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Heart NewsAmerican Heart Association Scientific Statement addresses gaps in training that lead to flat survival rates for cardiac arrest victims Circulation Journal ReportCirculation Journal ReportAmerican Heart Association, American Diabetes Association, Boehringer Ingelheim, Eli Lilly and Company, and Novo Nordisk unite to raise awareness about the dangerous link between type 2 diabetes and cardiovascular disease ATVB Journal Report Journal of the American Heart Association Report Circulation: Cardiovascular Quality and Outcomes Journal Report Circulation Journal ReportJournal of the American Heart Association Report Informe científico de la American Heart Association American Heart Association Scientific Statement Journal of the American Heart Association Report American Heart Association Scientific Statement Circulation: Heart Failure Journal Report American Heart Association Scientific Statement Journal of the American Heart Association Report American Heart Association Scientific AdvisoryHypertension Journal Report Circulation: Cardiovascular Intervention Journal Report American Heart Association Scientific Advisory
Updated: 2 min 56 sec ago

Improved CPR training could save more lives, research finds

5 hours 16 min ago
Statement Highlights:

  • Addresses gaps in resuscitation training that lead to flat survival rates for cardiac arrest victims.
  • Standardized online and in-person courses are falling short and not always implemented to optimize retention and mastery.
  • Examines best practices in education and applies the learning in new resuscitation science, offering suggestions for improvement in training on eight key elements.

Embargoed until 9:01 a.m. CT / 10:01 a.m. ET Thursday, June 21, 2018

DALLAS, June 21, 2018 — More people will survive cardiac arrest if resuscitation course designers and instructors address shortcomings in educational offerings, new research shows. A new statement released today by the American Heart Association, the world’s leading voluntary health organization devoted to fighting cardiovascular disease, in its journal Circulation, indicates standardized online and in-person courses are falling short and not always implemented to optimize retention and mastery.

Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest examines best practices in education and applies the learning in new resuscitation science, offering suggestions for improvement in training on eight key elements:

  • Mastery learning and deliberate practice (practice until learners demonstrate mastery of skills)
  • Spaced practice (shorter, more frequent learning sessions)
  • Contextual learning (use of “real world” training experiences recognized by learners)
  • Feedback and debriefing (providing structured opportunities for reflection and feedback)
  • Assessment (measuring competency throughout a course with a variety of tools)
  • Innovative educational strategies (exploration of gamification, social and digital platforms to make learning “stick”)
  • Faculty development (continuous coaching and training of instructors)
  • Knowledge translation and implementation (localize programs to fit learners’ needs)

“Poor CPR quality is preventable. Educational activities are not consistently achieving their intended outcomes, as proven by significant decay in provider skills within months after training,” said Adam Cheng, M.D., associate professor at the University of Calgary, Alberta Children’s Hospital.

The Association is striving to double survival rates from cardiac arrest to 38 percent in-hospital and 15.8 percent for out-of-hospital as well as double bystander response to out-of-hospital cardiac arrest to 62 percent by the year 2020.

This statement marks the first time that resuscitation specialists have applied education best practices to resuscitation training, offering consolidated guidance to CPR instructors, educators and others who develop relevant content. It is applicable to all resuscitation training programs with students as diverse as medical professionals to bystanders.

“If we want to move the needle on cardiac arrest survival rates in the next two years, then we must focus on improving the quality of resuscitation education and knowledge translation efforts,” added Cheng, who is also an American Heart Association volunteer. “We identified an opportunity to build on the current scientific process in order to close the gap between desired and actual performance in resuscitation events – both for lay providers and healthcare professionals.”

For development of this statement, the Association assembled a steering committee whose members had expertise in resuscitation science and resuscitation education. This committee identified individuals with expertise in a key topic area for its working groups; various professions (nursing, medicine, paramedicine, respiratory therapy, psychology, research, education and hospital administration) and clinical specialties (critical care, pediatrics, neonatology, emergency medicine, anesthesia, internal medicine and cardiology) were represented in each working group.

The statement’s authors systematically examined the relevant published research, as well as published reviews relevant to the topic. The Association then held an educational summit focused on the eight key topic areas that are most likely to lead to improvements in educational and patient outcomes. Small-group sessions and roundtable discussions were integrated into the summit which allowed refinement of the recommendations coming from the literature review.

Since establishing its Guidelines for CPR & Emergency Cardiovascular Care in 1966, the Association has led evaluation and dissemination of the latest resuscitation science to help inform and modernize CPR. These guidelines have been used to train more than 22 million people annually in CPR, cardiovascular care and first aid around the world. This Statement builds on the Guidelines to help support improvement in CPR education and implementation – and ultimately save more lives.

The Association’s CPR and Emergency Cardiovascular Care courses include several of the eight key concepts, such as the flexibility to localize (contextualize) and standard performance based on observable behavior. In the coming months, the Association will examine its current courses to emphasize ways to further implement these concepts.

Additional Resources:

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About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries: 214-706-1173

Marie Manning:703-965-2788, marie.manning@heart.org

For Public Inquiries: (800) AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsScientific Statements/GuidelinesThu, 21 Jun 2018 14:02:06 GMTStatement Highlights: Addresses gaps in resuscitation training that lead to flat survival rates for cardiac arrest victims. Standardized online and in-person courses are falling short and not always implemented to optimize retention and...https://newsroom.heart.org/news/improved-cpr-training-could-save-more-lives-research-findsThu, 21 Jun 2018 14:01:00 GMT

Gene editing technology may improve accuracy of predicting individuals’ heart disease risk

Tue, 06/19/2018 - 09:16
Study Highlights:

  • Gene-editing technology may help scientists discern whether genetic variations with undetermined effects are harmless or dangerous.
  • Researchers used the technology to assess a genetic variant suspected to have a role in enlarged hearts.
  • Gene editing may help assess a person’s individual disease risk and improve the quality and predictive abilities of precision medicine.

Embargoed until 4 a.m. CT / 5 a.m. ET Monday, June 18, 2018

DALLAS, July 18, 2018 — Scientists may now be able to predict whether carrying a specific genetic variant increases a person’s risk for disease using gene editing and stem cell technologies, according to new research in the American Heart Association’s journal Circulation.

For the first time, the study demonstrates the unique potential of combining stem cell-based disease modeling (Induced pluripotent stem cells) and CRISPR/Cas9-mediated genome editing technology as a personalized risk-assessment platform for determining the disease-causing ability of a yet undescribed genetic variant, known as a “variant of uncertain significance" or VUS.

Numerous genetic variations are identified as “related” to a medical condition, but it is uncertain if they actually lead to disease, said study senior author Joseph C. Wu, M.D., Ph.D., director of the Stanford Cardiovascular Institute and Simon H. Stertzer, M.D. Endowed Professor in the Department of Medicine (Cardiology) and Department of Radiology at the Stanford University School of Medicine in California.

“Random genetic testing will create a lot of stress for a healthy individual who may be getting echocardiograms, MRIs or medications that they may not need,” Wu said. “Results from this study will help improve the interpretation and diagnostic accuracy of gene variants, especially in the era of personalized medicine and precision health. The goal is to optimize the decision making of clinicians in their choices of therapy by providing a much clearer result for the ‘variant of uncertain significance’ carriers.”

Researchers studied genetic variants associated with hypertrophic cardiomyopathy, a condition in which the heart muscle thickens. It is a common cause of sudden cardiac death in young people and young athletes.

They harvested DNA from 54 "healthy" or symptom-free individuals without heart disease, then sequenced their DNA using a custom DNA panel of 135 cardiomyopathy and congenital heart disease genes associated with sudden cardiac death.

The sequence results uncovered 592 unique genetic variants, with 78 percent of genetic variants being classified as “benign,” “likely benign,” or a “variant of uncertain significance.” However, 17 genetic variants were annotated as “likely pathogenic” or disease-causing.

One individual who had multigenerational family members carrying a variation in gene MYL3, which is associated with hypertrophic cardiomyopathy, was chosen in this study.  

After collecting the patients’ peripheral blood mononuclear cells, the cells were reprogrammed to induced pluripotent stem cells (iPSCs) and genome edited using the CRISPR/Cas9 gene editing technology to engineer cells with the same genetics (isogenic iPSC lines). Comprehensive analysis was next performed on the engineered cell lines to determine the MYL3 variant could lead to disease.

Traditionally, treating hypertrophic cardiomyopathy depends on whether a patient has symptoms and the severity of those symptoms. People who have "silent" hypertrophic cardiomyopathy without symptoms are not treated. For those with symptoms, physicians may recommend lifestyle changes such as adopting a heart-healthy diet, reducing stress and incorporating exercise while treating underlying illnesses that can make the condition worse. They may also prescribe medications for hypertrophic cardiomyopathy, typically reserving surgery for more severe cases.

“Given the diversity of the human genome – no one of us is identical to another – it is difficult to determine whether a genetic “variant” is meaningful or not. As a result, we risk treating patients with medications or more for a variant that, in the end, is benign,” said Circulation editor, Joseph A. Hill, M.D., Ph.D., chief of cardiology at UT Southwestern Medical Center in Dallas. “This study combined two new powerful technologies, induced pluripotent stem cells and CRISPR-Cas9 gene editing, to model a patient’s heart in a dish and to test whether those heart cells manifested signs of disease. This approach heralds a new era of in vitro disease modeling and drug testing as pivotal elements of precision medicine.”

Co-authors are Ning Ma, Ph.D.; Joe Zhang M.D., Ph.D.; Ilanit Itzhaki, Ph.D.; Sophia Zhang, Haodong Chen, Ph.D.; Francois Haddad, M.D.; Tomoya Kitani, M.D., Ph.D.; Kitchener D. Wilson, M.D., Ph.D.; Lei Tian, Ph.D.; Rajani Shrestha; Haodi Wu, Ph.D.; Chi Keung Lam Ph.D.; and Nazish Sayed, M.D., Ph.D. The authors had no financial disclosures.

This study was funded by the Stanford Frankenstein@200 grant, National Institutes of Health and the American Heart Association Merit Award.

Additional Resources:

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Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Bridgette McNeill: 214-706-1135; bridgette.mcneill@heart.org   

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsTue, 19 Jun 2018 14:08:00 GMTStudy Highlights: Gene-editing technology may help scientists discern whether genetic variations with undetermined effects are harmless or dangerous. Researchers used the technology to assess a genetic variant suspected to have a role in enlarged...https://newsroom.heart.org/news/gene-editing-technology-may-improve-accuracy-of-predicting-individuals-heart-disease-riskMon, 18 Jun 2018 09:00:00 GMT

Studying heart disease after death can help the living

Tue, 06/19/2018 - 09:16
Study Highlights:

  • Autopsy findings provide valuable information about causes and natural history of overall cardiovascular disease.
  • Several papers in a special issue of Circulation offer insight into how autopsy contributes to answers about the causes of sudden cardiac death, information from implantable device to improve heart function, and identifying the original cause of atherosclerosis.

Embargoed until 4 a.m. CT / 5 a.m. ET Monday, June 18, 2018

DALLAS, June 18, 2018 — Autopsy is often an overlooked source of medical insight which may be hindering advances in cardiovascular medicine, according to new research published in a special issue of the American Heart Association’s journal Circulation.

“Autopsy is a source of discovery that informs the way we think about disease systemically,” said Jeffrey E. Saffitz, M.D., Ph.D., co-editor of the special issue and chair of the department of pathology at Beth Israel Deaconess Medical Center in Boston. "Atherosclerosis, hypertension, diabetes and metabolic syndrome – these are the diseases you study during an autopsy. These are the diseases that are killing hundreds of thousands of people and autopsy is important to help understand how these diseases develop and progress.”

The special issue explores the role of autopsy in cardiovascular medicine through a series of original papers and commentaries. “If the papers and commentaries in this issue of Circulation are any indication, there is still much to be learned from autopsy,” Saffitz said.

Saffitz, pathology content editor for Circulation, sets the theme by tracing the history of autopsy back to the 16th century at the University of Padua, where Andreas Vesalius used postmortem exams to place the heart at the center of the human body the way Copernicus put the Sun at the center of the solar system.

Autopsy information provided the first image of the human coronary system 60 years ago when Monroe Schlesinger, a pathologist at Beth Israel Hospital in Boston, working with Hermann Blumgart, chief of medicine and the father of nuclear cardiology, were the first to image the human coronary system by x-ray of autopsy hearts injected with a lead-based agar medium. Their findings provided insight into the basic processes underlying chest pain and heart attack; identified collateral heart circulation; defined the anatomy of the disease heart and the vascular changes of congestive heart failure and cardiogenic shock.

Yet, the autopsy rate has declined steadily for several reasons, chief among them is because hospitals are no longer required to maintain a threshold rate of autopsies for accreditation; the lack of reimbursement for autopsies; and advances in imaging technology, which is often viewed as a substitute for autopsy. As a result, today most autopsies are done by medical examiners who are seeking a cause of death, rather than answers about disease.

In the Circulation special autopsy issue, three studies offer insight into how autopsy contributes to answers about the causes of sudden cardiac death, gathering information from implantable devices about time and cause of death as well as ways to improve heart function, and identifying the original cause of atherosclerosis – fatty deposits that can clog arteries and lead to heart attack and stroke).

The first study suggests that molecular autopsy may provide answers regarding sudden unexplained death in the young and whether surviving family members are also at risk.

Michael J. Ackerman, M.D., Ph.D., of the Mayo Clinic’s Windland Smith Rice Sudden Death Genomics Laboratory in Rochester, Minnesota, worked with an international team of scientists who studied sudden unexplained death in the young at a cellular level using a technique called whole exome molecular autopsy. The process was used on 25 cases that occurred in the Chicago area from January 2012 through December 2013. Twelve deaths were in blacks and 13 in whites.

They identified 27 ultra-rare mutations in 16 of the 25 autopsies (64 percent). Nine of those unusual defects occurred in 12 blacks (75 percent) and seven in 13 whites (54 percent). Ackerman’s team concluded that 14 percent of the cases represented mutations that could have been detected by genetic testing, which suggests the need for genetic testing of surviving family members.

Ackerman’s co-authors and disclosures are included in the manuscript. The study was funded by the Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program.

In the second study, Florian Blaschke, M.D., of the Charité – Universitaetsmedizin Berlin, Campus Virchow-Klinikum in Germany, and colleagues studied autopsy subjects with cardiac implantable electronic devices (CIEDs). These devices often store valuable downloadable information which is useful to determine cause, mechanism and time of death more precisely than autopsy alone.

The researchers collected and analyzed data from 151 cardiac implanted electronic devices – 109 pacemakers, 35 defibrillators and seven implantable loop recorders – removed during 5,368 autopsies conducted from February 2012 to April 2017. Device and data analysis determined the time of death in 70 percent of these cases and clarified the cause of death in 60.8 percent. In addition, device analysis in an important tool to detect potential CIED-related safety issues.

Blaschke’s co-authors and disclosures are included in the manuscript.

In the last study, David Herrington, M.D., M.H.S., Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues took tissue samples harvested from 100 autopsies of young adults and used mass-spectrometry to identify early signs of “re-wiring” at a cellular level that appear to be the earliest sign of atherosclerosis.

Tests of the tissue samples detected changes in a handful of mitochondrial proteins – considered the building blocks of tissue. Importantly all the changes occurred in protein networks believed to be markers for atherosclerosis.

Herrington’s work, Shaffitz said, is representative of the role autopsy information can play in the American Heart Association’s One Brave Idea initiative, which is intended as a multipronged campaign to identify the root cause of heart disease and identify strategies to prevent it.

Herrington’s co-authors and disclosures are included in the manuscript. The research was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Additional Resources:

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Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Carrie Thacker: 214-706-1665; c.thacker@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

]]>Heart NewsTue, 19 Jun 2018 14:07:18 GMTStudy Highlights: Autopsy findings provide valuable information about causes and natural history of overall cardiovascular disease. Several papers in a special issue of Circulation offer insight into how autopsy contributes to answers about the causes of sudden cardiac death, information from implantable device to improve heart function, and identifying the original cause of atherosclerosis. https://newsroom.heart.org/news/studying-heart-disease-after-death-can-help-the-livingMon, 18 Jun 2018 09:00:00 GMT

Leading health organizations collaborate with industry on new initiative to combat growing diabetes and cardiovascular disease threat

Thu, 06/14/2018 - 16:31
DALLAS, June 14, 2018 – The American Heart Association (AHA) and the American Diabetes Association (ADA) today announced the start of a new multi-year collaborative initiative supported by founding sponsors Boehringer Ingelheim, Eli Lilly and Company (Lilly), and Novo Nordisk. The initiative’s goal is to help people with type 2 diabetes reduce their risk of disability and death due to cardiovascular events such as heart attack and stroke. Additional support for the initiative is provided by national sponsor, Sanofi.

Cardiovascular disease is the leading cause of death and a major cause of disability for this population.

Adults with diabetes are two to four times more likely to have cardiovascular disease, which includes heart disease, heart failure, heart attack and stroke, than people without diabetes. The combined risks have a significant impact – shortening life expectancy by an average of 12 years for adults at age 60 with both conditions.

Type 2 diabetes, which accounts for 90-95 percent of all diabetes cases, occurs when blood glucose (sugar) levels rise higher than normal because the body doesn’t respond to the hormone insulin properly. It is estimated that more than 30 million American adults have diabetes, including about 7.2 million who are undiagnosed.

In people with type 2 diabetes, cardiovascular risk remains high even when blood sugar levels are controlled, leaving many unaware of the danger.

The new initiative will enhance consumer awareness, patient education, healthcare provider training, and quality improvement measures for clinics, practices and hospitals treating people with type 2 diabetes.

Together, the AHA and ADA bring strong credentials to this effort, with more than 30 million volunteers, members and healthcare professionals with a combined 170 years of expertise. The AHA is the world’s leading voluntary organization working to build lives free of cardiovascular disease and stroke. The ADA is the nation’s leading voluntary health organization working to prevent, cure and improve the lives of those affected by diabetes.

“Diabetes is a significant threat to the cardiovascular health of many Americans,” said Nancy Brown, Chief Executive Officer of the American Heart Association. “As we work toward our goal to improve Americans’ health, this collaboration aims to unite the healthcare community with a comprehensive approach to caring for, educating, treating and empowering patients with diabetes to improve their cardiovascular health and their quality of life.”

“Diabetes is the most expensive chronic health condition in the U.S., totaling $327 billion in overall annual costs in 2017; moreover, one in every seven healthcare dollars is spent directly treating diabetes and its complications,” said Tracey D. Brown, Chief Executive Officer of the American Diabetes Association. “Reducing cardiovascular disease risk among people with type 2 diabetes can improve quality and length of life, and it can help to reduce our national healthcare expenses. This collaboration codifies a critical collective mission — to improve and enhance the lives of the more than 30 million Americans with diabetes.”

The longer people live with type 2 diabetes, the higher their risk of developing cardiovascular disease and, potentially, additional health concerns and risk factors. These are challenges the AHA, ADA and industry collaborators are ready to combat together.

“This new collaboration has the potential to improve the lives of millions living with diabetes who are at an increased risk for cardiovascular disease and reduce the impact of these conditions on our health care system,” said Thomas Seck, M.D., Vice President of Clinical Development and Medical Affairs – Primary Care at Boehringer Ingelheim Pharmaceuticals, Inc. “Boehringer Ingelheim and our Alliance partner Lilly are proud to launch this important initiative, which is a testament to the critical shifts needed in diabetes care to properly address the life-threatening consequences of diabetes and heart disease.”

“As a founding partner of this initiative, we’re excited about joining together with the ADA and AHA to launch this initiative to help people with diabetes learn more about the critical link between diabetes and the risk of cardiovascular disease,” said Todd Hobbs, M.D., Vice President and Chief Medical Officer of Novo Nordisk. “Addressing cardiovascular risk is an important part of overall diabetes management, and we’re hopeful that the collective power of the AHA, ADA and industry will change the trajectory of type 2 diabetes and bring about meaningful change for the people living with diabetes and those who love, support and care for them.”

More information about the initiative will be released in coming months. Learn more by visiting heart.org/aboutdiabetes.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook (@AmericanHeart) and Twitter (@American_Heart).

About the American Diabetes Association

Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have diabetes; and every 21 seconds, another individual is diagnosed with diabetes in the U.S. Founded in 1940, the American Diabetes Association (ADA) is the nation's leading voluntary health organization whose mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. The ADA drives discovery by funding research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and works to safeguard policies and programs that protect people with diabetes. In addition, the ADA supports people living with diabetes, those at risk of developing diabetes, and the health care professionals who serve them through information and programs that can improve health outcomes and quality of life. For more information, please call the ADA at 1-800-DIABETES (1-800-342-2383) or visit diabetes.org. Information from both of these sources is available in English and Spanish. Find us on Facebook (@AmericanDiabetesAssociation), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

About Boehringer Ingelheim and Eli Lilly and Company

In January 2011, Boehringer Ingelheim and Eli Lilly and Company announced an alliance in diabetes that centers on compounds representing several of the largest diabetes treatment classes. This alliance leverages the strengths of two of the world’s leading pharmaceutical companies. By joining forces, the companies demonstrate commitment in the care of patients with diabetes and stand together to focus on patient needs. Find out more about the alliance at boehringer-ingelheim.com or lilly.com.

About Novo Nordisk

Novo Nordisk, a global healthcare company, has been committed to discovering and developing innovative medicines to help people living with diabetes lead longer, healthier lives for 95 years. This heritage has given us experience and capabilities that also enable us to help people defeat other serious diseases including obesity, hemophilia and growth disorders. We remain steadfast in our conviction that the formula for success is to stay focused, think long term and do business in a financially, socially and environmentally responsible way. With U.S. headquarters in New Jersey and production and research facilities in four states, Novo Nordisk employs nearly 6,000 people throughout the country. For more information, visit novonordisk.us, Facebook and Twitter @NovoNordiskUS.

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For Media Inquiries:

AHA – Maggie Francis: 214-706-1382; Maggie.Francis@heart.org

ADA – Michelle Kirkwood: 703-299-2053; press@diabetes.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

]]>Program NewsHeart NewsThu, 14 Jun 2018 21:31:33 GMTThe American Heart Association (AHA) and the American Diabetes Association (ADA) today announced the start of a new multi-year collaborative initiative supported by founding sponsors Boehringer Ingelheim, Eli Lilly and Company (Lilly), and Novo Nordisk. The initiative’s goal is to help people with type 2 diabetes reduce their risk of disability and death due to cardiovascular events such as heart attack and stroke.https://newsroom.heart.org/news/leading-health-organizations-collaborate-with-industry-on-new-initiative-to-combat-growing-diabetes-and-cardiovascular-disease-threatThu, 14 Jun 2018 17:00:00 GMT

Tobacco aside, e-cigarette flavorings may harm blood vessels

Thu, 06/14/2018 - 04:58
Study Highlights:

  • Flavoring chemicals widely used in e-cigarettes and other tobacco products may be toxic to the cells that line and regulate blood vessel function.
  • The adverse effects observed with chemical flavor additives on endothelial cells could be early warning signs of future heart disease, researchers say.

Embargoed until 4 a.m. CT / 5 a.m. ET Thursday, June 14, 2018

DALLAS, June 14, 2018 – Flavor additives used in electronic cigarettes and related tobacco products could impair blood vessel function and may be an early indicator of heart damage, according to new laboratory research in Arteriosclerosis, Thrombosis and Vascular Biology, an American Heart Association journal.

The health effects of “combustible” tobacco products including traditional cigarettes and hookah are well-established, but the potential dangers of e-cigarettes have not yet been extensively studied. E-cigarettes are battery-powered devices that heat a liquid — including tobacco-derived nicotine, flavoring and other additives — and produce an aerosol that is inhaled.

Nine chemical flavorings – menthol (mint), acetylpyridine (burnt flavor), vanillin (vanilla), cinnamaldehyde (cinnamon), eugenol (clove), diacetyl (butter), dimethylpyrazine (strawberry), isoamyl acetate (banana) and eucalyptol (spicy cooling) – which are widely used in e-cigarettes, hookah, little cigars and cigarillos were tested for their short-term effects on endothelial cells, the cells which line the blood vessels and the inside of the heart.

Researchers found all nine flavors were dangerous to cells in the laboratory at the highest levels tested and all the flavorings impaired nitric oxide production in endothelial cells in culture (outside of the body). Several of the flavorings – menthol, clove, vanillin, cinnamon and burnt flavoring – resulted in higher levels of an inflammatory marker and lower levels of nitric oxide, a molecule that inhibits inflammation and clotting, and regulates vessels’ ability to widen in response to greater blood flow.

“Increased inflammation and a loss of nitric oxide are some of the first changes to occur leading up to cardiovascular disease and events like heart attacks and stroke, so they are considered early predictors of heart disease,” said lead study author Jessica L. Fetterman, Ph.D., assistant professor of medicine at Boston University School of Medicine in Massachusetts. “Our findings suggest that these flavoring additives may have serious health consequences.”

Endothelial cells were collected from volunteers (nine non-smokers/non-e-cigarette users; six non-menthol and six menthol cigarette smokers) and tested in the lab. Researchers found that both groups of smokers had a similar deficit in nitric oxide production when stimulated by a chemical called A23187. Nonsmokers’ cells that were treated with menthol or a clove flavoring also had impaired nitric oxide production, suggesting those flavorings cause damage like that found in active smokers.

The team also exposed commercially-available human aortic endothelial cells to the flavorings. Burnt flavor, vanilla, cinnamon and clove flavors impaired nitric oxide production and boosted an inflammatory chemical called interleukin-6 (IL-6) at all concentrations tested, suggesting the endothelium is particularly sensitive to these flavors.

Menthol applied to the cells increased IL-6 at high concentrations and reduced nitric oxide even at low doses. In smokers, scientists don’t see differences in heart disease between menthol and non-menthol users — probably because cigarette smoke is overwhelmingly toxic, Fetterman said. “But menthol is certainly not a benign player, based upon our work.”

At the highest levels tested, all nine chemicals caused cell death, while at lower levels cinnamon, clove, strawberry, banana and spicy cooling flavor did. Dimethylpyrazine/strawberry flavor had that effect even at very low levels, suggesting endothelial cells are especially sensitive to it. Vanillin and eugenol also increased oxidative stress in the cells.

Three flavorings were tested when heated, to mimic what happens in e-cigarettes. Nitric oxide production was impaired with vanillin and eugenol, but not with menthol.

“Our work and prior research have provided evidence that flavorings induce toxicity in the lung and cardiovascular systems. Flavorings are also a driver of youth tobacco use and sustained tobacco use among smokers,” Fetterman said.

A key strength of the new research was that it directly tested effects of just the flavorings, at levels likely to be reached in the body. Limitations include the fact that testing did not heat all the flavorings or include other chemicals used in e-cigarettes. Also, the study gauged just the flavorings’ short-term effects and captured these with cells outside the body, not inside.

“We still don’t know what concentrations of the flavorings make it inside the body,” Fetterman said.

Most adult e-cigarette users are current or former combustible cigarette smokers who may use e-cigarettes as an aid in smoking cessation or as a harm-reduction tool. In addition, e-cigarette use by youth is rising rapidly with 37 percent of high schoolers reporting they have had an e-cigarette in 2015. Flavored tobacco products are a major driver of experimentation among youth.

The American Heart Association cautions against the use of e-cigarettes, stating that e-cigarettes containing nicotine are tobacco products that should be subject to all laws that apply to these products. The Association also calls for strong new regulations to prevent access, sales and marketing of e-cigarettes to youth, and for more research into the product’s health impact.

Co-authors are Robert M. Weisbrod, M.S.; Bihua Feng, M.D.; Reena Bastin; Shawn T. Tuttle; Monica Holbrook, M.S.; Gregory Baker; Rose Marie Robertson, M.D.; Daniel J. Conklin, Ph.D.; Aruni Bhatnagar, Ph.D.; and Naomi M. Hamburg, M.D. Author disclosures are on the manuscript.

The National Heart, Lung, and Blood Institute, Food and Drug Administration Center for Tobacco Products and the American Heart Association funded the study.

Additional Resources:

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Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at http://www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Bridgette McNeill: 214-706-1135; bridgette.mcneill@heart.org  

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsAdvocacy News Stroke NewsThu, 14 Jun 2018 09:00:09 GMTStudy Highlights: Flavoring chemicals widely used in e-cigarettes and other tobacco products may be toxic to the cells that line and regulate blood vessel function. The adverse effects observed with chemical flavor additives on endothelial cells could...https://newsroom.heart.org/news/tobacco-aside-e-cigarette-flavorings-may-harm-blood-vesselsThu, 14 Jun 2018 09:00:00 GMT

Cash and goal setting help motivate heart patients to take healthy steps

Wed, 06/13/2018 - 04:04
Study Highlight:

  • Wearable devices combined with financial incentives and personalized goal-setting significantly increased physical activity among ischemic heart patients.

Embargoed until 4 a.m. CT / 5 a.m. ET Wednesday, June 13, 2018

DALLAS, June 13, 2018 — The thought of losing up to $14 a week along with personalized goal setting may have motivated ischemic heart disease patients to increase their exercise, according to a new clinical trial published in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Ischemic heart disease is the leading cause of death in the United States. Yet, while regular exercise has been shown to reduce the risk of cardiovascular events and risk of death by up to 30 percent among these patients, most don’t participate in exercise-based rehabilitation programs or obtain enough physical activity on their own.

“There is a lot of interest in using wearable devices to increase activity levels among high-risk cardiovascular patients, but the best way to design these types of programs is unknown,” said Neel Chokshi, M.D., M.BA., first author and cardiologist at the Perelman School of Medicine and medical director of the Sports Cardiology and Fitness Program at Penn Medicine both located in Philadelphia. “Our trial is one of the first to test the use of mobile technology through a home-based program and found that while wearable devices alone were not effective, combining them with financial incentives and personalized goal-setting significantly increased physical activity levels during the 6-month period.”

Researchers obtained baseline step counts and tracked 105 ischemic heart disease patients (average age 60; 70 percent men) for 24-weeks to see if financial incentives and personalized goal setting would increase physical activity. Patients in the incentive group received a wrist-worn activity tracking device, personalized step goals, daily feedback and were allocated $14 each week to a virtual account for the first 16 weeks – $2 of which could be lost per day for not achieving step goals. They also selected whether to receive personalized goal-setting communications by text, email, interactive voice recording or a combination.

Patients in the control group received a wearable device that counted steps but no incentives or feedback.

Researchers found:

  • Patients in the incentive group significantly increased their physical activity levels, 1,368 more steps per day during the main intervention period, compared to the control group.
  • After financial incentives were stopped in the follow up period, the incentive group still increased their physical activity by 1,154 steps per day compared to the control group.
  • Patients in the control group had no significant change in their physical activity levels.

“This is one of the first clinical trials that used financial incentives and found increases in physical activity were sustained even after incentives stopped, a potential sign of habit formation,” said Mitesh Patel, M.D., senior author and assistant professor at the Perelman School of Medicine at the University of Pennsylvania and director of the Penn Medicine Nudge Unit, both located in Philadelphia. “A key element of our study was that incentives were designed to leverage the behavioral economic principle of loss aversion, which finds that for the same reward size, most people are more motivated when they are told they might lose a reward than when told they could earn a reward.”

Other co-authors are Srinath Adusumalli, M.D.; Dylan S. Small, Ph.D.; Alexander Morris, B.S.; Jordyn Feingold, MAPP; Yoonhee P. Ha, M.Sc., M.Phil.; Marta D. Lynch, B.S.; Charles A. L. Rareshide, M.S.; and Victoria Hilbert, M.P.H., R.D. Author disclosures are in the manuscript.

The trial was funded by the National Center for Advancing Translational Science, the Institute for Translational Medicine and Therapeutics at the University of Pennsylvania, and the University of Pennsylvania Health System through the Penn Medicine Nudge Unit. These funding sources had no role in the design and conduct of the study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Karen Astle: 214-706-1392; karen.astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsWed, 13 Jun 2018 09:00:08 GMTStudy Highlight: Wearable devices combined with financial incentives and personalized goal-setting significantly increased physical activity among ischemic heart patients. https://newsroom.heart.org/news/cash-and-goal-setting-help-motivate-heart-patients-to-take-healthy-stepsWed, 13 Jun 2018 09:00:00 GMT

Patients unable to resume work after heart attack face depression and financial hardship

Tue, 06/12/2018 - 04:19
Study Highlights:

  • About 90 percent of people who suffer a major heart attack return to work.
  • However, of the patients who can’t return to work or must work less, many report poor quality of life, depression and moderate to extreme financial hardship, including trouble affording medications.
  • People readmitted to the hospital after a heart attack are less likely to return to work.

Embargoed until 4 a.m. CT / 5 a.m. ET Tuesday, June 12, 2018

DALLAS, June 12, 2018 – More people than ever are able to resume working after a heart attack, but those working less or unable to work reported lower quality of life with increased depression and difficulty affording their medication, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Advances in the prevention and treatment of heart attacks have led to better survival rates and overall patient health. But researchers wanted to assess whether these improved health outcomes translated into the real-world benefit of remaining employed.

“Social determinants of health are strongly linked to the risk of heart disease, with employment – or the lack of employment – being one of the most significant,” said study lead author Haider J. Warraich, M.D., cardiologist at Duke University Medical Center and the Duke Clinical Research Institute in Durham, North Carolina. “Job loss significantly interacts with other psychosocial factors such as depression and health status.”

Researchers examined data from 9,319 heart attack patients (average age 61, 27 percent female) enrolled in a longitudinal registry at 233 U.S. hospitals between April 2010 and October 2012.

More than half the patients were employed at the time of their heart attack. A year later, 90 percent of them were back at work, 3 percent were working less than before their heart attack and 7 percent were not working. This is the lowest level of job loss after heart attack reported to date, with levels as high as 51 percent in 1940, 37 percent in 2003 and 20 percent in 2007.  

However, among the 10 percent of patients who experienced employment difficulties, more people reported lower quality of life, increased rates of depression and financial difficulties, including trouble paying for medications. Specifically, 41 percent of patients working less or not at all reported moderate to extreme financial hardship. The best predictor of whether patients would have adverse change in employment was unplanned readmission to the hospital or post heart attack bleeding.

“These findings help us identify patients at high risk of not returning to work,” Warraich said. “This can help us focus our resources on, for example, patients readmitted after a heart attack, as a way of targeting those at most risk of not returning to work.”

An accompanying editorial by Rachel P. Dreyer, Ph.D. and Victoria Vaughan Dickson, Ph.D., R.N., noted that the findings lacked detailed information on work type, i.e. professional, clerical, skilled and occupational characteristics like level of stress, social support and job satisfaction.

“As the demographics of America’s workforce changes, the magnitude of heart attacks among working adults and the need for interventions that support successful return to work requires continued attention by researchers and clinicians,” they wrote.

Co-authors are Lisa A. Kaltenbach, M.S.; Gregg C. Fonarow, M.D.; Eric D. Peterson, M.D., MPH; and Tracy Y. Wang, M.D., MHS, M.Sc. Author disclosures are on the manuscript.

Daiichi Sankyo, Inc. and Lilly USA sponsored the TRANSLATE-ACS registry; the Duke Clinical Research Institute, the American College of Cardiology and the National Heart, Lung, and Blood Institute funded the analysis.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Bridgette McNeill contact: 214-706-1135; bridgettte.mcneill@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsTue, 12 Jun 2018 09:00:07 GMTAbout 90 percent of people who suffer a major heart attack return to work. However, of the patients who can’t return to work or must work less, many report poor quality of life, depression and moderate to extreme financial hardship, including trouble affording medications. People readmitted to the hospital after a heart attack are less likely to return to work. https://newsroom.heart.org/news/patients-unable-to-resume-work-after-heart-attack-face-depression-and-financial-hardshipTue, 12 Jun 2018 09:00:00 GMT

Erectile dysfunction means increased risk for heart disease, regardless of other risk factors

Mon, 06/11/2018 - 04:29
Study Highlights:

  • Men with erectile dysfunction are at greater risk for heart attacks, strokes and sudden cardiac death.
  • New study provides strongest link to date between sexual dysfunction and cardiovascular risk.
  • Erectile dysfunction can be an important factor for physicians in gauging cardiovascular risk.
  • Men with erectile dysfunction warrant further testing and more aggressive management of cardiovascular risk factors.

Embargoed until 4 a.m. CT / 5 a.m. ET Monday, June 11, 2018

DALLAS, June 11, 2018 — Erectile dysfunction (ED) indicates greater cardiovascular risk, regardless of other risk factors, such as cholesterol, smoking and high blood pressure, according new research published in the American Heart Association’s journal Circulation.

In the study, which followed more than 1,900 men, ages 60 to 78, over 4 years, those who reported ED were twice as likely to experience heart attacks, cardiac arrests, sudden cardiac death and fatal or non-fatal strokes.

The findings, the research team says, suggest that ED is an important telltale sign that can help physicians gauge cardiovascular risk among middle-aged men—an indicator the United Kingdom formally incorporated last year in the risk-scoring algorithm used by clinicians to assess a patient’s 10-year risk for suffering an adverse cardiovascular event.1

Erectile dysfunction (ED) — defined as the inability to achieve or maintain an erection for satisfactory sexual intercourse — affects nearly 20 percent of men over age 20, according to research. Cardiovascular disease and ED share common risk factors, including obesity, hypertension, smoking, diabetes and metabolic syndrome — a condition marked by a cluster of features such as elevated blood sugar, hypertension and excess abdominal fat.

“Our results reveal that erectile dysfunction is, in and of itself, a potent predictor of cardiovascular risk,” says study senior investigator Michael Blaha, M.D., M.P.H., associate professor of medicine at the Johns Hopkins School of Medicine in Baltimore, Maryland. “Our findings suggest that clinicians should perform further targeted screening in men with erectile dysfunction, regardless of other cardiac risk factors and should consider managing any other risk factors -- such as high blood pressure or cholesterol -- that much more aggressively.”

Limited evidence of a link between ED and cardiovascular disease has emerged over the last several years, but results of this latest study provide what researchers say is the strongest indication to date that sexual dysfunction indicates heightened cardiovascular risk.

During the four-year follow-up, there were a total of 115 fatal and non-fatal heart attacks, fatal and non-fatal strokes, cardiac arrests and sudden cardiac deaths. A greater proportion of men who reported ED (6.3 percent) suffered heart attacks, cardiac arrests or strokes than men who didn’t report ED (2.6 percent). When the investigators adjusted their analysis to eliminate the potential influence of other risk factors, that risk was somewhat lessened but still markedly higher: Men with ED were nearly twice as likely to suffer cardiovascular events than men without ED.

Participants in the research are part of the ongoing Multi-Ethnic Study of Atherosclerosis, which is following more than 6,000 people of various ethnic and racial backgrounds at several cities across the United States.

Men seeking treatment and evaluation for ED should be a signal to conduct a comprehensive cardiovascular evaluation, said Blaha. Additionally, the researchers say, men should be aware that ED places them at elevated risk for cardiovascular disease.

“The onset of ED should prompt men to seek comprehensive cardiovascular risk evaluation from a preventive cardiologist,” Blaha noted. “It is incredible how many men avoid the doctor and ignore early signs of cardiovascular disease, but present for the first time with a chief complaint of ED.  This is a wonderful opportunity to identify otherwise undetected high-risk cases.”

Co-authors on the study included Iftekhar Uddin, M.B.B.S., M.S.P.H.; Mohammadhassan Mirbolouk, M.D., M.P.H.; Zeina Dardari, M.P.H.; David Feldman, B.S.; Miguel Cainzos, M.D., M.P.H.; Andrew DeFilippis, M.D., M.Sc.; Philip Greenland, M.D.; Ron Blankstein, M.D.; Kevin Billups, M.D.; Martin Miner, M.D.; and Khurram Nasir, M.D., M.P.H.

The work was funded by the National Heart, Lung, and Blood Institute and by the National Center for Research Resources, with additional support by the U.S. Environmental Protection Agency.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Carrie Thacker: 214-706-1665; c.thacker@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

 

]]>Heart NewsMon, 11 Jun 2018 09:00:08 GMTStudy Highlights: Men with erectile dysfunction are at greater risk for heart attacks, strokes and sudden cardiac death. New study provides strongest link to date between sexual dysfunction and cardiovascular risk. Erectile dysfunction can be an important factor for physicians in gauging cardiovascular risk. Men with erectile dysfunction warrant further testing and more aggressive management of cardiovascular risk factors. https://newsroom.heart.org/news/erectile-dysfunction-means-increased-risk-for-heart-disease-regardless-of-other-risk-factorsMon, 11 Jun 2018 09:00:00 GMT

Stroke survivors could gain the most from new blood pressure guidelines

Wed, 06/06/2018 - 04:59
Study Highlights

  • More than half of all strokes can be attributed to uncontrolled high blood pressure.
  • If stroke survivors were treated so their blood pressures reach the new target of less than 130/80 mmHg, deaths might be cut 33 percent compared with previous guidelines with a higher target blood pressure.

Embargoed until 4 a.m. CT / 5 a.m. ET Wednesday, June 6, 2018

DALLAS, June 6, 2018 — Treating high blood pressure in stroke survivors more aggressively, could cut deaths by one-third, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

“The potential to reduce mortality and recurrent stroke is immense, because more than half of all strokes are attributable to uncontrolled high blood pressure,” said Alain Lekoubou, M.D., M.S., study lead author and clinical instructor in neurology at the Medical University of South Carolina in Charleston.

In the AHA/ACC guideline for hypertension, released in 2017, the threshold for stage 1 hypertension, or high blood pressure was changed to at or above 130 mmHg for the top number or  80 mmHg for the bottom number. The previous threshold for high blood pressure was, at or above 140/90 mmHg.

Overall, while many more people will be diagnosed with hypertension under the new guideline, there will be only a small increase in the percentage of people who require medication. However, blood pressure-lowering medications are recommended for all stroke survivors with blood pressures of 130/80 mmHg or higher, and additional drugs if needed to reduce blood pressure below that threshold.

In the new study, researchers used data from the National Health and Nutrition Examination Surveys to estimate the nationwide impact of applying that approach. The surveys, conducted between 2003 and 2014, included blood pressure measurement and asked participants about their stroke history and blood pressure treatment.

If clinicians fully shift from the previous guidelines to the new ones, the researchers calculated the impact on stroke would be:

  • a 66.7 percent increase in the proportion of stroke survivors diagnosed with hypertension and recommended for pressure-lowering medication (from 29.9 percent to 49.8 percent);

  • a 53.9 percent increase in the proportion of stroke survivors already taking pressure-lowering drugs who will be prescribed additional medication to reach their target blood pressure (from 36.3 percent to 56 percent); and

  • a 32.7 percent reduction in deaths, based on the difference in death rates in stroke survivors above and below the 130/80 mmHg target blood pressure (8.3 percent vs. 5.6 percent).

“The new guideline offers physicians and policymakers a unique opportunity to reinforce the already decreasing stroke-related mortality trends of the last few decades,” Lekoubou said. “It is our responsibility to ensure that stroke survivors identified with hypertension are treated more aggressively and to ensure that those on treatment remain on treatment.”

While the potential to prevent recurrent strokes and save lives is large, the researchers acknowledge that there are special challenges in treating blood pressure in stroke survivors.

“Stroke survivors can face many hurdles in adhering to treatment, including major neurological impairments and depression, which can reduce the motivation to take medication. Caring for stroke survivors may be complicated because it is primarily a disease of the elderly, who are often taking several medications to treat their medical conditions,” said Lekoubou.

The study is limited by relying on self-reports of a history of stroke and the inability to separately analyze the impact of the new guidelines on survivors of clot-caused or bleeding strokes.

“The true magnitude of the impact of these changes in high blood pressure definition and treatment recommendations will best be evaluated by prospective studies, which will also offer the opportunity to identify gaps and improve treatment protocols among stroke survivors,” Lekoubou said.

Co-authors are Kinfe G. Bishu, Ph.D. and Bruce Ovbiagele, M.D., M.Sc., M.A.S., M.B.A. Author disclosures are on the manuscript.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Maggie Francis: 214-706-1382; Maggie.Francis@heart.org  

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

]]>Heart NewsStroke NewsWed, 06 Jun 2018 09:00:08 GMTStudy Highlights: More than half of all strokes can be attributed to uncontrolled high blood pressure. If stroke survivors were treated so their blood pressures reach the new target of less than 130/80 mmHg, deaths might be cut 33 percent compared...https://newsroom.heart.org/news/stroke-survivors-could-gain-the-most-from-new-blood-pressure-guidelinesWed, 06 Jun 2018 09:00:00 GMT

Disponer de escasos conocimientos sobre salud constituye un gran obstáculo para la prevención y el tratamiento de las cardiopatías

Mon, 06/04/2018 - 04:59
Puntos destacados del informe

  • Disponer de escasos conocimientos sobre salud constituye un gran obstáculo para la salud cardíaca, así como para la gestión de las cardiopatías y los accidentes cerebrovasculares.
  • Los conocimientos sobre la salud resultan esenciales para orientarse en el sistema de salud, utilizar la medicación de forma efectiva y mejorar los comportamientos saludables para el corazón.

Prohibida su divulgación hasta las 04:00 CT/ 5:00 (ET) del lunes 4 de junio de 2018

DALLAS, 4 de junio de 2018. Disponer de escasos conocimientos sobre salud constituye un gran obstáculo para que multitud de personas gocen de una buena salud cardiovascular o se beneficien de un tratamiento efectivo frente a ataques cardíacos, insuficiencia cardíaca, accidentes cerebrovasculares y otras enfermedades cardiovasculares, según un informe científico publicado en la revista Circulation de la American Heart Association.

Los conocimientos sobre salud no solo incluyen la capacidad de leer, sino también habilidades como ser capaz de preguntar acerca de nuestra salud, comprender documentos con terminología médica, realizar operaciones aritméticas básicas para tomar correctamente la medicación y negociar con los proveedores de la salud y las compañías de seguros. La incapacidad para realizar estas acciones de forma efectiva puede conllevar consecuencias graves para la salud.

El informe ofrece una descripción general de los problemas a los que se enfrentan las personas con escasos conocimientos sobre salud. Para ello, este informe se basa en la revisión de numerosos estudios sobre este aspecto publicados entre 2004 y 2016. Estos son algunos de los puntos destacados:

  • Más de la mitad de las personas con escasos conocimientos sobre salud no fueron capaces de reconocer una lectura de presión arterial de 160/100 mmHg como anormal. Asimismo, disponer de escasos conocimientos sobre salud reduce entre un 1,8 y 2,7 las posibilidades de que personas con hipertensión sean capaces de controlarla.

  • Las personas con escasos conocimientos sobre salud tienen más probabilidades de desarrollar adicción a la nicotina y 3 veces más de posibilidades de recaer tras seguir un programa para dejar de fumar.

  • Las personas con diabetes y escasos conocimientos sobre salud tienen más probabilidades de desarrollar complicaciones derivadas de la enfermedad, como retinopatía diabética. Igualmente, estas personas tienen un 1,7 menos de posibilidades de utilizar un portal para pacientes en línea, una tecnología de comunicación y gestión de enfermedades cada más utilizada.

  • Los padres con escasos conocimientos sobre salud tienen el doble de posibilidades de percibir como normal el peso de su hijo con sobrepeso.

“Las probabilidades de que haya una falta de entendimiento entre el proveedor de la salud y sus pacientes con factores de riesgo de cardiopatía, insuficiencias cardíacas y enfermedades cardiovasculares crecen exponencialmente”, afirma Jared W. Magnani, M.D., M.Sc., presidente del equipo de redacción del informe científico y profesor asociado de medicina en la Facultad de Medicina de la Universidad de Pittsburgh, Pennsylvania. “Un gran número de pacientes no comprende el material escrito que recibe como parte de su asistencia sanitaria, o no dispone de las destrezas matemáticas suficientes como para entender la información cuantitativa. Del mismo modo, el sistema de asistencia sanitaria utiliza una cantidad considerable de terminología especializada que denominamos jerga”.

“Un paciente con escasos conocimientos sobre salud puede no comprender que un test de estrés calificado como “positivo” no es un buen resultado”, continúa Magnani. “Asimismo, instruimos a nuestros pacientes para que sepan identificar y cuantificar su ingesta de sodio e interpretar las etiquetas nutricionales en caso de que no sepan cómo”.

Según el comité, en la actualidad, solo el 12 por ciento de los estadounidenses disponen de los conocimientos sobre salud necesarios para orientarse con éxito en el sistema de asistencia sanitaria y las dificultades asociadas a esta falta de conocimientos empeorará con toda probabilidad. Según los datos del informe, disponer de escasos conocimientos sobre salud es un hecho habitual entre las minorías raciales y étnicas, las personas mayores, los ciudadanos con poco dominio del inglés y las personas con menos nivel educativo y menor estabilidad económica. Los autores del informe hicieron hincapié en el hecho de que incluso las personas con formación universitaria pueden tener escasos o insuficientes conocimientos sobre salud si no están familiarizados con la terminología sanitaria y se enfrentan a situaciones en las que no tienen experiencia.

“La última década ha visto numerosos avances tecnológicos y farmacéuticos en cuanto a la atención sanitaria, dispositivos cardíacos e iniciativas móviles para la salud junto con un énfasis cada vez mayor en la toma de decisiones consensuada y los resultados percibidos por los pacientes. Si no intentamos aumentar los conocimientos sobre salud de las personas, estos avances no beneficiarán a aquellos que más los necesitan”, afirma Magnani. 

Los autores del informe abogan por el uso del sistema de precauciones universales, creado por la agencia federal para la investigación y calidad médica.

“Este conjunto de instrumentos nos recuerda que los conocimientos sobre salud no es un problema del paciente sino el resultado de las complejidades del sistema de prestación de asistencia sanitaria. Por otra parte, hace un llamamiento a los profesionales de la salud para que realicen cambios que mejoren el acceso a la atención sanitaria por parte de todos los pacientes”, sostiene Magnani. Estas son algunas de las estrategias recomendadas en el sistema para los proveedores de la salud:

  • Evitar el uso de jerga e integrar imágenes como herramientas de enseñanza.

  • Crear formularios, consentimientos informados y folletos fáciles de entender.

  • Mejorar el seguimiento y el acceso telefónico de los pacientes.

  • Pedir a los pacientes que lleven toda su medicación para que el proveedor de la salud pueda valorar el cumplimiento y la seguridad de la misma.

  • Considerar la cultura, las costumbres y las creencias de los pacientes en su asistencia sanitaria.

  • Vincular a los pacientes con apoyo de especialistas, gestión de casos y recursos comunitarios.

“Empleamos asistencia especializada para nuestros pacientes y esperamos que entiendan las razones para ello, así como que realicen cambios en su estilo de vida y se tomen la medicación a diario, algunos de ellos de por vida. Se lo debemos. Queremos asegurarnos de que comprenden perfectamente su estado y sus tratamientos”, afirma Magnani.

Los coautores del informe son: Mahasin S. Mujahid, Ph.D., M.S.; Herbert D. Aronow, M.D., M.P.H.; Crystal W. Cené, M.D., M.P.H.; Victoria Vaughan Dickson, Ph.D., R.N.; Edward Havranek, M.D.; Lewis B. Morgenstern, M.D.; Michael K. Paasche-Orlow, M.D., M.S.; Amu Pollak, M.D.; y Joshua Willey, M.D. Las declaraciones del autor se encuentran en el manuscrito.

Recursos adicionales:

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La American Heart Association/American Stroke Association recibe fondos principalmente de individuos. Las fundaciones y las corporaciones también realizan donaciones y financian programas y eventos específicos. Se aplican políticas estrictas para evitar que estas relaciones influyan en el contenido científico de la asociación. La información financiera para la American Heart Association, que incluye una lista de contribuciones de compañías farmacéuticas, fabricantes de dispositivos y proveedores de seguros de salud, está disponible en www.heart.org/corporatefunding.

Acerca de la American Heart Association

La American Heart Association se dedica a luchar contra las cardiopatías y los accidentes cerebrovasculares, las dos causas principales de muerte en el mundo. Trabajamos de manera conjunta con millones de voluntarios con el fin de financiar investigaciones innovadoras, conseguir políticas de salud pública más eficaces y proporcionar herramientas e información de emergencia para evitar y tratar estas enfermedades. Con sede en Dallas, la American Heart Association es la organización de la salud integrada por voluntarios más antigua e importante del país, y se dedica a combatir enfermedades cardíacas y accidentes cerebrovasculares. Para obtener más información o sumarse a nuestra misión, llame al 1-800-AHA-USA1, visite heart.org o llame a cualquiera de nuestras oficinas en todo el país. Síganos en Facebook y Twitter.

Si es un representante de un medio de comunicación: 214-706-1173

Darcy Spitz: 212-878-5940; Darcy.Spitz@heart.org

Para consultas públicas: 1-800-AHA-USA1 (242-8721)

heart.org y strokeassociation.org

 

 

 

]]>Heart NewsStroke NewsMon, 04 Jun 2018 09:00:11 GMTPuntos destacados del informe: Disponer de escasos conocimientos sobre salud constituye un gran obstáculo para la salud cardíaca, así como para la gestión de las cardiopatías y los accidentes cerebrovasculares. Los conocimientos sobre la salud...https://newsroom.heart.org/news/disponer-de-escasos-conocimientos-sobre-salud-constituye-un-gran-obstaculo-para-la-prevencion-y-el-tratamiento-de-las-cardiopatiasMon, 04 Jun 2018 09:00:00 GMT

Limited health literacy is a major barrier to heart disease prevention and treatment

Mon, 06/04/2018 - 04:59
Statement Highlights

  • Limited health literacy is a major barrier to heart health and managing heart disease and stroke.
  • Health literacy is essential to navigate the health care system, use medication effectively and improve heart-healthy behaviors.

Embargoed until 4 a.m. CT / 5 a.m. ET Mon. June 4, 2018

DALLAS, June 4, 2018 —Limited healthy literacy is a major barrier blocking many people from achieving good cardiovascular health or benefiting from effective treatment for heart attacks, heart failure, strokes and other cardiovascular diseases, according to a scientific statement published in the American Heart Association’s journal Circulation.

Health literacy encompasses not only the ability to read, but skills such as being able to ask questions about your care, understand documents with medical terminology, perform the basic arithmetic needed to take medication correctly and negotiate with health care providers and insurance companies. Inability to do these things effectively can have serious health consequences.

The statement provides an overview of the issues faced by people with limited health literacy, based on a review of studies on the topic that were published between 2004 and 2016. Highlights include:

  • More than half of people with low health literacy did not recognize a blood pressure reading of 160/100 mmHg as abnormal and limited health literacy makes it 1.8 to 2.7 times less likely that those with high blood pressure will get it under control;
  • People with low health literacy are more likely to be dependent on nicotine and are 3 times as likely to relapse after going through a smoking cessation program;
  • People with diabetes and low health literacy are more likely to develop complications of the disease, such as diabetic retinopathy. They are 1.7 times less likely to use an online patient portal, which is an increasingly used technology for patient communication and disease management;
  • Parents with low health literacy are twice as likely to perceive their overweight child as being normal weight.

“The opportunities for communication failure by healthcare providers who treat people for heart disease risk factors, heart diseases and strokes are rampant,” said Jared W. Magnani, M.D., M.Sc., chair of the writing group for the scientific statement and associate professor of medicine at the University of Pittsburgh School of Medicine in Pennsylvania. “Many patients do not understand the written materials they receive as part of health care, or do not have the numeric skills to understand quantitative information. Also, medical care uses a considerable amount of specialized terminology, which some call jargon.

“A patient with limited health literacy may not understand that a stress test described as “positive” is not a good result.,” he continued. “Or we instruct patients to avoid sodium, when they may not know how to identify and quantify sodium intake or even how to interpret nutrition labels.”

Currently, only 12 percent of Americans have the health literacy skills to successfully navigate the health care system, and the difficulties associated with inadequate health literacy will likely get worse, the committee found. Limited health literacy is common among racial and ethnic minorities, older adults, people who with limited English skills and those with less education and economic stability, according to the statement. The statement authors emphasized that even people with higher education may have poor or limited health literacy if they are not familiar with health terminology and face situations that beyond their normal experience.

“The last decade has seen technological and pharmacologic advances in health care, cardiac devices, and mobile health initiatives alongside a growing emphasis on shared decision-making and patient-reported outcomes. If we don’t address health literacy these advances won’t benefit many of the people who have the greatest need,” Magnani said.

The authors of the statement advocate the use of The Universal Precautions Toolkit, which was created by the federal Agency for Health Research and Quality.

“The toolkit reminds us that health literacy is not a patient problem but is the result of the complexities of health care delivery. It calls on health care professionals to make changes that improve access to care for all patients,” said Magnani. Some of the strategies recommended for healthcare providers in the toolkit include:

  • Avoiding jargon and integrating pictures as teaching tools;
  • Creating understandable forms, informed consents and brochures;
  • Improving patient follow-up and telephone access;
  • Asking patients to bring in all of their medications so that the healthcare provider can assess medication adherence and safety;
  • Considering the patient’s culture, customs and beliefs in their care;
  • Linking patients to support from specialists, case management and community resources.

“We employ specialized care for our patients and expect them to understand the reasons for it and make lifestyle changes and take medications daily, many of them for life. We owe it to our patients to ensure that they fully understand their conditions and treatments,” Magnani said.

Co-authors are Mahasin S. Mujahid, Ph.D., M.S.; Herbert D. Aronow, M.D., M.P.H.; Crystal W. Cené, M.D., M.P.H.; Victoria Vaughan Dickson, Ph.D., R.N.; Edward Havranek, M.D.; Lewis B. Morgenstern, M.D.; Michael K. Paasche-Orlow, M.D., M.S.; Amu Pollak, M.D.; and Joshua Willey, M.D., Author disclosures are on the manuscript.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

 

For Media Inquiries: 214-706-1173

Darcy Spitz: 212-878-5940; Darcy.Spitz@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

 

 

]]>Heart NewsScientific Statements/GuidelinesMon, 04 Jun 2018 09:00:08 GMTStatement Highlights: Limited health literacy is a major barrier to heart health and managing heart disease and stroke. Health literacy is essential to navigate the health care system, use medication effectively and improve heart-healthy...https://newsroom.heart.org/news/limited-health-literacy-is-a-major-barrier-to-heart-disease-prevention-and-treatmentMon, 04 Jun 2018 09:00:00 GMT

Adults with high blood pressure face higher healthcare costs

Wed, 05/30/2018 - 04:04
Study Highlights:

  • Adults with high blood pressure are estimated to pay almost $2,000 more in annual healthcare costs compared to those without high blood pressure.
  • Nationally, annual healthcare costs for the U.S. population with high blood pressure are estimated to be $131 billion higher compared to those without the disease.

Embargoed until 4 a.m. CT / 5 a.m. ET Wednesday, May 30, 2018

DALLAS, May 30, 2018 — Adults with high blood pressure face $1,920 higher healthcare costs each year compared to those without high blood pressure, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Based on the U.S. prevalence of hypertension, researchers estimate the national adjusted annual cost for the adult population with high blood pressure to be $131 billion higher compared to those without the disease.

It is important to note that this twelve-year study was done using previous hypertension guidelines – which defined high blood pressure as 140/90 mm Hg or higher. In 2017, the American Heart Association and the American College of Cardiology lowered the definition of high blood pressure to 130/80 mm Hg or higher.

“The new lower definition of high blood pressure will increase the number of adults in the hypertensive population,” said study lead author Elizabeth B. Kirkland, M.D., M.S.C.R., an assistant professor of internal medicine at Medical University of South Carolina in Charleston. “This may decrease the average cost of hypertension for individual patients while increasing the overall societal costs of hypertension.”

For this study, researchers used 2003-2014 Medical Expenditure Panel Survey (MEPS) data that included 224,920 adults, of whom 36.9 percent had high blood pressure, to measure trends and calculate estimated annual healthcare costs. Researchers adjusted for other medical reasons, such as a history of stroke or diabetes, that would contribute to their medical expenses.

Compared to patients without high blood pressure, those with high blood pressure had:

  • 2.5 times the inpatient costs;
  • almost double the outpatient costs; and
  • nearly triple the prescription medication expenditures.

“While the increased cost for patients with high blood pressure remained stable from 2003-2014, the rising prevalence of hypertension will become an increasingly large burden on the U.S. population for hypertension expenditures,” Kirkland said. “The better we can learn to recognize high blood pressure, treat it and manage it, the better we'll be able to address these costs.”

Although expenditures were higher for inpatient and outpatient care, over the course of the study period, the researchers observed a shift toward more cost in the outpatient setting than the inpatient setting, which may reflect a larger societal trend to try to bring care out of the hospital system and into locations that are more accessible to most patients, Kirkland said.

National statistics from the 2017 hypertension guidelines estimate that 46 percent of U.S. adults — 103 million people — have high blood pressure, but only about half of those have their blood pressure controlled despite improvements in diagnosing, treating and controlling hypertension.

Co-authors are Marc Heincelman, M.D.; Kinfe G. Bishu, Ph.D.; Samuel O. Schumann, M.D., M.S.C.R.; Andrew Schreiner, M.D., M.S.C.R.; R. Neal Axon, M.D., M.S.C.R.; Patrick D. Mauldin, Ph.D.; and William P. Moran, M.D., M.S. Author disclosures are on the manuscript.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Karen Astle: 214-706-1392; karen.astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsStroke NewsWed, 30 May 2018 09:00:08 GMTStudy Highlights: Adults with high blood pressure are estimated to pay almost $2,000 more in annual healthcare costs compared to those without high blood pressure. Nationally, annual healthcare costs for the U.S. population with high blood pressure are estimated to be $131 billion higher compared to those without the disease. https://newsroom.heart.org/news/adults-with-high-blood-pressure-face-higher-healthcare-costsWed, 30 May 2018 09:00:00 GMT

Genomic medicine may one day revolutionize cardiovascular care

Tue, 05/29/2018 - 04:05
Statement Highlight:

  • Genomic medicine could enable doctors to make predictions about people's health, from the likelihood of developing heart disease or stroke to the severity of disease, as well as medications for treatment.

Embargoed until 4 a.m. CT / 5 a.m. ET Tues., May 29, 2018

DALLAS, May 29, 2018 — A new scientific statement from the American Heart Association summarizes the state-of-the-science of genomic medicine — the study of the health effects of the molecular interactions of a person’s unique genes — for studying cardiovascular traits and disorders and for therapeutic screening.

“The promise of genomic medicine is to be able to use a patient’s specific genetic material to make a personalized forecast of their risk for heart disease, and if they develop disease, predict its course and determine the particular medications that are more likely to help with their disease,” said Kiran Musunuru, M.D., Ph.D., M.P.H., chair of the writing committee for the statement and an associate professor of cardiovascular medicine and genetics at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.  

“Over the next decade, as we learn about cardiovascular disease at the molecular level, the hope is that we can develop therapies that will take advantage of this knowledge and be able to either treat or potentially cure disease,” Musunuru said.

DNA and RNA are two types of molecules found in most living organisms. DNA contains genetic information that is “translated” by means of RNA into proteins and metabolites, the tiny components that form cells and which play many other critical roles in the body. While genes, which are made up of DNA, carry traits inherited from your ancestors and are relatively stable during your lifetime, their “translation” can be altered by environmental factors, such as tobacco smoke, diet and exercise, for example.

Genomic medicine looks at all the types of molecular variation, from the DNA and RNA to the microorganisms in the human gut that seem to play an increasingly important role in maintaining health, and it seeks to find associations between patterns in these data and health outcomes.

An example of genomic medicine that is currently available to doctors is a noninvasive blood test for heart transplant patients, which measures the levels of 11 different RNA molecules to determine whether the patient’s immune system is rejecting the transplant. Traditionally, physicians biopsy cells from the patient’s heart on a weekly or biweekly basis by inserting a catheter into the heart to extract cells to monitor the transplanted organ for signs of rejection. While biopsies are considered relatively safe, there are risks, costs and discomfort for the patient. 

“The hope is that with genomic medicine, there will be hundreds of examples of noninvasive tests like this that doctors can do to better forecast and better manage disease,” Musunuru said.

Researchers similarly hope that induced pluripotent stem cells (iPSCs) — stem cells that are grown from mature cells in the body, such as skin or blood, and can be converted into any type of cell — can provide clinicians with a noninvasive method to learn more about a person’s risk of cardiovascular disease and test potential treatments before they are given to a patient.

For example, doctors could use iPSCs to grow millions of a patient’s heart cells in the laboratory and use these cells to identify the best course of treatment to benefit the patient.

The use of iPSCs is still in early testing and not yet available to patients, but the preliminary results are promising, Musunuru said.

“With induced pluripotent stem cells, we will be able to determine upfront which medications are going to work better and get a sense of a medication’s potential side effects,” Musunuru said. “I am confident we will reach the point where we can start incorporating these kinds of cells into actual patient care.”

The statement is published in the American Heart Association journal Circulation: Genomic and Precision Medicine, where Musunuru serves as editor-in-chief.

Co-authors are Calum A. MacRae, M.D., Ph.D. (Co-chair); Vice-Pankaj Arora, M.D.; John P. Cooke, M.D., Ph.D.; Jane F. Ferguson, Ph.D.; Ray E. Hershberger, M.D.; Kathleen T. Hickey, Ed.D., A.N.P.; Jin-Moo Lee, M.D., Ph.D.; João A.C. Lima, M.D., M.B.A.; Joseph Loscalzo, M.D., Ph.D.; Naveen L. Pereira, M.D.; Mark W. Russell, M.D.; Svati H. Shah, M.D., M.H.S.; Farah Sheikh, Ph.D.; and Thomas J. Wang, M.D.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries: 214-706-1173

Darcy Spitz: 212-878-5940; Darcy.Spitz@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Scientific Statements/GuidelinesHeart NewsTue, 29 May 2018 09:00:11 GMTStatement Highlight: Genomic medicine could enable doctors to make predictions about people's health, from the likelihood of developing heart disease or stroke to the severity of disease, as well as medications for treatment.   Embargoed until 4...https://newsroom.heart.org/news/genomic-medicine-may-one-day-revolutionize-cardiovascular-careTue, 29 May 2018 09:00:00 GMT

High protein diet associated with small increased heart failure risk in middle-aged men

Tue, 05/29/2018 - 04:05
Study Highlights:

  • For middle-aged men, eating higher amounts of protein was associated with a slightly elevated risk for heart failure than those who ate less protein.
  • Proteins from fish and eggs were not associated with heart failure risk in this study.

Embargoed until 4 a.m. CT / 5 a.m. ET Tuesday, May 29, 2018

DALLAS, May 29, 2018 – For middle-aged men, eating higher amounts of protein was associated with a slightly elevated risk for heart failure than those who ate less protein, according to new research in Circulation: Heart Failure, an American Heart Association journal.

Despite the popularity of high protein diets, there is little research about how diets high in protein might impact men’s heart failure risk.

“As many people seem to take the health benefits of high-protein diets for granted, it is important to make clear the possible risks and benefits of these diets,” said Jyrki Virtanen, Ph.D., study author and an adjunct professor of nutritional epidemiology at the University of Eastern Finland in Kuopio. “Earlier studies had linked diets high in protein – especially from animal sources -- with increased risks of Type 2 diabetes and even death.”

The American Heart Association estimates that one in five Americans 40 and older will develop heart failure – the body is unable to pump enough blood and oxygen to remain healthy. Heart failure can shorten life expectancy. And with no cure, preventing heart failure through diet, lifestyle and more is vital.

Researchers studied 2,441 men, age 42 to 60, at the study’s start and followed them for an average 22 years. Overall, researchers found 334 cases of heart failure were diagnosed during the study and 70 percent of the protein consumed was from animal sources and 27.7 percent from plant sources. Higher intake of protein from most dietary sources, was associated with slightly higher risk. Only proteins from fish and eggs were not associated with heart failure risk in this study, researchers said.

For this study, researchers divided the men into four groups based on their daily protein consumption. When they compared men who ate the most protein to those who ate the least, they found their risk of heart failure was:

  • 33 percent higher for all sources of protein;
  • 43 percent higher for animal protein;
  • 49 percent higher for dairy protein.
  • 17 percent higher for plant protein.

“As this is one of the first studies reporting on the association between dietary protein and heart failure risk, more research is needed before we know whether moderating protein intake may be beneficial in the prevention of heart failure,” said Heli E.K. Virtanen, M.Sc., first author of study, Ph.D. student and early career researcher at the University of Eastern Finland in Kuopio. “Long-term interventions comparing diets with differential protein compositions and emphasizing differential protein sources would be important to reveal possible effects of protein intake on risk factors of heart failure. More research is also needed in other study populations.”

The American Heart Association recommends a dietary pattern that includes a variety of fruits and vegetables, whole grains, low-fat dairy products, poultry, fish, beans, non-tropical vegetable oils and nuts; and limits intake of sweets, sugar-sweetened beverages and red meats.

Other co-authors are Sari Voutilainen, Ph.D.; Timo T. Koskinen, M.Sc.; Jaakko Mursu, Ph.D.; and Tomi-Pekka Tuomainen, M.D., Ph.D. No disclosures were reported by the authors.

The Finnish Cultural Foundation North Savo Regional fund, Päivikki and Sakari Sohlberg Foundation, Paavo Nurmi Foundation and The Finnish Association of Academic Agronomists funded the study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Karen Astle: 214-706-1392; karen.astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsTue, 29 May 2018 09:00:08 GMTStudy Highlights: For middle-aged men, eating higher amounts of protein was associated with a slightly elevated risk for heart failure than those who ate less protein. Proteins from fish and eggs were not associated with heart failure risk in this study. https://newsroom.heart.org/news/high-protein-diet-associated-with-small-increased-heart-failure-risk-in-middle-aged-menTue, 29 May 2018 09:00:00 GMT

South Asian Americans are at high risk for heart disease and stroke

Thu, 05/24/2018 - 04:11
Statement Highlights

  • South Asian Americans are more likely to die of atherosclerosis than other Asians and people of European ancestry.
  • Higher rates of diabetes and lack of exercise appear to be important factors in their increased risk.

Embargoed until 4 a.m. CT / 5 a.m. ET Thurs., May 24, 2018

DALLAS, May 24,2018 — South Asians are more likely to die of heart disease, such as heart attacks and strokes caused by atherosclerosis – the disease process that narrows arteries – than East Asians and non-Hispanic whites living in the United States, according to a new scientific statement from the American Heart Association published in its journal Circulation.

The statement provides an overview of the behaviors that influence the risk factors for heart disease and stroke among South Asians living in the United States based on a review of existing scientific research.

“Statistics about heart disease and stroke risk among Asians can be deceiving when all people of Asian ethnicity are combined into one group. Overall, Asians are at a lower risk for heart disease and stroke compared to people of European ancestry. But when you look at South Asians – both immigrants and people of South Asian ancestry born in the United States – their risk for heart disease and stroke is higher than people from East Asia and people of European ancestry,” said Annabelle S. Volgman, M.D., chair of the statement’s writing group and professor of medicine at Rush Medical College and medical director of the Rush Heart Center for Women in Chicago, Illinois. 

More than 3.4 million people who identify themselves as South Asians live in the United States, and about 80 percent come from India. Others come from Bangladesh, Bhutan, the Maldives, Nepal, Pakistan and Sri Lanka. This group includes both immigrants and people of South Asian ancestry who were born in America, according to the United States Census.

Compared to people of European ancestry South Asian Americans:

  • have a greater risk of having severe atherosclerosis – the narrowing of the arteries that underlies most heart disease and strokes;
  • are more likely to have multiple segments of their arteries narrowed by atherosclerosis;
  • have higher levels of artery clogging LDL cholesterol and triglycerides and lower levels of HDL (good) cholesterol, which predispose the arteries to develop fatty deposits in artery walls that cause them to narrow;
  • have a higher level of calcium deposits, a marker for atherosclerosis, if they are of Indian ancestry and over age 60;
  • are more likely to have diabetes, which is believed to accelerate atherosclerosis; and
  • develop diabetes at a younger age.  

The statement also focuses on behavioral factors that may increase the risk of developing atherosclerosis among South Asian Americans and suggests ways that they can be changed to improve health.

Volgman notes that diet is a key factor – many South Asians, even if they are vegetarians, eat a lot of saturated fats from tropical oils – such as palm and coconut oil – and refined carbohydrates, – such as sugar, white bread and highly processed foods.

Ongoing studies are looking into improving diet quality among South Asians by reintroducing traditional whole grains which were once a mainstay of diet in the region, in addition to suggesting replacing ghee (butter with all the water removed) with monounsaturated oils, such as olive, corn or other oils.

South Asian Americans also engage in less physical activity than other minority group members, according to the statement “As healthcare providers, we need to do a better job of helping our South Asian patients understand the importance of exercise, because many don’t realize how important it is to their health,” said Volgman. A recent study found that only 49 percent of South Asian Americans believed that exercise was important in preventing heart disease.

The authors cite studies that suggest that community programs that encourage South Asians to exercise and reduce stress through yoga and Bollywood dancing or other culturally specific physical activities are likely to be more successful than other forms of physical activity.

South Asians represent one of the fastest growing ethnic groups in the U.S. The statement concludes with a call to action to include more South Asians in research studies to better understand how to reduce their risk for heart disease and stroke.

Co-authors are Latha S. Palaniappan, M.D., (Vice-Chair); Neelum T. Aggarwal, M.D.; Milan Gupta, M.D.; Abha Khandelwal, M.D.; Aruna V. Krishnan, Ph.D.; Judith H. Lichtman, Ph.D.; Laxmi S. Mehta, M.D.; Hena N. Patel, M.D.; Kevin S. Shah, M.D.; Svati H. Shah, M.D.; and Karol E. Watson, M.D., Ph.D. Author disclosures are on the manuscript.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries: 214-706-1173

Darcy Spitz: 212-878-5940; Darcy.Spitz@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsStroke NewsThu, 24 May 2018 09:00:05 GMTStatement Highlights: South Asian Americans are more likely to die of atherosclerosis than other Asians and people of European ancestry. Higher rates of diabetes and lack of exercise appear to be important factors in their increased...https://newsroom.heart.org/news/south-asian-americans-are-at-high-risk-for-heart-disease-and-strokeThu, 24 May 2018 09:00:00 GMT

Social isolation plus heart failure could increase hospitalizations, deaths

Wed, 05/23/2018 - 04:11
Study Highlights:

  • Heart failure patients who felt socially isolated were much more likely to die or be hospitalized than more socially connected patients.
  • Screening heart failure patients for social isolation could help identify those at risk of poor outcomes.

Embargoed until 4 a.m. CT / 5 a.m. ET Wednesday, May 23, 2018

DALLAS, May 23, 2018 — Patients with heart failure who felt socially isolated were much more likely to die or be hospitalized than more socially connected patients, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

More than 6 million U.S. adults are estimated to have heart failure and that number continues to rise. In an earlier study, these researchers found that social isolation may increase the risk of depression and anxiety. However, little is known about the possible connection between patients’ feelings of social isolation, risk of death and use of medical care.

In this study, researchers surveyed 1,681 patients (average age 73, mostly white, 53 percent men) about their sense of loneliness or isolation. All the patients – residents of 11 counties in southeastern Minnesota – had been diagnosed with heart failure between January 2013 and March 2015.

About 6 percent of the heart failure patients reported a high level of perceived social isolation. Researchers compared the heart failure patients reporting high perceived social isolation with those reporting low perceived social isolation. They found those in the high perceived social isolation group had:

  • 3.7 times or more increased risk of death;
  • 1.7 times increased risk of hospitalization; and
  • 1.6 times higher risk of emergency department visits.

“Our study found a patient’s sense of feelings of loneliness or isolation, may contribute to poor prognosis in heart failure,” said study senior author Lila Rutten, Ph.D., professor of health services research at the Mayo Clinic in Rochester, Minnesota. “Healthcare providers may aid their heart failure patients by implementing a valid, reliable and brief screening tool to help identify those who are experiencing social isolation.”

This study may not apply to other populations, as it lacks racial and geographic diversity. There was also limited follow-up and patients who felt less socially isolated may have been more likely to respond.

Co-authors are Sheila M. Manemann, M.P.H.; Alanna M. Chamberlain, Ph.D.; Véronique L. Roger, M.D., M.P.H.; Joan M. Griffin, Ph.D.; Cynthia M. Boyd, M.D., M.P.H.; Thomas K. M. Cudjoe, M.D., M.P.H.; Daniel Jensen, M.P.H.; Susan A. Weston, M.S.; Matteo Fabbri, M.D.; and Ruoxiang Jiang, B.S. Author disclosures are on the manuscript.

The National Heart, Lung and Blood Institute and the Patient Centered Outcomes Research Institute funded the study, which was made possible by the Rochester Epidemiology Project from the National Institute on Aging.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Bridgette McNeill: 214-706-1135; bridgette.mcneill@heart.org  

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsWed, 23 May 2018 09:00:07 GMTStudy Highlights: Heart failure patients who felt socially isolated were much more likely to die or be hospitalized than more socially connected patients. Screening heart failure patients for social isolation could help identify those at risk of poor outcomes. https://newsroom.heart.org/news/social-isolation-plus-heart-failure-could-increase-hospitalizations-deathsWed, 23 May 2018 09:00:00 GMT

Keep saying yes to fish twice a week for heart health

Thu, 05/17/2018 - 04:43
Advisory Highlight:

  • A new scientific advisory from the American Heart Association reaffirms the Association’s recommendation to eat two servings of fish per week.

Embargoed until 4 a.m. CT / 5 a.m. ET Thurs., May 17, 2018

DALLAS, May 17, 2018 — A new scientific advisory reaffirms the American Heart Association’s recommendation to eat fish- especially those rich in Omega-3 fatty acids twice a week to help reduce the risk of  heart failure, coronary heart disease, cardiac arrest and the most common type of stroke (ischemic). The advisory is published in the American Heart Association’s journal Circulation.

“Since the last advisory on eating fish was issued by the Association in 2002, scientific studies have further established the beneficial effects of eating seafood rich in Omega-3 fatty acids, especially when it replaces less healthy foods such as meats that are high in artery-clogging saturated fat,” said Eric B. Rimm, Sc.D., chair of the American Heart Association writing group and professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health in Boston.

The Association recommends eating two 3.5-ounce servings of non-fried fish, or about ¾ cup of flaked fish every week. Emphasis should be placed on eating oily fish like salmon, mackerel, herring, lake trout, sardines or albacore tuna, which are all high in omega-3 fatty acids.

The advisory was written by a panel of nutrition experts, who also reviewed studies about mercury in fish. Mercury is found in most seafood but is prevalent in large fish such as shark, swordfish, tilefish, king mackerel, bigeye tuna, marlin and orange roughy. The writing group concluded that while mercury contamination may be associated with serious neurological problems in newborns, existing scientific research finds that mercury contamination does not have adverse effects on heart disease risk in adults, and the benefits of eating fish substantially outweigh any risks associated with mercury contamination, especially if a variety of seafood is consumed.

The importance of environmentally sustainable fish farming techniques and other topics are also briefly discussed in the advisory. A previously published American Heart Association advisory on Omega-3 fish oil supplements noted that the supplements are not recommended for the general public to prevent clinical cardiovascular disease because of a lack of scientific evidence regarding any effect on cardiovascular risk.

Co-authors are Lawrence J. Appel, M.D., M.P.H.; Stephanie E. Chiuve, Sc.D.; Luc Djoussé, M.D., M.P.H. Sc.D.; Mary B. Engler, Ph.D., R.N, M.S.; Penny M. Kris-Etherton, Ph.D., R.D.;

Dariush Mozaffarian, M.D., Dr.PH.; David S. Siscovick, M.D., M.P.H.; and Alice H. Lichtenstein, Sc.D.

Author disclosures are on the manuscript.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries: 214-706-1173

Darcy Spitz: 212-878-5940; Darcy.Spitz@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Advisories & CommentsHeart NewsThu, 17 May 2018 09:00:11 GMTAdvisory Highlight: A new scientific advisory from the American Heart Association reaffirms the Association’s recommendation to eat two servings of fish per week. https://newsroom.heart.org/news/keep-saying-yes-to-fish-twice-a-week-for-heart-healthThu, 17 May 2018 09:00:00 GMT

In-womb air pollution exposure associated with higher blood pressure in childhood

Mon, 05/14/2018 - 04:16
Study Highlights:

  • Children who were exposed to higher levels air pollution while in the womb had a higher risk of elevated blood pressure in childhood.
  • This is one of the first studies to show that air pollution may have negative health effects on offspring exposed during pregnancy.

Embargoed 4 a.m. CT / 5 a.m. ET Monday, May 14, 2018

DALLAS, May 14, 2018 – Children who were exposed to higher levels of air pollution during the third trimester of their mother’s pregnancy had a higher risk of elevated blood pressure in childhood, according to new research in the American Heart Association’s journal Hypertension.

Fine particulate matter of 2.5 microns or less (PM2.5) is a form of air pollution produced by motor vehicles and the burning of oil, coal and biomass, and has been shown to enter the circulatory system and negatively affect human health. Previous studies found, direct exposure to fine air pollution was associated with high blood pressure in both children and adults and is a major contributor to illness and premature death worldwide.

“Ours is one of the first studies to show breathing polluted air during pregnancy may have a direct negative influence on the cardiovascular health of the offspring during childhood,” said Noel T. Mueller, Ph.D., M.P.H., senior author of the study and an assistant professor of epidemiology at the Johns Hopkins University Bloomberg School of Public Health in Baltimore, Maryland. “High blood pressure during childhood often leads to high blood pressure in adulthood and hypertension is the leading cause of cardiovascular disease.”

Researchers examined 1,293 mothers and their children who were part of the large, ongoing Boston Birth Cohort study. Blood pressure was measured at each childhood physical examination at 3- to 9- years old. A systolic (top number) blood pressure was considered elevated if it was in the highest 10 percent for children the same age on national data. Researchers also adjusted for other factors known to influence childhood blood pressure, such as birthweight and maternal smoking.

They found:

  • Children exposed to higher levels (the top third) of ambient fine-particulate pollution in the womb during the third trimester were 61 percent more likely to have elevated systolic blood pressure in childhood compared to those exposed to the lowest level (the bottom third).
  • Higher exposure to air pollution in the third trimester, when fetal weight gain is the most rapid, was already known to influence (lower) birthweight, but this study found the association with elevated blood pressure regardless of whether a child was of low-, normal- or high birthweight.
  • A woman’s fine-particulate matter exposure before pregnancy was not associated with blood pressure in her offspring, thus providing evidence of the significant impact of in-utero exposure.

“These results reinforce the importance of reducing emissions of PM2.5 in the environment. Not only does exposure increase the risk of illness and death in those directly exposed, but it may also cross the placental barrier in pregnancy and effect fetal growth and increase future risks for high blood pressure,” Mueller said.

Researchers used each woman’s residential address and information from the nearest U.S. Environmental Protection Agency’s (EPA) air quality monitor to estimate exposure to air pollution in each trimester of pregnancy.

The concentrations of PM2.5 in the highest category in this study (11.8 micrograms per cubic meter or higher) were slightly lower than the EPA’s National Air Quality Standard (12 micrograms per cubic meter).

“The science on the health effects of air pollution is under review by the EPA. The findings of our study provide additional support for maintaining, if not lowering, the standard of 12 micrograms of PM2.5 per cubic meter set in 2012 by the National Ambient Air Quality Standards under the Clean Air Act. We need regulations to keep our air clean, not only for the health of our planet but also for the health of our children” Mueller said.

This study established an association. It did not prove a direct cause-and-effect relationship. However, the by size of the study, follow-up and ability to adjust for many factors that might influence childhood blood pressure add to the strength of the findings, researchers noted.

Co-authors are Mingyu Zhang, B.Sc, BEcon; Hongjian Wang, M.D., Ph.D.; Xiumei Hong, M.D., Ph.D.; Lawrence J. Appel, M.D., M.P.H.; and Xiaobin Wang, M.D., M.P.H., Sc.D. The researchers reported no disclosures.

The Boston Birth Cohort received grant support from The March of Dimes Birth Defects Foundation, the National Institute of Child Health and Human Development and the Maternal and Child Bureau of the Health Resources and Services Administration.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Karen Astle: 214-706-1392; karen.astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

]]>Heart NewsStroke NewsMon, 14 May 2018 09:00:06 GMTStudy Highlights: Children who were exposed to higher levels air pollution while in the womb had a higher risk of elevated blood pressure in childhood. This is one of the first studies to show that air pollution may have negative health effects on offspring exposed during pregnancy. https://newsroom.heart.org/news/in-womb-air-pollution-exposure-associated-with-higher-blood-pressure-in-childhoodMon, 14 May 2018 09:00:00 GMT

Patients get faster life-saving treatment in states with policies allowing direct transport to specialized heart attack care hospitals

Tue, 05/01/2018 - 05:01
Study Highlights:

  • People having heart attacks get faster life-saving treatment if they live in states that allow EMS to bypass closer hospitals that don’t offer the specialized treatment, taking patients directly to those that do.
  • Reducing the time from first medical contact to treatment that restores blood flow to the heart is the most critical factor in improving patient survival. 

Embargoed until 4 a.m. CT / 5 a.m. ET Tuesday, May 1, 2018

DALLAS, May 1, 2018 — People having a heart attack get faster life-saving treatment to restore blood flow to the heart if they live in states that allow emergency medical crews to bypass hospitals that don’t offer the specialized treatment in favor of hospitals that do, according to new research in Circulation: Cardiovascular Interventions, an American Heart Association journal.

The study looked at how quickly heart attack patients received percutaneous coronary intervention, or PCI, a preferred treatment to open blocked arteries. Not all hospitals have the specialized capability to perform PCI, so researchers compared treatment times in states with and without policies that allow emergency medical services (EMS) to take patients directly to hospitals that offer PCI, even if that means bypassing closer facilities.

In this study, 57.9 percent of patients living in states with hospital bypass policies received PCI within relevant guideline-recommended times, compared to 47.5 percent of those living in states without bypass policies.

American Heart Association/American College of Cardiology guidelines call for patients to receive PCI within 90 minutes or less from first medical contact if they’re taken directly to a PCI-capable hospital and within 120 minutes or less if first taken to a non-PCI-capable facility and transferred.

“Our findings provide a compelling case for state-level policies that allow emergency medical services to take patients directly to the PCI-capable centers,” said Jacqueline Green, M.D., M.P.H., the study lead author and a cardiologist at Piedmont Heart Institute in Fayetteville, Ga. “A policy that improves access to timely care for even an additional 10 percent of patients could have a significant impact on a population level.”

Green conducted the study during fellowship training at the University of Michigan in Ann Arbor.
The analysis involved 19,287 patients treated at 379 hospitals in 12 states. Researchers compared time to treatment for heart attack patients receiving care in 2013 and 2014 in six states with bypass policies (Delaware, Iowa, Maryland, Massachusetts, North Carolina and Pennsylvania) to treatment times for patients in six states without bypass policies (Connecticut, New York, Minnesota, South Carolina, Texas and Virginia.)

Even though the time from symptom onset to hospital arrival did not differ across states, patients treated in states with bypass policies received faster intervention once they contacted emergency medical services.

  • In states with bypass policies, 57 percent of people having heart attacks received PCI within 90 minutes or less of first medical contact and 82 percent underwent PCI within 120 minutes or less of first medical contact.
  • Those numbers were significantly lower in states that did not have bypass policies, where 45 percent of people received PCI within 90 minutes or less and 77 percent within 120 minutes or less.

Patients taken to non-specializing nearby hospitals often face critical delays in treatment because they need an initial evaluation before being triaged to a specialized hospital. Patients in states with bypass policies were more likely to receive a diagnostic electrocardiogram prior to hospital arrival, compared with patients treated in states without those policies (75 percent compared with 69 percent). This earlier diagnosis can allow for faster life-saving treatment once the patient arrives at the hospital.

Researchers noted a key challenge in any heart attack care was that a substantial number of patients (27 percent) delayed accessing EMS or didn’t access EMS at all and took themselves to the hospital.
The study was funded by the American Heart Association’s Mission: Lifeline program which aims to develop coordinated systems of care led by EMS and hospitals teams to use guidelines and best practices to treat heart attack, stroke and cardiac arrest. The goal is to improve and expediate care from the moment a person first has symptoms, to calling 9-1-1, getting to the right facility to get the right treatment and continuing through hospital discharge, rehabilitation and recovery.

An accompanying editorial notes that the timely delivery of appropriate care to heart attack patients is complex and has many unique facets.

“The present analysis demonstrates that allowing EMS providers to bypass non-PCI-capable hospitals in favor of PCI-capable hospitals can significantly reduce time to appropriate reperfusion therapy,” write authors Daniel Kolansky, M.D. and Paul Fiorilli, M.D. of the University of Pennsylvania in Philadelphia.

“Although much work has already been accomplished to expedite the care of these patients, we need to continue to put together all the pieces of this puzzle to provide the best possible heart attack care for our patients.”

They note areas for improvement including:

  • routine use of pre-hospital ECG transmission (and early cath lab activation),
  • development of community-based education outreach programs to improve patient symptoms recognition, and
  • continued development of regionalized systems of care for STEMI patients to reduce the overall time from EMS activation to reperfusion therapy.

“This study strengthens the case for state government leadership in developing robust systems of EMS care that can triage and transport patients with time-critical conditions such as heart attacks,” Green said.

Co-authors are Alice Jacobs, M.D.; DaJuanicia Holmes; Karen Chiswell, Ph.D.; Rosalia Blanco, M.B.A.; Matthew Roe, M.D.; Eric Bates, M.D.; William French, M.D.; Douglas Kupas, M.D.; Greg Mears, M.D.; and Brahmajee Nallamothu, M.D.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at heart.org/corporate funding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Cathy Lewis: 214-706-1324; cathy.lewis@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsTue, 01 May 2018 09:00:08 GMTStudy Highlights: People having heart attacks get faster life-saving treatment if they live in states that allow EMS to bypass closer hospitals that don’t offer the specialized treatment, taking patients directly to those that do. Reducing the time from first medical contact to treatment that restores blood flow to the heart is the most critical factor in improving patient survival. https://newsroom.heart.org/news/patients-get-faster-life-saving-treatment-in-states-with-policies-allowing-direct-transport-to-specialized-heart-attack-care-hospitalsTue, 01 May 2018 09:00:00 GMT

New strategies needed to help healthcare providers gain knowledge to counsel patients on diet

Mon, 04/30/2018 - 04:09
Statement Highlight:

  • Healthcare providers are willing to counsel heart disease patients on diet but need more educational support.

Embargoed until 4 a.m. CT / 5 a.m. ET Mon. April 30, 2018

DALLAS, April 30, 2018 — A new scientific advisory from the American Heart Association reviews current gaps in medical nutrition education and training in the United States and summarizes reforms in undergraduate and graduate medical education to support more robust nutrition education and training efforts.

“Despite evidence that physicians are willing to help educate patients about healthy eating and are viewed as credible sources of diet information, they engage patients in diet counseling at less-than-desirable rates and cite insufficient knowledge and training as barriers, even during their peak learning years,” said Karen E. Aspry, M.D., M.S., the lead statement author and assistant professor of medicine at Brown University in Providence, Rhode Island.  

The National Academy of Sciences recommends undergraduate medical students receive a minimum of 25 classroom hours dedicated to nutrition education, but a 2013 survey found that 71 percent of medical schools provide less than the recommended hours and 36 percent provide less than half that amount.

The advisory provides examples of successful approaches currently being used to integrate clinical nutrition throughout undergraduate and graduate medical education courses, instead of a one-time course. In addition, it also provides information about assessing nutrition knowledge and competencies and outlines nutrition resources and continuing medical education activities.

“Nutrition is a dynamic science with a rapidly evolving evidence base requiring continual updating and renewed translational efforts. The competencies outlined in this statement provide a foundation with flexible options for advancing nutrition knowledge and skills across the learning continuum, and a toolkit for medical school curriculum directors, program directors, faculty, trainees and students,” said Linda Van Horn, Ph.D., R.D., co-chair of the writing group and professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago, Illinois. The advisory is published in the American Heart Association journal Circulation.

Other co-authors are Jo Ann S. Carson, Ph.D., R.D.; Judith Wylie-Rosett, Ed.D., R.D.; Robert F. Kushner, M.D.; Alice H. Lichtenstein, D.Sc.; Stephen Devries, M.D.; Andrew M. Freeman, M.D.; Allison Crawford, M.D.; and Penny Kris-Etherton, Ph.D., R.D. Author disclosures are on the manuscript.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries: 214-706-1173

Darcy Spitz: 212-878-5940; Darcy.Spitz@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org
 

]]>Heart NewsAdvisories & CommentsMon, 30 Apr 2018 09:00:09 GMTStatement Highlight: Healthcare providers are willing to counsel heart disease patients on diet but need more educational support. https://newsroom.heart.org/news/new-strategies-needed-to-help-healthcare-providers-gain-knowledge-to-counsel-patients-on-dietMon, 30 Apr 2018 09:00:00 GMT

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