Women Benefit More In Certain Heart Disease Treatment!

Heart failure is a condition in which heart is unable to pump blood at an adequate rate or in adequate volume. In serious cases, heart failure patients could lose their life with cessation of heartbeat.

There are numerous reasons why one might develop heart failure, which can be sudden or happen gradually over a periods of time. Some common causes are heart attack, high blood pressure, defective valves in the heart, cardiomyopathies (diseases of the heart muscle), too much alcohol, and congenital conditions that one is born with.

Besides taking right mix of medications, heart failure patients could have their condition reversed if the heart valve is repaired or fast heart rhythm is controlled. In some cases, certain devices are used to help the heart beat and contract properly. For example, cardiac resynchronization therapy with defibrillator (CRT-D), which is a form of therapy for congestive heart failure caused by dilated cardiomyopathy, have been found to have remarkable benefits on appropriately selected patients with heart failure.

CRT-D can help guard against sudden death from irregular heart rhythm by using a specialized pacemaker to re-coordinate the action of the right and left ventricles in patients with heart failure. It can also help strengthen pumping action in patients with heart damage.

Researchers from the University of Rochester pointed out in their findings that CRT-D works twice as well in women. Their study, which was published on February 7, 2011 in the ‘Journal of the American College of Cardiology’, found that when using CRT-D, there was a 70 percent reduction in heart failure in women compared a 35 percent drop in men.

This is probably the first time in history of heart disease research that has credited a certain type of treatment that is more effective in women than in men. In the past cardiac studies, men and women generally received similar benefit from preventive medical therapy.

According to researchers, CRT-D works better in women because women tend to suffer from a different type of heart disease than men. The male participants in the study were more likely to have coronary heart disease while the female participants were more likely to suffer from non-ischemic heart disease.

Coronary artery disease, which is also known as ischemic heart disease, is a condition in which narrowed vessels restrict blood flow to the heart. Non-ischemic heart disease, on the other hand, is one that involves more generalized scarring of heart tissue.

Can Fish Oil Really Prevent Heart Disease?

Omega-3 fatty acid is healthy for all from growing children to heart disease patients. This is the message conveyed to people for years by many health professionals and doctors. In recent years, omega-3 has even been added to some foods such as margarine and eggs.

However, Dutch researchers found in their study of about 5,000 heart attack survivors that eating about 400 milligrams of fish fatty acids per day did not significantly decrease the risk of getting heart attack, stroke, heart failure and other cardiovascular events for those patients who were already getting good care. 400 milligrams of fish fatty acids is the equivalent of 2 fatty fish meals.

At the end of 3 and half years, there was no change in death, heart attack and other heart problems between those who consumed margarine with added omega-3 fatty acids and those who did not.

The findings were presented by researchers from Wageningen University in the Netherlands during the month of August 2010 at the European Society of Cardiology meeting in Stockholm, Sweden, and published online by the New England Journal Of Medicine.

Does the results mean that getting more of the fatty acid does not has any benefit? Of course NO!

As confirmed by several studies, omega-3 fish fatty acid (mostly from fish oil) help reduce heart disease. It would reduce the risk of abnormal heartbeats (arrhythmias) that can lead to sudden death, decrease triglyceride (harmful fats) levels, slow the growth of atherosclerotic plaque that could clog arteries, and lower blood pressure (slightly).

The reason that adding a low-dose of omega-3 fatty acid did not offer extra protection, as explained by the researchers, is that the participants were taken good care by their doctors: they were taking the best medicines to prevent future heart problem. Among the participants, about 98 percent were on anti-platelet treatments, 90 percent were taking blood pressure lowering agents and 85 percent were taking lipid-lowering agents.

As compared to those heart patients in earlier research who did benefit by taking fish oil pills, the participants in this study were also older (aged between 60 and 80) and took part in the study years after their heart attack.

Have People Strived Hard to Lower Their Bad Cholesterol?

When people’s bad cholesterol or low-density lipoprotein (LDL) is high, they actually have a much higher risk of developing high blood pressure, stroke and even heart disease. As such, it is advisable for them to lower their LDL level.

A recent study by researchers from the University of California, San Francisco showed that over the last decade, the number of patients who have lowered their LDL to the recommended level has nearly doubled in 9 countries, namely Brazil, Canada, France, Mexico, the Netherlands, South Korea, Spain, Taiwan and the United States.

Published in the American Heart Association's journal Circulation on June 22, 2009, the findings revealed that patients in the United States, Brazil, France and South Korea had accepted a combination of medical treatment and lifestyle changes to improve their bad cholesterol.

In the study, close to 10,000 people with an average age of 62 were surveyed. The number of patients, who had successfully reached their target LDL level, was found to rise from 38 percent to 73 percent over the last 10 years.

On the other hand, only 30 percent of the high-risk patients, who have existing coronary artery disease or risk factors such as obesity, diabetes or smoking, had successfully reached their target LDL of 70mg per deciliter or less.

Although there is still some room for improvement, particularly in very high-risk patients, the results did indicate that LDL-lowering therapy has been applied much more successfully than it had been a decade ago.

The target LDL level in the United States depends on how many risk factors are present in the patient.

For patients without coronary artery disease, diabetes, or other cardiovascular risk factors, the ideal LDL is 160 mg/dL or less. People without either coronary artery disease or diabetes but with at least 2 other risk factors should keep their LDL level to less than 130 mg/dL

Patients who have cardiovascular diseases or diabetes should keep their bad cholesterol level no higher than 100 mg/dL, and should try to maintain a level lower than 70 mg/dL if they also have other risk factors.

Drugs Combination Could Raise The Risk of Another Heart Attack!

It is common practice for doctors to prescribe blood-thinning medication such as Plavix or aspirin together with a proton pump inhibitor (PPI) like Prilosec to their patients who had heart attack.

Plavix is also known as clopidogrel, and is manufactured by Sanofi-Aventis SA and Bristol-Myers Squibb Co. On the other hand, Prilosec is a drug for heartburn and is product of AstraZeneca Plc. The purpose of taking PPI is to cut the risk of gastrointestinal bleeding from blood thinners.

However, the latest research showed that people who suffer a heart attack will nearly double their chance of getting another if they are taking Plavix together with a heartburn drug.

A study conducted by researchers from the Denver VA Medical Center indicated that two-thirds of the heart attack patients who took Plavix and aspirin together with a PPI, primarily Prilosec, had almost double the risk of having another heart attack or bout of unstable angina, comparing with those not taking a PPI. Their findings were published on March 3, 2009 in the Journal of the American Medical Association.

In the study, the researchers tracked some 8,205 United States patients, who were treated for a heart attack or chest pain known as unstable angina, and who were given Plavix and aspirin. The study highlighted a potential interaction between clopidogrel and PPI medication, and the researchers believed that this drug combination might be responsible for thousands of repeat heart attacks.

Therefore, they suggested that PPI medication should not just be prescribed routinely or prophylactically in patients who are on aspirin and clopidogrel.

Nevertheless, the findings have not been widely accepted among medical circles and some doctors actually express their worries. If PPIs are not prescribed for heart attack patients, it is possible that more bleeding complications would occur among the patients. It is undeniably that a big bleed for a patient with significant coronary artery disease could be fatal.

As such, some doctors urged caution regarding the findings. Perhaps, more studies should be carried out to strengthen the findings and better still to look for alternative ways of treatment.

Can Electrocardiogram Predict Heart Disease?

Angina is a common symptom of coronary artery disease. It is a condition characterized by sharp chest pain or discomfort. It occurs when an area of the heart muscle does not receive enough oxygen-rich blood. Sometimes, the pain may also occur in the neck, arms, shoulders, jaw or even back, and it can feel like indigestion too.

People usually regard electrocardiogram (or better known as ECG or EKG) as one that is given only to patients who are having attack of angina. It is estimated that about 1 in 50 people in Britain experience angina.

A paper published on November 14, 2008 in the British Medical Journal indicated that a routine examination by a doctor works almost as well as ECG in predicting heart disease.

During the ECG test, electrodes are placed on a patient’s skin and the electrical activity of the heart is recorded over time so that abnormal rhythms could be detected. Although ECG has been shown to be effective in revealing damage, its ability in predicting future heart disease was unknown.

As such, a team of researchers at the London Queen Mary's School of Medicine and Dentistry carried out a study that examined 8,176 patients with suspected angina but with no prior history of heart disease.

A standard clinical assessment, which looked at criteria including age, sex, ethnicity, duration of symptoms, description of chest pain, smoking status, and history of hypertension (high blood pressure) and medicines, was carried out on all the patients.

ECG was given to all the patients while they were at rest, and some 60 percent of them were arranged to have an exercise ECG that was performed while they were in motion. All the patients were monitored during the following year.

The researchers found that half of all heart incidents, which occurred during that period, happened in patients whose ECG tests had not shown any indication of heart disease. Meanwhile, they also found that a routine clinical assessment was almost as good an indicator of future heart problems.

Such findings might highlight the importance of taking a detailed medical history and making a thorough physical examination. ECG might be helpful for some patients by the additional information it provides, but it is a pity that it does not predict heart disease risk for everyone.

If You Have High Cholesterol, Take Statin First!

A person with high cholesterol level is subject to high risk of developing heart disease, stroke, or high blood pressure. This is an undeniable fact. Therefore, when your cholesterol level reaches a dangerous high level, your family doctor will almost certainly advise you to take some cholesterol drug to help control the level. Then, the next question is which drug to take?

On March 31, 2008, a new study reported by American College of Cardiology (ACC) that patients having trouble controlling their cholesterol levels should first take stronger doses of statin drugs before trying Vytorin. The findings reinforced earlier findings that Vytorin worked no better than an older, cheaper statin in reversing the progression of heart disease.

Vytorin combines the statin Zocor with another cholesterol medicine, Zetia (or ezetimibe), is marketed by a joint venture of Merck and Schering-Plough. Vytorin is claimed to be the only product that can help block the absorption of cholesterol coming from food, and reduce the cholesterol made naturally by the body. Vytorin can lower LDL (bad) cholesterol, total cholesterol and triglycerides (fatty substances in the body), as well as raise HDL (good) cholesterol. Nevertheless, it has not been shown to reduce heart attacks or strokes more than Zocor alone.

In the views of the group, representing heart specialists, the results of this new study should be taken into consideration while the National Heart, Lung, and Blood Institute (NHLBI) is working to update its national cholesterol treatment guidelines. The new study, known as “Enhance”, actually mirrored the results obtained in January that found that Vytorin failed to show that it is any better than a cheaper generic statin in reducing the thickness of artery walls in patients with an inherited form of heart disease.

Because of the lack of beneficial evidence, an ACC expert panel recommended that doctors should first put patients on a high-dose statin, and then try other drugs before reaching for Vytorin or Zetia.

The results also suggests it is necessary to stick to the current American College of Cardiology/American Heart Association Guidelines, which recommend statins to the maximally tolerated dose or to goal as first-line treatment for patients with coronary artery disease.

Is Cholesterol Tied To Stroke Or Heart Disease?

A group of researchers reported in the Lancet medical journal that "lower total cholesterol was associated with lower death rates from coronary artery disease (also called ischemic heart disease) among men and women of all ages studied."

Being a leading cause of worldwide death, coronary artery disease is caused by fatty deposits that clog arteries. The deposits build up in the arteries, which supply the heart with blood, will narrow the arteries and reduce the blood flow to the heart. This can lead to heart attack and other conditions.

The researchers' initial aim for their study was to establish whether high cholesterol raises the risk of stroke but what they found at the end of their research was that "lower cholesterol levels were not linked to reduced stroke deaths."

Definitive previous research established that drugs called statins, which lower low density lipoprotein cholesterol (also called LDL or 'bad cholesterol) substantially reduce stroke risk. However, based on the researchers' analysis of 61 previous studies involving almost 900,000 adults, conducted mostly in western Europe and North America, people with lower total blood cholesterol levels had a lower heart disease death rate.

The study tracked on people who aged between 40 and 89, and found that about 34,000 of them died of heart disease and 12,000 died of a stroke. The study, nevertheless, did not separate those died of ischemic stroke (caused by blocked arteries) from haemorrhagic stroke (caused by a burst blood vessel).

Surprisingly, the study could not establish any relationship between total cholesterol levels and risk of stroke death, especially at older ages and among people with higher blood pressures.

The researchers could not really understand what is going on. And they stressed that they need to know more about cholesterol and more about stroke sub-types to find out the reasons behind this. In the meantime, they do not want people already on a statin thinking that they should stop taking the drug because if their cholesterol gets lower, then they are at a higher risk of stroke. That is absolutely not the case.

Does Heart Surgery Benefit Elderly With Diabetes?

It has been known that revascularization (that is, surgery or angioplasty) to restore blood flow to the heart muscle can benefit angina (heart-related chest pain) in elderly patients with symptomatic coronary artery disease (CAD).

A recent study, conducted on elderly patients over a period of 4 years, reported that diabetic patients benefited similarly as non-diabetics from revascularization in terms of survival rate although they had a worse outcome than non-diabetics in terms of hypertension, risk factors and cardiovascular events of heart failure and heart attacks.

Therefore, diabetic patients should be given the choice of revascularization to improve their symptomatic and overall outcomes.

Sudden Cardiac Death?

For the past few weeks, there were 4 young male victims who had no known health problems or family history of sudden deaths died during sleep. Although actual reasons have not been known, most deaths of this kind were believed to be caused by cardiovascular conditions.

According to cardiologists, the chances of sudden cardiac death are small for healthy persons with no family history of sudden death, congenital heart disease and multiple risk factors such as diabetes and hypertension. It is estimated to be one in 1,000.

Men are more at risk as they are generally more prone to coronary artery disease. There is no well-documented data on sudden death during sleep. But, a French study conducted in 1994 found that one-third of all sudden deaths occur during sleep. Often, victims were not aware that they had congenital or underlying heart conditions such as a blockage in a blood vessel or the heart.

The abnormalities in the heart or brain, if detected early, can be treated with medication, surgery, or devices such as pacemaker. Nevertheless, the best approach is to minimize the chances of developing a heart condition through a balanced diet, regular exercise and strict control of existing conditions like hypertension, diabetes, and high cholesterol.