 16:45:21 EDT

Results showing that people eat less when they know how many calories are in that Big Mac are mixed, but experts say that menu labeling provides only upside, with no public-health cost, and that over time results will show the information to have a positive effect on obesity rates in the US.

Distribution of body fat important in VTE

Mon, 26 Oct 2009 16:00:00 EDT

The distribution of body fat, as well as the amount, is important when it comes to the risk of venous thromboembolism, Danish researchers have discovered.

Less exposure to cardiovascular risk factors with intensive diabetes intervention: Look AHEAD

Mon, 26 Oct 2009 10:00:00 EDT

Intensive lifestyle intervention in the management of diabetes produces sustained weight loss and improvements in fitness, as well as improvements in glycemic control, systolic blood pressure, and HDL-cholesterol levels.

New MESA data: Pericardial fat a better predictor of CHD than BMI

Fri, 23 Oct 2009 17:00:00 EDT

Pericardial fat, which is found around the heart, predicts future CHD events and may even be a better predictor of these than conventional obesity measures, such as BMI and waist circumference, a new study of MESA participants shows.

New model connects low-dose radiation to CVD risk

Fri, 23 Oct 2009 15:30:21 EDT

Data from Japanese atomic-bomb survivors and people exposed to radiation in their jobs show that even low doses of ionizing radiation may contribute to cardiovascular disease risk. British researchers have created a complex mathematical model to better understand the relationship between radiation exposure and heart disease.

GLP-1 analog liraglutide promising in obesity

Thu, 22 Oct 2009 18:30:00 EDT

A drug originally developed to treat diabetes may have promise as an obesity therapy, a new study shows. Those taking liraglutide, a GLP-1 analog, lost more weight than those on an established obesity medication, orlistat.

HCM transmitted by sperm donation: A case report

Thu, 22 Oct 2009 15:45:36 EDT

The donor, who was later shown to be affected by a novel beta-myosin heavy-chain mutation that causes HCM, is responsible for at least nine children known to be genetically affected with HCM.

Glucose lowering in type 2 diabetes to prevent CVD remains controversial but still important

Thu, 22 Oct 2009 14:45:51 EDT

Although the case for intensive glucose lowering in diabetic patients to prevent CVD is not straightforward, glucose control is still important for other reasons, and blood pressure and lipid control should not be neglected, according to debaters at a diabetes meeting.

Current risk equations may overestimate CVD risk in diabetic patients

Wed, 21 Oct 2009 10:00:31 EDT

Researchers using different international databases report that the Framingham and UKPDS risk equations overestimate the probability of CV events in diabetic patients.

Thiazolidinediones have a role for appropriate diabetic patients

Tue, 20 Oct 2009 12:45:38 EDT

After 10 years of clinical use of TZDs, "we are still at the beginning," and randomized controlled trials shed light on their use in appropriate diabetic patients, speakers at a diabetes symposium reported.

Expanded indication for telmisartan

Mon, 19 Oct 2009 13:30:16 EDT

The drug can now be used to reduce the risk of MI, stroke, or death from cardiovascular causes in patients 55 years of age or older who are intolerant to ACE inhibitors but at high risk for cardiovascular events.

Rosuvastatin cleared for pediatric FH

Fri, 16 Oct 2009 16:30:01 EDT

The FDA has approved rosuvastatin for use in children aged 10 to 17 years old with familial hypercholesterolemia.

Smoking bans reduce the risk of acute coronary events: IOM report

Fri, 16 Oct 2009 16:00:09 EDT

IOM report confirms the cardiovascular benefit of implementing a ban on smoking in public places. The reduction in acute MI, anywhere from 6% to 47%, typically occurs quickly, often within 12 months of the ban.

Zero CAC score not 100% reassuring in those presenting to ER with chest pain

Fri, 16 Oct 2009 12:45:08 EDT

In those presenting to the ER with chest pain, a prior zero calcium score cannot completely rule out a coronary obstruction, a new analysis of the MESA study has shown. This is likely due to the presence of soft plaques not detected by calcium screening, the researchers say.

No link seen between heart failure and coffee intake

Fri, 16 Oct 2009 10:15:02 EDT

With few studies in the literature specifically looking at the issue, a prospective, population-based study in Sweden has found no significant rise or fall in risk of heart-failure hospitalization or death at increasing levels of coffee intake.

Can statins prevent and treat infection?

Thu, 15 Oct 2009 14:45:36 EDT

Results from a new meta-analysis show the pleiotropic effects of statins are useful in the treatment and prevention of different infections, including bacteremia, pneumonia, and sepsis.

Racial background woefully underreported in CV trials

Thu, 15 Oct 2009 13:15:10 EDT

Two-thirds of the 156 trials considered by the AHA in preparing a recent guideline failed to even record the ethnic backgrounds of participants, a new study has found. The researchers call for the reporting of race/ethnicity to be mandatory in all clinical trials, and they suggest medical journals should enforce this policy.

A fish tale with merit: Omega-3 PUFAs underrated for heart failure

Wed, 14 Oct 2009 12:30:27 EDT

Are the data not shouting loud enough, or is cardiology hard of herring? Omega-3 fatty acids may have only a modest treatment effect in heart failure, but they've performed swimmingly in randomized and observational studies considering how few new HF drugs have been reeled in lately.

Diuretics effective as second-line therapy for hypertension

Tue, 13 Oct 2009 12:00:48 EDT

Diuretics, especially hydrochlorothiazide, are as effective when given as second-line therapy for high blood pressure as they are when used as initial treatment, according to the first review to look at this issue.

EULAR: CV risk management in inflammatory arthritis

Fri, 09 Oct 2009 11:45:12 EDT

The European League Against Rheumatism has issued 10 recommendations for cardiovascular risk management in patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.

FDA clears colesevelam for FH in kids

Fri, 09 Oct 2009 11:00:39 EDT

The FDA has approved an expanded indication for colesevelam tablets and a new powder for oral suspension as an adjunct to diet and exercise to reduce LDL-C levels in boys and postmenarchal girls aged 10 to 17 years with heterozygous familial hypercholesterolemia.

Coronary thrombosis�the culprit is not just plaque rupture

Thu, 08 Oct 2009 17:45:48 EDT

Clots derived from a different source—erosions of the arterial wall—may be an important cause of MI and sudden death, particularly in younger women, who may need a different approach to treatment, new research suggests.

New joint statement streamlines definition of metabolic syndrome

Thu, 08 Oct 2009 16:45:46 EDT

The statement from the International Diabetes Federation, the National Heart, Lung, and Blood Institute, and the American Heart Association, among others, formalizes the definition of the metabolic disorder with the hope of eliminating some of the confusion regarding how to identify patients with the syndrome.

New review confirms homocysteine lowering does not prevent CVD events

Thu, 08 Oct 2009 15:30:45 EDT

The latest review to look at the effects of homocysteine lowering with vitamin-B supplementation has come to much the same conclusions as most other studies and analyses in this field.

Mercury/blood-pressure link should guide fish choices

Tue, 06 Oct 2009 16:45:03 EDT

An association seen between mercury levels and blood pressure, even after considering omega-3s and selenium, has researchers warning about the need to weigh the risks and benefits of fish consumption and to steer clear of bigger predators.

China death toll due to hypertension worse than predicted

Tue, 06 Oct 2009 14:15:24 EDT

The first prospective study using real data to inform the number of people suffering from and dying due to high blood pressure in China finds the problem is much worse than previously thought. A number of initiatives are planned to try to tackle this crisis.

Simple, fixed-dose drug bundle may lower MI and stroke risk

Tue, 06 Oct 2009 10:15:41 EDT

A bundle of medium doses of a statin and an ACE inhibitor appears to lower CV risk in high-risk individuals, an observational study suggests, but critics caution that these are early days.

New "principles" on authorship and COI from PhRMA get mixed response

Fri, 02 Oct 2009 12:00:10 EDT

The "Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results" echo recent standards set by medical journal editors, but some observers say the document, which has no penalty component, lacks real teeth.

Time to act: Cardiologists, diabetes docs, and psychiatrists urged to work together to tackle CVD in the mentally ill

Wed, 30 Sep 2009 14:00:04 EDT

Doctors from across the specialties of cardiology, diabetes, and psychiatry are being urged to collaborate to improve care for the mentally ill, who are more likely to die from cardiovascular disease than any other cause.

BNP-boosting gene variant hints at possible screening, cardioprotective roles

Fri, 25 Sep 2009 10:45:02 EDT

A single-nucleotide polymorphism associated with chronically raised natriuretic-peptide levels is common enough to potentially influence interpretation of BNP and NT-proBNP assays under some circumstances, researchers say; there is increasing evidence that the gene variant may enhance survival in some patient groups.

COGENT: No CV events but significant GI benefits of PPI omeprazole

Thu, 24 Sep 2009 16:30:07 EDT

The randomized controlled trial results should put a stop to alarmist headlines about PPIs blunting efficacy of antiplatelet drugs, experts say. By withholding PPIs, physicians are doing more harm than good, the results suggest.

New Canadian lipid guidelines will recommend CRP testing for certain patients

Thu, 24 Sep 2009 13:45:07 EDT

New Canadian guidelines for the diagnosis and treatment of dyslipidemia and the prevention of cardiovascular disease will recommend the testing of hs-CRP for certain patients, most notably those at intermediate risk. However, the lead author stresses that the majority of patients will not require a CRP test and that recommending and promoting a healthy lifestyle must be the first port-of-call for doctors.

Flu vaccine may protect against MI

Mon, 21 Sep 2009 18:30:00 EDT

A protective effect was seen in patients with established cardiovascular disease. Whether vaccination is protective in people with no vascular disease is less clear, a new review suggests.

Smoking bans cut heart attacks by up to a quarter

Mon, 21 Sep 2009 17:00:00 EDT

A nationwide smoking ban in the US would prevent up to 150�000 new MIs every year, the authors of a new meta-analysis estimate. They show that similar bans in parts of the US and in other countries have reduced the incidence of MI by almost 20% and that the longer the ban is in place, the greater the benefits seem to be.

How to shave 10 years off your life: Have high cholesterol, be hypertensive, and smoke

Fri, 18 Sep 2009 15:30:13 EDT

Smoking, together with high cholesterol and blood pressure, can knock 10 years off life expectancy in middle-aged men, new UK research shows. If excessive weight and glucose intolerance are added in, the difference can be as much as 15 years, they add.

Cutting salt intake in US could save $50 billion a year

Thu, 17 Sep 2009 11:00:49 EDT

A new economic analysis concludes that regulations to reduce sodium content in processed foods and/or voluntary reductions in salt by companies could save up to $50 billion a year in healthcare costs in the US.

New ASCOT analysis: Beta blockers not beneficial in hypertensives with tachycardia

Tue, 15 Sep 2009 14:15:57 EDT

Pulse rate should not be the determinant of which drugs are used in hypertension, conclude the authors of a new subgroup analysis of the ASCOT trial.

Conflicts of interest affect best practices in both industry-funded and non-industry-funded trials

Tue, 15 Sep 2009 12:00:19 EDT

Clinicians and researchers need to be more aware before signing on to studies about what potential conflicts might arise with the sponsor and set the ground rules for such areas as access to data, manuscript preparation, and right to publish.

Cardiovascular health of Americans is "at a crossroad"

Mon, 14 Sep 2009 16:00:00 EDT

The number of Americans who have a low cardiovascular risk-factor profile is decreasing, indicating that after two decades of improvement, progress appears to be reversing. The overriding driver of this phenomenon is excessive weight, say the researchers, which in turn contributes to hypertension and diabetes, itself a major contributor to heart disease.

Ghost authorship on the wane, but guest authorship still common

Fri, 11 Sep 2009 11:00:38 EDT

UPDATED // Compared with a 1996 survey by JAMA editors, a 2008 survey indicates that the practice of having ghost writers pen papers, then not appear as authors, is down to 8%, from 12% in 1996. The practice of inviting a prominent name to appear in the list of authors, without requiring that person to contribute to the research, has held steady at roughly 20%.

Novel insulin-resistance variant identified

Thu, 10 Sep 2009 14:00:29 EDT

A new genetic variant associated with type 2 diabetes has been identified; crucially, this appears to be implicated in insulin resistance rather than having an effect on beta-cell activity in the pancreas.

MIST correction published; no new information on disputed echo review for PFO/migraine trial

Wed, 09 Sep 2009 14:30:44 EDT

UPDATED // The correction in Circulation runs over 700 words long, with a four-page data supplement, but includes no details on residual-shunt data allegedly obtained with an "off-protocol" review of the echocardiographic results.

New ESC guidelines on infective endocarditis

Wed, 09 Sep 2009 09:45:03 EDT

The ESC issues new recommendations on the prevention, diagnosis, and treatment of infective endocarditis—"an old but changing disease." The guidance with respect to antibiotic prophylaxis is similar to US advice, experts say.

Experts question routine aspirin for patients with type 2 diabetes

Tue, 08 Sep 2009 12:30:07 EDT

Not all patients with type 2 diabetes respond in the same way to aspirin, and its routine use in the primary prevention of cardiovascular events in this population needs careful evaluation in large randomized controlled trials, experts say.