Heart
Medicare rules hit heart device makers
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Proposed rules changing the way the U.S. Medicare health insurance agency reimburses hospitals would hurt makers of pricey heart devices the most, and is most favorable to rural hospital companies, analysts said on Thursday.
The U.S. Centers for Medicare and Medicaid Services, a major source of hospital revenue, released draft rules late Wednesday with an aim to redistribute profits from highly reimbursed procedures such as some heart surgeries, to conditions seen as underpaid, like treating pneumonia.
The rules are subject to a public comment period and cover 2007 and 2008.
Cholesterol-lowering drug might not promote healthy hearts
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Antioxidants, such as beta-carotene and Vitamin E, have been touted for their ability to protect against heart disease.
This protective effect is attributed to their ability to prevent the oxidation of bad cholesterol by free radicals - a process thought to contribute to the build-up of disease-causing fatty deposits on artery walls. But a new study, published in The Journal of Experimental Medicine, suggests that the heart-healthy effect of one antioxidant has little to do with cholesterol oxidation.
A group of researchers at the University of New South Wales in Australia, led by Roland Stocker, studied a cholesterol-lowering drug called Probucol (Lorelco) in laboratory rodents with vascular disease. Probucol reduces the risk of heart disease in humans, but is no longer prescribed in the US and Australia because of adverse side effects: a tendency to lower good cholesterol along with the bad and the potential to induce an irregular heartbeat. Probucol is still available in Canada and Europe.
Heart patients take their meds, but won’t exercise
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Older patients with heart failure are more likely to take their medications as directed and to keep their office appointments, but they are less likely to follow advice to exercise and to check their weight regularly, according to a new study. Depression, the authors suggest, may contribute to the patients’ lack of compliance.
Non-compliance with heart failure medication and diet recommendations contributes to worsening symptoms, leading to hospitalization in many instances. To pinpoint patient-related factors that influence compliance with heart failure regimens, Dr. Martje H. L. van der Wal from University Medical Center Groningen, the Netherlands, and colleagues surveyed 501 older heart failure patients.
First human implant of new style Australian artificial heart
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On 22 March 2006, a 48 year old male patient suffering NYHA Class IV Heart Failure became the first recipient of HeartWare’s HVAD mechanical circulatory assist device.
The implant was conducted at the Vienna General Hospital and the surgical team was led by Dr Georg Wieselthaler, Clinical Director of Mechanical Circulatory Support at the University of Vienna.
The successful implant marks the start of HeartWare’s CE mark clinical study. The trial protocol calls for the implantation of the device in twenty patients suffering advanced heart failure. The implants are to be conducted at the Vienna General Hospital (Austria), the Royal Perth Hospital (Australia), the Hannover Medical Centre (Germany) and Harefield Hospital (UK). HeartWare expects to complete patient enrolment in the trial by the end of 2006.
Noisy environment may raise heart attack risk
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Living or working in noisy surroundings may raise a person’s risk of suffering a heart attack, a new study suggests.
Researchers in Germany found that urban middle-aged adults who lived near high-traffic roads were 46 percent more likely to suffer a heart attack than those who lived in more peaceful neighborhoods.
Similarly, men whose jobs exposed them to high noise levels were about one-third more likely to have a heart attack than their peers in quieter workplaces.
Chest pain equally common in women and men
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Women have a similarly high incidence of stable angina—chest pain due to inadequate blood flow to the heart—as men, the results of a study released today indicate.
Moreover, “angina in women appears to be more serious than many doctors, or indeed the general public, realize,” study chief Dr. Harry Hemingway from University College London Medical School told Reuters Health. “Angina in women is associated with an increased risk of dying from heart disease.”
Early blood pressure treatment with candesartan may postpone hypertension
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A new study offers intriguing insight into the possibility of postponing hypertension among the 59 million Americans whose blood pressure is slightly high.
If confirmed, the concept may offer a chance to keep many people from facing the high risk of heart disease and stroke that currently confronts the 65 million Americans with hypertension. But for now, the researchers call it a “proof of principle” result and note that this is the first study to address the issue thoroughly.
The results come from a rigorous four-year study of 772 people with a condition called pre-hypertension, in which blood pressure is elevated over normal levels but not high enough to meet the criteria for a formal diagnosis of hypertension.
Growth of Hypertension Poses Challenges In Training And Research
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A looming shortage of specialists, and the need for research focusing on prevention as well as treatment, are two of the most important challenges in managing an inexorable growth in the incidence of hypertension, according to two dozen experts who attended the Seventh Annual Winter Conference of the American Society of Hypertension (ASH).
The day-long January 13th meeting in Coconut Grove, Florida was convened by ASH president Thomas D. Giles, MD, professor of medicine at the Louisiana State University School of Medicine in New Orleans, as a forum to address “The Future of Hypertension Training and Research in Academic Medicine.” It was attended by twenty four of the nation’s foremost experts in hypertension, representing eighteen schools of medicine and academic medical centers, two government institutions devoted to healthcare research, and two of the nation’s leading pharmaceutical companies.
Creative new therapies for atherosclerotic disease
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Patients with a build-up of plaque in arteries in the heart, brain and leg face a high risk of major cardiovascular complications.
Researchers worldwide are responding to that threat by gathering comprehensive data and developing innovative new therapies, according to studies presented at the American College of Cardiology’s 55th Annual Scientific Session in Atlanta, Ga. ACC.06 is the premier cardiovascular medical meeting, bringing together more than 30,000 cardiologists to further breakthroughs in cardiovascular medicine.
“These new studies help us not only to understand the scope of the problem, but also to evaluate the effectiveness of new therapies for atherosclerotic disease, wherever it occurs in the body,” said George A. Beller, M.D., F.A.C.C., University of Virginia Health Center.
Anti-clotting drugs beat heparin for heart attack
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Heart attack patients treated with anti-thrombosis drugs instead of the blood-thinner heparin are less likely to die or have another heart attack, researchers told a meeting of cardiologists on Tuesday.
“This is a better blood-thinning strategy for patients who have a heart attack,” said Harvard Medical School professor Dr. Elliott Antman, lead investigator of the trial comparing the drug Lovenox to heparin.
Lovenox, sold by France’s Sanofi Aventis , is designed to block thrombin, a blood protein that plays a key role in the formation of new blood clots. It is given by injection.
B vitamins and folic acid don’t cut the risk of further heart attacks
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Scientists have found that levels of the amino acid homocysteine may be high in people destined for a heart attack or stroke, and some studies in the past have linked homocysteine to an increased risk of heart disease.
But according to two new studies, it seems lowering homocysteine levels with B vitamins and folic acid does not reduce the risk of recurrent cardiovascular disease after a heart attack.
They both also found a harmful effect from the combined B vitamin treatment was suggested and say such treatment should not be recommended.
Study finds aspirin still the best for heart risk
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Adding the blood-thinning drug Plavix to a daily dose of aspirin does not lower the risk of death, heart attack or stroke in high-risk patients, researchers said on Sunday.
“The overall findings were negative, but a benefit was seen in patients with established cardiovascular disease,” said Dr. Deepak Bhatt, associate director of the Cleveland Clinic Cardiovascular Coordinating Center and the study’s lead investigator.
Coffee Consumption Linked to Heart Attack for Persons With Gene Variation
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Individuals who have a genetic variation associated with slower caffeine metabolism appear to have an increased risk of non-fatal heart attack associated with higher amounts of coffee intake, according to a study in the March 8 issue of JAMA.
Studies examining the association between coffee consumption and risk of myocardial infarction (MI - heart attack) have been inconclusive. Coffee is a major source of caffeine, which is the most widely consumed stimulant in the world and has been implicated in the development of cardiovascular diseases such as heart attack, according to background information in the article. However, coffee contains a number of other chemicals that have variable effects on the cardiovascular system. It is not clear whether caffeine alone affects the risk of heart attack or whether other chemicals found in coffee may be responsible. Caffeine is metabolized primarily by the enzyme cytochrome P450 1A2 (CYP1A2) in the liver.
Fine Particle Air Pollution Associated With Respiratory and Cardiovascular Diseases
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Being exposed to fine particle matter air pollution increases a person’s risk for hospital admission for cardiovascular and respiratory diseases, according to a study in the March 8 issue of JAMA.
Numerous studies have shown associations of chronic exposure to airborne particles and increased health risks. Recent evidence on adverse effects of particulate air pollution on public health has motivated the development of more stringent standards for levels of particulate matter in outdoor air in the United States and in other countries, according to background information in the article. In 1997, the standard for airborne particulate matter was revised, maintaining the previous indicator of particulate matter of less than or equal to 10 µm in aerodynamic diameter (PM10) and creating a new indicator for fine particulate matter of less than or equal to 2.5 µm in aerodynamic diameter (PM2.5). Particles in this size range have a much greater probability of reaching the small airways and the alveoli (air sacs) of the lung than do larger particles. Evidence is limited on the health risks of this size range of particulate matter.
Spousal spats may harm heart health
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The manner in which husbands and wives argue over such hot-button topics such as money, in-laws, and children, may be a factor in their risk of developing coronary atherosclerosis, or hardening of the arteries of the heart.
In a study of 150 couples, mostly in their 60s, researchers found that women who behaved in a hostile manner during marital disputes were more likely to have atherosclerosis, especially if their husbands were also hostile.
In men, hostility—their own or their wives—was not related to atherosclerosis. However, men who behaved in a dominating or controlling manner—or whose wives behaved in that way—were more likely to have clogged coronary arteries.
