Traditional yoga is done by slowly stretching the body into a variety of poses while focusing on breathing and meditation. “Yoga is designed to bring about increased physical, mental and emotional well-being,” said M. Mala Cunningham, Ph.D., counseling psychologist and founder of Cardiac Yoga. “Hand in hand with leading a heart-healthy lifestyle, it really is possible for a yoga-based model to help prevent or reverse heart disease. It may not completely reverse it, but you will definitely see benefits.”

AHA Recommendation for Physical Activity

For overall health benefits to the heart, lungs and circulation, perform any moderate- to vigorous-intensity aerobic activity using the following guidelines:

• Get the equivalent of at least 150 minutes of moderate intensity aerobic physical activity (2 hours and 30 minutes) each week.
• You can incorporate your weekly physical activity with 30 minutes a day on at least five days a week.
• Physical activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
• Include flexibility and stretching exercises.
• Include muscle strengthening activity at least two days each week.

Yoga can be used to improve heart health as a preventive measure or after facing a cardiac event, said Cunningham, who has taught yoga for 40 years and is also president of Positive Health Solutions.

Why  yoga?
Thinking prevention? As part of an overall healthy lifestyle, Cunningham said yoga can help lower blood pressure, increase lung capacity, improve respiratory function and heart rate, and boost circulation and muscle tone. It can also improve your overall well-being while offering strength-building benefits.

Yoga also has proven benefits for those who have faced cardiac arrest, heart attack or other heart event, according to Cunningham. “The acute emotional stress of such an event certainly has a significant and adverse effect on the heart,” she said. “That’s where yoga can be a tremendous benefit to manage the stress.” For example, Cunningham said that half of bypass surgery patients go through depression, facing emotions ranging from anxiety to grieving. “All these things come into play when you’ve got a potentially chronic disease to manage for the rest of your life.”

The calming benefits of yoga may help with that — and you may see benefits right away. After your first yoga class, your blood pressure will likely be lower, you’ll be relaxed and you’ll feel better, Cunningham said.

Long-term, sustained yoga may play a role in improving overall health, according to Cunningham.

“The more energy you put into it, the more you’re going to get out of it,” she said. “After 12 weeks, you may see a dramatic increase in exercise functionality, and blood pressure and cholesterol levels may decrease.”
If you have heart disease, diabetes or are obese, check with your doctor before starting a yoga program. “I highly recommend going to a qualified and trained cardiac medical yoga instructor,” Cunningham said.  To find an instructor in your area, check with your local cardiac rehab center or visit cardiacyoga.com.

If you ask women to name the number one cause of death, most will say cancer. But University of Alabama at Birmingham experts say more women die from heart disease than all forms of cancer combined, and many of these deaths are preventable.

“One of every three women will die of heart disease,” says Donna Arnett, Ph.D., chair of the Department of Epidemiology in the UAB School of Public Health. Arnett, who is president-elect of the American Heart Association, says one in eight women get breast cancer and as many as 94 percent survive, yet women are more afraid of cancer than heart disease.

“I think with all the media coverage of breast cancer, women are unaware that heart disease actually kills more women, young and old,” Arnett says.

“For some reason women still don’t perceive themselves to be at risk for heart disease,” says Vera Bittner, M.D., professor of medicine in UAB’s Division of Cardiovascular Disease and section head of Preventive Cardiology.

“Women see it as a men’s disease, and they are more likely to interpret chest discomfort as coming from indigestion instead of a heart attack,” says Bittner.

Symptoms of a heart attack in woman also may differ from those in men. “Many women may not have the classic chest pain or jaw discomfort. Women may often have more nausea and vomiting or back pain than men,” Arnett says.

To combat the onset of the disease, Arnett points to the Life’s Simple 7 plan, which focuses on managing blood pressure, reducing blood sugar, quitting smoking, losing weight, getting active, controlling cholesterol and eating better.

“Women need to take as much care of themselves as they do for their families. You cannot put yourself last, but women tend to do that,” Arnett says.

But during American Heart Month, Arnett and Bittner want to draw attention to the good news about this disease — it’s preventable.

“A lot of people think if they are genetically predisposed, that is a fate they cannot alter, and that is not true,” Bittner says. “The patient has a lot of control.”

The heart-healthy focus needs to start as young as childhood, Bittner says. Any risk factors you have as a kid can become exaggerated as an adult, she says.

“We like to do primordial prevention, which is prevention of risk factors themselves. In the younger age groups the focus needs to be on lifestyle — getting regular exercise, having a heart healthy diet, maintaining normal weight and staying away from smoking,” Bittner says.

“If you make it to age 50 with normal cholesterol levels, are non-diabetic, not hypertensive or overweight, have a healthy diet, get physical activity and have never smoked, then your chances of developing heart disease are close to zero,” Arnett says.

But if you don’t get to that magic number without some bumps in the road, both doctors advise you not to despair — it’s almost never too late to start focusing on heart health.

Source: JPost.com

Minimally invasive procedure

Just as machines wear out with age, so do moving parts in the human heart.

For years, surgeons have replaced failing heart valves with artificial devices during open-heart surgery. But that requires stopping the heart and placing patients on a heart-lung bypass machine, and many are too frail to survive such drastic treatment.

Now, they have an option besides waiting to die.

With a minimally invasive procedure called transcatheter aortic valve replacement, doctors can thread an artificial valve to the heart without cracking open a patient’s chest.

“This is going to be a game changer,” said Dr. Yele Aluko, a cardiologist at Mid Carolina Cardiology in Charlotte.

In the last week and a half, Aluko has led a team of Presbyterian Hospital doctors that performed the procedure on four patients, all age 80 or older. Presbyterian is the first hospital in the Carolinas to offer the new procedure outside of clinical trials at Duke University and Wake Forest University.

Doctors at Sanger Heart & Vascular Institute have scheduled their first two patients for the procedure Wednesday at Carolinas Medical Center.

The treatment became available in November, when the Food and Drug Administration approved the Sapien artificial valve made by California-based Edwards Lifesciences. It is approved only for older, high-risk patients who cannot withstand open-heart surgery.

The study leading to FDA approval found that, despite a risk of stroke and other complications, the valve replacement procedure “significantly reduced the rates of death from any cause” for patients whose average age was 83.

Aluko and other doctors say the procedure’s significance for treating valve disease is comparable to the use of balloon angioplasty and stents as less invasive alternatives to open-heart bypass surgery for blocked arteries.

The procedure “is a transformational technology that brings hope to people that did not have a solution to their potentially lethal problem,” said Dr. Murat Tuzcu, a cardiologist at the Cleveland Clinic, which is affiliated with Presbyterian and is one of 26 medical centers that tested the Sapien device.

Common in people over 60

Heart valve disease is not as prevalent as coronary artery disease, but it is common in people over 60.

About 1.5 million Americans suffer from aortic stenosis – a narrowing of the major artery that supplies the heart and body with blood. About 500,000 have severe disease. Once symptoms occur, more than half of patients will die within two years without treatment.

“This is a very common problem as we get older,” said Dr. William Downey, a Sanger cardiologist. He said he sees about three patients a week with aortic stenosis compared to 30 a week with coronary artery disease.

“There are no medicines that can improve it,” he said. “It’s really bad and universally fatal (in a year or two) unless we replace the valve.”

In recent years, heart specialists eagerly awaited results of clinical trials the new way – implanting valves via catheters threaded through vessels, the way stents are delivered to open blockages.

The Sapien valve, made of cow tissue and polyester, is the only one approved for this use, but a second valve, made by Medtronic, is under study. Doctors at Duke and Wake Forest are participating in the latter trial and have been doing catheter-based valve replacements for about a year.

“Opening the chest is still the standard of care,” said Dr. Kevin Harrison, a cardiologist leading the Duke trial. “These valves are reserved for patients that have higher risk … and are turned down for open-heart surgery. You wouldn’t want to recommend that as a standard option for a patient that has a standard risk.”

Collaboration required

In the new procedure, the valve is compressed at the end of a catheter, slightly wider than a pencil. It’s inserted into a leg artery through a small incision in the groin. From there, the catheter is snaked to the heart, where it’s released and expanded with a balloon. The new valve replaces the body’s original, which does not have to be removed.

Patients are anesthetized during the procedure, and their hearts continue beating. Doctors monitor the catheter and valve placement using images from cardiac ultrasound and X-rays.

A team of doctors – including interventional cardiologists, heart surgeons and imaging specialists – work in a “hybrid operating room” that accommodates both cardiac catheterization and surgery. Both Presbyterian and CMC have built such rooms, at a cost of $1.5 million and $2 million, respectively.

Unlike angioplasty and stent placement, which are performed by cardiologists usually without input from surgeons, the new valve treatment requires collaboration among many specialists, Aluko said. They meet regularly to discuss cases and decide which patients are appropriate for the treatment.

“Not everybody who has aortic stenosis who is old is eligible for this,” Aluko said. “The surgeon has to say, ‘I can’t operate on you.’ ”

Risks and benefits

Despite enthusiasm among heart specialists and valve manufacturers, some doctors urge caution.

“It’s a very high-risk procedure, and it takes a lot of training,” said Dr. Rita Redberg, a cardiologist at the University of California in San Francisco. “I think we need more data on more patients and long follow-up to know truly how this is going to stack up.”

In a letter to the New England Journal of Medicine after it published results of the Sapien trial, Redberg noted the “alarmingly high percentage of patients” who had strokes after the procedure.

Redberg said it should take more than one study to get FDA approval. “It’s a very expensive device to put in,” she said. “And it’s a big device. It’s not easy to use.”

There is a risk of bleeding as the result of damage to vessels as the valve, inside a catheter, is threaded to the heart.

In the study, patients who received the valve were 2 1/2 times more likely to have a stroke and eight times more likely to have a bleeding complication than patients who didn’t.

But those who had the procedure were more likely to be alive one year later than those who didn’t. After a year, 69 percent of patients were alive compared to 50 percent of those who didn’t get the valve.

As part of approval, the FDA is requiring a registry to track patients who get the new valve. Redberg said this is important to show whether problems develop as it’s used more widely. The Sapien study involved 365 patients, but only half received the valve.

A financial analysis of the Sapien valve study suggested the total cost for transcatheter aortic valve replacement was about $80,000. Edwards Lifesciences projects U.S. sales of the device at $200 million to $260 million in 2012.

Presbyterian patient

Fred High, a retired elementary school principal from Monroe, is one of the first two Presbyterian patients who had the procedure Jan. 12.

At 80, High had been told by doctors that he was too old and sick to have open-heart surgery to replace his aortic valve. Without treatment, they said he’d probably die in a year.

Since 1996, when High had a heart attack, he said he has been “too weak to do anything.” He’s been using leg braces, a cane, a walker and a motorized scooter to get around, said Larry High, one of his three grown sons.

After the procedure, Larry High said his father looked “fantastic.”

From his hospital bed, Fred High said he looks forward to being more active. “I hope to have a better life all the way around. I want to keep up with my family. They’re young and agile.”

His wife, Wanda, said: “We’re just excited about all of this. We think he’s going to have a longer life and happier life and a better life.”

Presbyterian’s other patients declined to be identified publicly, but Aluko said they are all doing well.

The new procedure won’t replace open-heart surgery, but Aluko said it could, with further study and refinement, become available for younger patients who may be as frail.

“This is the beginning of a potential revolution in the treatment of valve disease.”

Source: charlotteobserver.com

Researchers in Boston said that while there is no proof that a few extra inches protect the heart, it was possible that short and tall people are different in other ways, including in their diets or diseases growing up, and that this too could affect heart risks.

“This study doesn’t say any-thing definite about whether height, itself, is going to lead to anything,” said lead researcher Luc Djousse, of Brigham and Women’s Hospital and Harvard Medical Center.

But the researchers, whose findings were published in the American Journal of Cardiology, said it’s also possible that something about the biology of taller people, such as the distance between their hearts and certain branches of arteries and blood vessels, could decrease stress on the heart.

Data came from 22,000 male doctors who were followed as part of a large study of heart disease and cancer, starting when they were in their mid-50s, on average.

After responding to an initial questionnaire that asked about their height, weight and health condition, the men filled out followup surveys where they reported new medical diagnoses every year. The report included data from an average 22 years of that followup, during which 1,444 men, or about seven per cent, developed heart failure.

The taller men were, the lower their chance of heart failure, the researchers found.

The tallest men in the study, those over six feet, were 24 per cent less likely to report a heart failure diagnosis during the study period than men who were 5-foot-8 and shorter.

That was after their age and weight, as well as whether they had high blood pressure and diabetes, had all been taken into account. Even with those considerations, the study couldn’t prove that there wasn’t another reason for the findings, said Jeffrey Teuteberg, a cardiologist at the University of Pittsburgh Medical Center who was not involved in the study.

Others agreed, noting that how rich or poor the participants were growing up, and what their nutrition was like during key periods, could also have had an effect on both height and overall heart health. Djousse said that childhood infections could both stunt growth and ultimately lead to plaque buildup in the arteries and high blood pressure, which are tied to heart failure.

A taller frame might mean that when blood is directed back to the heart at certain points in artery and blood vessel branches, it takes longer to get there or hits the heart during a less-stressful part of its rhythm, Teuteberg said.

He added that height is not a big consideration when thinking about heart risks. “The message certainly shouldn’t be: ‘If you’re tall, don’t worry about these sorts of things, or if you’re short, you’re doomed.”

Source: vancouversun.com

The researchers found that women of childbearing age who never ate fish had 50 percent more cardiovascular problems than women who ate fish often, and a 90 percent higher risk than women who ate fish weekly.

“We found that even women who ate fish only a couple of times a month benefited,” said lead researcher Marin Strom, a postdoctoral fellow at the Center for Fetal Programming at the Statens Serum Institute in Copenhagen.

“Women who eat fish should find the results encouraging, but it is important to emphasize that to obtain the greatest benefit from fish and fish oils, women should follow the dietary recommendations to eat fish as a main meal at least twice a week,” she said.

However, the report, published in the Dec. 5 online edition ofHypertension, doesn’t show a cause-and-effect relationship between eating fish and lowering cardiovascular risk, merely an association.

Strom’s team collected data on some 49,000 pregnant women between 1996 and 2008. They asked how much and what fish they ate, hoping to determine if eating certain types of fish helps reduce the risk of cardiovascular disease. The women, aged 15 to 49 at the study’s start, were also asked about lifestyle and family medical history.

Over eight years of follow-up, 577 cardiovascular events — including hypertension, stroke and heart disease — were recorded. Five women died of cardiovascular disease.

Overall, more women who ate little or no fish were hospitalized for cardiovascular disease than those who ate fish, the researchers found.

When the researchers evaluated a subset of woman on three different occasions, the risk for cardiovascular disease was three times higher for women who never ate fish than for women who ate fish that was high in omega-3 at least once a week, they added.

Fish oil has long chain omega-3 polyunsaturated fatty acids, which appear to be the protective factor against heart and vascular disease, Strom explained.

“The best sources to obtain the long chained omega-3 fatty acids are fatty fish, such as salmon, herring, mackerel, trout, and Greenland halibut,” Strom said.

The fish the women reported eating most often were cod, plaice, salmon, herring, and mackerel. Women who took fish oil supplements were excluded from the study.

Although fried fish may be less healthy, it probably doesn’t eliminate the fatty acids, Strom said.

According to Strom, similar studies in the past focused on men, not women. “To our knowledge this is the first study of this size that focuses exclusively on women of childbearing age,” she said.

Both sexes share many of the same risk factors for cardiovascular disease, but certain ones, such as inflammation, triglyceride and cholesterol, might be more important in women, she noted.

“This study substantiates a cardioprotective effect of fish intake and underlines the importance of promoting fish intake by dietary recommendations,” Strom said. The positive effect noted with even modest fish consumption is encouraging for people who aren’t big fish eaters, she added.

The authors acknowledge some limitations to the study, including that the data were self-reported.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said the findings are consistent with other studies in older women and in men.

“This study provides further supporting data that omega-3 fatty acids in the diet or as supplements are cardioprotective,” Fonarow said.

Source: Health.com

“This study provides new evidence that preoperative aspirin therapy (versus no preoperative aspirin) is associated with a significant decrease in risk of 30 day mortality (3.5% versus 6.5%), renal failure (3.7% versus 7.1%), dialysis required (1.9% versus 3.6%), ICU stay (average 107.2 hours versus 136.1), and a composite outcome — MACE (8.7% versus 10.8%); and is not associated with increased risk of readmissions (14.5% versus 12.8%),” Jianzhong Sun, MD, PhD, of Thomas Jefferson University in Philadelphia, and colleagues wrote in Annals of Surgery.

Moreover, aspirin was beneficial even though patients taking preoperative aspirin were significantly older and had more comorbidities than those not taking aspirin.

Taken together, preoperative aspirin seems to have efficacy in the face of the “most important confounding factors — comorbidities” in these high-risk patients, they said.

Previous studies have found a benefit for early postoperative aspirin therapy after coronary artery bypass graft (CABG) surgery, but evidence supporting the role of preoperative aspirin therapy was less consistent, they said.

The investigators wrote that the Society of Thoracic Surgeons and the European Association for Cardio-Thoracic Surgery recommend discontinuation of aspirin several days prior to cardiac surgery, which also had been the recommendation of the American College of Cardiology (ACC) and the American Heart Association (AHA).

However, in updated guidelines released in November, the ACC and AHA now recommend preoperative aspirin before CABG surgery.

Sun and colleagues analyzed data from 2,868 consecutive patients undergoing CABG, valve surgery, or other cardiac surgery at Thomas Jefferson and UC Davis Medical Center in Sacramento, Calif.

The aspirin group comprised 1,923 patients, while the non-aspirin group consisted of 945 patients.

The major outcomes included 30-day all-cause mortality, postoperative renal failure and/or dialysis required, and a composite outcome of major adverse cardiocerebral events (MACE). MACE included permanent or transient stroke, coma, perioperative MI, heart block, and cardiac arrest. The researchers also looked at readmissions and ICU length of stay.

A total of 1,474 patients underwent CABG, 620 valve surgery, 442 CABG plus valve surgery, and 332 other cardiac surgery.

Overall, the 30-day all-cause mortality rate occurred in 4.5% of patients. In the unadjusted univariate analysis, the breakdown was 3.5% versus 6.5% for those taking and not taking aspirin, respectively (P<0.001).

In the unadjusted analysis, preoperative use of aspirin significantly reduced postoperative renal failure (3.7% versus 7.1%, P<0.001), dialysis required (1.9% versus 3.6%, P=0.007), and ICU stay (107.2 total hours versus 136.1, P<0.001). There was no difference in readmission rates between the two groups.

However, when the researchers adjusted for propensity score and covariates, they found no significant effect of preoperative aspirin on cardiocerebral events that included permanent stroke, transient ischemic attack, coma, heart block, and cardiac arrest. There was, however, a significant reduction in the risk of MACE, perioperative MI, renal failure, dialysis required, and 30-day mortality.

“The extent and scope of the effect (multiple diverse organs protection) of preoperative aspirin in cardiac surgery patients as showed in this study were unexpected and are most likely a reflection of its anti-inflammatory effect rather than its antithrombotic effect,” the authors wrote.

They cautioned that their findings might “overestimate the effect that might be achievable in clinical practice,” but noted that similar findings have been reported, most notably from Mangana, et al. (N Engl J Med 2002; 347: 1309–1317). A small 2005 study by Gerrah, et al. found that aspirin before CABG surgery resulted in shorter ICU stays.

Although further studies are needed, Sun and colleagues suggested that the benefits of preoperative aspirin, particularly low-dose aspirin, may outweigh the risk of bleeding.

The study is limited by potential biases associated with observational studies, researchers said. Also, the data did not indicate dosage or duration of aspirin therapy. However, they said that preoperative use generally means chronic use.

Source: MedPageToday.com

Reducing salt is still very important in people consuming more than 6,000 or 7,000 milligrams of sodium per day, said Dr. Martin O’Donnell, lead author of a study in the Nov. 23/30 issue of the Journal of the American Medical Association.

But people who already consume moderate or average amounts of salt may not need to reduce their intake further, added O’Donnell, an associate clinical professor at McMaster University in Hamilton, Ontario, in Canada.

“We’re seeing more and more that there may be an optimal moderate amount of salt that people should be eating,” said Dr. John Bisognano, professor of medicine and director of outpatient cardiology at the University of Rochester Medical Center, in New York. “This is reassuring for people who eat a diet that is moderate in salt.”

Bisognano was not involved with the study, which was funded by pharmaceutical company Boehringer Ingelheim.

After years of seemingly happy agreement that people should lower their salt intake, experts recently have begun debating whether or not lower salt intake is actually good for everyone.

One recent study found that although cutting back on salt does lower blood pressure, it may also increase levels of cholesterol, triglycerides and other risk factors for heart disease.

Another study found that lower sodium excretion (sodium excretion is a way to measure how much salt is consumed) was associated with an increased risk of heart-related deaths, while higher sodium excretion was not linked with increased risks for blood pressure or complications from heart disease in healthy people.

However, in the latest study, results were somewhat different.

These authors looked at how much sodium and potassium were excreted in urine in a group of about 30,000 men and women with heart disease or at high risk for heart disease. Participants were followed for an average of more than four years.

In this study, sodium excretion levels that were either higher or lower than the moderate range were each associated with increased risk.

For example, people who excreted higher levels of sodium than those with mid-range values had a greater risk of dying from heart disease, heart attack, stroke and hospitalization for heart failure, the report found.

On the other hand, people who excreted lower levels than mid-range were at a raised risk of dying from heart disease or being hospitalized for heart failure.

When the researchers assessed potassium levels, they found that a higher level of excretion of the nutrient was associated with a lower risk of stroke.

“The importance of potassium intake needs to be emphasized, a finding that may be lost in the discussion on sodium,” said O’Donnell, who is also an associate professor of translational medicine, at the National University of Ireland in Galway. “Diets rich in fruit and vegetables are also rich in potassium intake.”

It’s not clear if these findings — which came from a population already at high risk for heart trouble — may also apply to lower-risk populations.

“They’re really looking at the sickest of the sick. How does that apply to all of us?” said Dr. Daniel Anderson, an assistant professor of medicine at the University of Nebraska Medical Center. “I think the difficulty is it probably doesn’t. I worry that we’re going to misinterpret this as meaning that too little sodium is a bad thing.”

Bisognano agreed. “We don’t want to give people the message that they should salt their pizza from this point forward,” said Bisognano.

But consuming the right amount of sodium is only one aspect of heart health, said Karen Congro, director of the Wellness forLife Program at the Brooklyn Hospital Center in New York City.

“It’s not the be all and end all. You have to do other lifestyle interventions,” she said.

New U.S. dietary guidelines now recommend that people aged 2 years and older limit daily sodium intake to less than 2,300 milligrams (mg).

People aged 51 and older, blacks and anyone with high blood pressure, diabetes or chronic kidney disease should consider going down to 1,500 mg per day, many experts say.

It’s estimated that the average American consumes 3,400 milligrams of sodium a day.

Source: USNews.com

A total of 18 UAE cardiology experts attended the Gulf COAST Investigator Meeting recently to decide on plans and timelines for the launch of the “Gulf loCals with acute CorOnAry Syndrome evenTs” Registry, or Gulf COAST Registry.

“Heart disease is the number one killer, both in the region and in the UAE, accounting for 25 to 30 per cent of UAE deaths,” said Dr Fahad Omar Baslaib, President of the Emirates Cardiac Society and Head of the Cardiology Department at Rashid Hospital.

“This study is an important step for both our country and our region. Heart disease disproportionately affects our region, with the average age of acute coronary syndrome patients across the Middle East a decade younger compared with the West, and this study will help us understand why. At the investigator meeting, we will be working with renowned experts from across the region to agree on a path forward for the study.”

“We already know that many of our citizens suffer and die from heart disease. But, without understanding both the extent of the problem and how it’s actually being treated, it is difficult to make recommendations to improve patient care,” said Dr Abdulla Shehab, vice president of the Emirates Cardiac Society.

“While significant data exist at the international level, we lack the regionally specific information necessary to better understand and address ACS and the needs of our citizens. Gulf COAST will deliver the robust local data that we require,” he added.

Gulf COAST is a collaborative effort among leading cardiologists from Oman, Bahrain, the UAE and Kuwait. The study will track 4,000 Gulf citizens across 35 hospitals in the region for up to one year, who are admitted with a diagnosis of ACS, a leading form of heart disease associated with cardiovascular events such as heart attack.

The meeting marked a significant milestone in a process that began in Dubai this past June, with the signing of a Memorandum of Understanding (MOU) for coronary research by AstraZeneca Gulf.

Tarek Rabah, area vice president, Middle East and Africa, said: “Improving health is one of the toughest challenges facing the world today. But we can’t do it alone. Under the guidance of leading experts like Dr Fahad Omar Baslaib and Dr Abdulla Shehab, great research, such as the Gulf COAST study, will drive this quest for better health.”

“Gulf COAST aims to better understand and collect information of the state of patients with heart disease or Acute Coronary Syndrome, from the moment of hospitalization to discharge. This is crucial for patients’ long-term wellbeing and even survival.

AstraZeneca is committed to supporting the best possible care for patients, and ensuring that they are supported throughout their disease management and treatment,” he added.

The high-level objectives of Gulf COAST are to understand the incidence of ACS and regional risk factors and outcomes, to benchmark against current accepted practices and guidelines, and to establish a network of collaborators in this research.

Gulf COAST will cover the patient from the time they arrive at the hospital, through discharge and beyond, up to one year.

Gulf COAST is supervised by a 17-member study Steering Committee of senior cardiologists and leading experts from the four countries and an international scholar from the US.

Source:  TradeArabia.com

Linsay Gray, Ph.D., from the U.K. Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit in Glasgow, and colleagues investigated the correlation between early adulthood blood pressure and CVD mortality in men, taking into account middle-age hypertension. Blood pressure was measured in 18,881 males at university entry (1914 to 1952; mean age, 18.3 years), who subsequently reported their physician-diagnosed hypertension status at a mean age of 45.8 years (1962 to 1966) via mailed questionnaires. Participants were followed through 1998 for mortality.

The investigators found that, compared to participants who were normotensive at college entry (<120/<80 mm Hg), the multivariate adjusted risk of CHD mortality in men increased across blood pressure categories of pre-hypertension (hazard ratio [HR] for 120 to 139/80 to 89 mm Hg, 1.21), stage 1 (HR for 140 to 159/90 to 99 mm Hg, 1.46), and stage 2 hypertension (HR for ≥160/≥100 mm Hg, HR, 1.89). The estimates were reduced slightly after accounting for middle-age hypertension, but the pattern remained the same. Total and CVD mortality, but not stroke mortality had similar associations.

“Higher measured blood pressure in early adulthood was associated with an elevated risk of total, CVD, and CHD mortality several decades later, which appeared to persist even after accounting for self-reported hypertension in middle age,” the authors write.

Source: DoctorsLounge.com

The ATLAS ACS 2 trial pointed to a new era of triple antithrombotic therapy for prevention after a heart attack or unstable angina, Clyde W. Yancy, MD, chief of cardiology at Northwestern University in Chicago and a past president of the AHA, toldMedPage Today senior staff writer Crystal Phend.

Rivaroxaban (Xarelto) saved lives when added to dual antiplatelet therapy in that study, although with a much lower dose of the oral anticoagulant than used clinically in atrial fibrillation or for prevention of deep vein thrombosis.
“We have to be smart here,” Yancy cautioned. “As we start to use these newer antithrombotics, dose will matter and dose in the context of the disease will matter.”

He also pointed to practice-changing lessons in prevention from negative findings with extended-release niacin in the AIM-HIGH trial and the novel antiplatelet vorapaxar in TRACER and to the positive findings for a weight loss intervention in POWER and atherosclerosis regression with statin therapy in SATURN.

Source: MedPageToday.com