Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease

"Niacin or nicotinic acid (vitamin B3) raises the levels of high-density lipoprotein cholesterol (HDL) by about 30% to 35%. In patients with prior coronary disease, 7 trials have been published on clinical cardiovascular disease outcomes and the results, not surprisingly, are inconsistent. Hence, we performed this meta-analysis of randomized placebo-controlled trials (RCTs) to evaluate the effect of niacin on cardiovascular outcomes in patients with coronary artery disease. Methods: A systematic search using PubMed, EMBASE, and Cochrane library databases was performed. Seven studies with a total of 5137 patients met our inclusion criteria. Heterogeneity of the studies was analyzed by the Cochran Q statistics. The significance of common treatment effect was assessed by computing the combined relative risks using the Mantel-Haenszel fixed-effect model. A 2-sided alpha error of less than .05 was considered statistically significant (P < .05). Results: Compared to placebo group, niacin therapy significantly reduced coronary artery revascularization (RR [relative risk]: 0.307 with 95% CI: 0.150-0.628; P = .001), nonfatal myocardial infarction ([MI]; RR: 0.719; 95% CI: 0.603-0.856; P = .000), stroke, and TIA ([transient ischemic attack] RR: 0.759; 95%CI: 0.613-0.940; P = .012), as well as a possible but nonsignificant decrease in cardiac mortality (RR: 0.883: 95% CI: 0.773-1.008; p= 0.066). Conclusions: In a meta-analysis of seven trials of secondary prevention, niacin was associated with a significant reduction in cardiovascular events and possible small but non-significant decreases in coronary and cardiovascular mortality" First published on March 5, 2010 in the Journal of Cardiovascular Pharmacology and Therapeutics

Canadian Cardiovascular Congress 2010

The Canadian Cardiovascular Congress is the largest gathering of cardiovascular and allied health professionals in Canada. The event connects individuals working across the broad spectrum of cardiovascular healthcare, and stimulates communication within the cardiovascular community. On an annual basis, the CCC showcases the best research and promotes learning through scientific sessions, interactive workshops, late-breaking clinical trials, and engaging debates - 23-27 October, 2010 - Montreal, Canada

New book: Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health

Cardiovascular disease, once thought to be confined primarily to industrialized nations, has emerged as a major health threat in developing countries. Cardiovascular disease now accounts for nearly 30 percent of deaths in low and middle income countries each year, and is accompanied by significant economic repercussions. Yet most governments, global health institutions, and development agencies have largely overlooked CVD as they have invested in health in developing countries. Recognizing the gap between the compelling evidence of the global CVD burden and the investment needed to prevent and control CVD, the National Heart, Lung, and Blood Institute (NHLBI) turned to the IOM for advice on how to catalyze change. Read the book:

Vitamin D shines as heart attack fighter (Canada)

Another study has emerged that says vitamin D is good for you - this time, for your heart. The Journal of the American College of Cardiology says people with low levels of the vitamin, which comes from sunshine and pills but not much else, are twice as likely to have a heart attack or stroke within five years compared to people with higher vitamin levels. This adds to evidence that people lacking vitamin D have a higher risk of various cancers and diabetes as well. But as well, it shows that the early studies promoting the value of this cheap vitamin are being confirmed by scientific follow-up - unlike the faded early promise of vitamins C and E. - Canwest

Anyone of any age can have a heart attack (Ireland)

Virginia Teehan, University College Cork archivist, talks to the Irish Times about her heart attack, medication, blood pressure, subsequent care, return to work, and says - "My experience has also taught me that both the medical profession and the public need more education on cardiac issues. Cardiovascular disease remains the single leading cause of death in the world. Cardiologists acknowledge that they know more about men's hearts than women's hearts. It's important for everyone to realise that women often have smaller hearts and the way they experience a heart attack can be completely different (for example, they may not get a pain radiating down their arm or may not register severe pain as quickly as men). People should also be aware that cardiac events can be caused by a number of conditions and not all heart attacks are the results of blocked arteries or veins. We need to be reminded that anyone of any age can have a heart attack for a variety of reasons and that if you have severe symptoms, the most important thing is to get to a hospital fast. Getting to a hospital within an hour of my first symptoms is what saved my life"

Only a heartbeat away from a long, healthy life (Canada)

"Shawn and Shane Mamer don't worry anymore that they'll die if their hearts start skipping a beat. Because when it happens - and it will, says their cardiologist - a shock five to 12 seconds later will get their hearts beating properly again. The 31-year-old identical twins, dental students from Saskatoon who inherited a deadly heart condition, had defibrillators implanted in their chests last week at the Royal Alexandra Hospital, Edmonton, Canada. It's one of the ways doctors are reducing the number of seemingly healthy and fit young men who suddenly drop dead, usually while playing an explosive competitive sport such as hockey or football. A lot of people black out before they get the jolt of electricity from an implanted defibrillator, the shock of which is very painful, says Dr. Evan Lockwood, 'but feeling a shock is a good thing because it's a sign you're still alive.' The incidence of all sudden cardiac deaths is estimated to range from one in 50,000 to one in 200,000 people. One of the most common reasons for these tragic deaths is an undiagnosed genetic heart condition"

A year after cardiac event only 37 percent still exercising (USA)

Researchers from the Frances Payne Bolton School of Nursing at Case Western Reserve University, USA, found that one year after 248 individuals completed a 12-week cardiac rehabilitation program following a heart attack, bypass surgery or angioplasty, only 37 percent exercised three times a week to keep their hearts healthy. Women across the age groups were less inclined to make the healthy changes in comparison to men. Although all groups had a decline between months 9 and 12, younger men sustained healthy exercise patterns better than all the other groups. "The study points out that interventions are needed to keep people exercising," said Mary Dolansky, assistant professor of nursing and the lead investigator on the study. The research follows up on an assessment of individuals as they left a 12-week rehabilitation program to help cardiac patients make lifestyle changes in the area of exercise - a major factor in improving heart health

Flexible sensor array wraps beating hearts to map cardiac activity in real time (USA)

"Getting a cardiac map of the electrical activity coursing through a live, beating heart has proven impossible until now. For the first time, researchers have monitored the pulsing hearts of living pigs in real time, by wrapping a flexible array of silicon-based sensors around the heart. This could lead to minimally invasive treatments of arrhythmic hearts with erratic beats. The sensor array can map large areas of the heart with more than 2,000 silicon nanomembrane transistors. Such a technique could replace current heart-monitoring tactics that require many rigid, flat sensors and electrodes, which can only create a patchwork, point-by-point map of the heart. Researchers at the University of Illinois and Northwestern University managed to build the flexible circuits with single-crystal silicon based on stretchy material such as plastic or rubber. The ultrathin silicon layer allowed for folding and bending of the typically rigid semiconductor material."

Pepsi pledges cuts in fat, salt, sugar (USA)

"The world's second-largest food and beverage company says it will reduce the saturated fat, sodium, and sugar in its products to make them more nutritious. Pepsi says it will cut up to one-quarter of the unhealthy ingredients by 2020, and improve labels to give consumers clearer information on what they are eating. Several other major processed food manufacturers - Kraft, ConAgra, and Campbell Soup - have also announced cuts in sodium. Last week Pepsi said it would continue a program to take its high-calorie soft-drinks out of schools and replace them with less-fattening alternatives. The action by various companies comes as U.S. First Lady Michelle Obama has been campaigning for healthier foods and more physical activities in schools to fight childhood obesity"

Surplus Olympic defibrillators donated to public groups (Canada)

More than 200 community groups, aboriginal communities, search-and-rescue organizations, ski patrols, old-timer hockey leagues, schools and non-profit groups will receive surplus automatic external defibrillators that were used during the Vancouver 2010 Olympics and Paralympics. The gifts from the Vancouver Organizing Committee and Medtronic, the manufacturer, are in addition to defibrillators they left in every competition and non-competition venue. Shelley Parker, a spokeswoman for Medtronic, said nearly 350 groups across Canada applied for the machines, which can be used by bystanders when someone goes into cardiac arrest. More than 200 will be refurbished and distributed to the groups. A number of more advanced units that include monitoring devices and require a trained physician will also be delivered to sports development programs, university cardiac rehabilitation facilities and teaching institutions. The AEDs, as they are called, are in addition to seven that a Burnaby-based memorial society, the Gianfranco Giammaria Memorial Society, is installing in Vancouver city rinks. Dr. Mike Wilkinson, Vanoc's chief medical officer, said Medtronic agreed to the $2-million donation as part of its involvement as a "Friend of the Games." Medtronic expects to begin sending out the AEDs by May

Saskatoon Health Region faces $24 million shortfall in 2010-11 budget

The Government of Saskatchewan delivered the 2010-2011 provincial budget on March 24, 2010. The result is a $24 million shortfall for Saskatoon Health Region. To explain the impact of the budget shortfall, Health Region President and CEO Maura Davies sent the following message to physicians, staff and volunteers:

March 24, 2010

The Government of Saskatchewan delivered the 2010-2011 provincial budget on March 24, 2010. The total health budget increase of 3.1 per cent reflects the operational needs and commitments of the current government during a period of fiscal restraint. While some of you may have already received details of this budget, I would like to share with you a few of the highlights as they relate to Saskatoon Health Region.

The provincial government provided regional health authorities with an increase in funding of approximately 5 per cent. The increase will partially cover inflation related to increased labour costs, drug costs, etc. as well as targeted investments related to surgical wait lists and selected programs.

What does this mean for us in Saskatoon Health Region? Our share, although welcome, is less than what the Region requires to maintain our current services as they are currently structured and delivered. It means that, despite an increase of approximately 6.2 per cent to our Region’s funding, we will experience a shortfall of approximately $24 million for the 2010-2011 fiscal year. This shortfall is made up of:

* Reduction of $10M in the 2010-11 budget allocation related to region-specific targets for reduction in sick time, WCB time lost claims and overtime, shared services and other operational efficiencies; and

* 2009-10 deficit of $14M. Operating costs will need to be reduced by this amount to avoid these cost overruns in 2010/11.

The Ministry is providing the funding required to expand the chronic kidney disease program and operating the new Irene and Leslie Dubé Centre for Mental Health.

As we plan our 2010-11 budget, we also need to find ways to make strategic investments to meet the needs of our communities and improve the quality, safety and efficiency of our care. These include investments in patient safety, chronic disease management, electronic health record and other areas. If we want to make these investments, we will need to make internal reallocations to reflect Regional priorities.

Another significant issue for us is the issue of capital funding. We will continue to work with the Ministry to confirm our 2010-11 capital funding allocation. In addition, during 2010-11, we will draw upon previous government funding to complete prior approved infrastructure improvements. Government remains committed to the Children’s Hospital of Saskatchewan and planning will continue on this project.

Despite the cuts and efficiencies that we have already implemented, this budget will require all of us to dig a bit deeper and focus on even more creative ways to be efficient. It will not be business as usual. The budget challenges us to do things differently and to work more collaboratively with other regions. It is a call for shared leadership in ensuring we provide good value for money and invest in care, services and strategic initiatives that put patients first.

Our response to this budget will challenge us all. But it is also an opportunity. We are stewards of more than $850 million of tax payers’ money. We are also entrusted to use the abundance of talent and experience possessed by our 12,000 staff, 850 physicians, and thousands of volunteers in ways that lead to better care, a more positive patient experience and a better workplace.

Recently, Saskatoon Health Region developed a promise statement. Our promise is: Every moment is an opportunity to create a positive experience in the way we treat and care for people, in how we work and interact with each other, and in how we deliver quality service. We promise to seize every opportunity.

Responding to this budget is an opportunity we must seize. Over the next few weeks we will finalize our budget plans and submit them to the Saskatoon Regional Health Authority and the Ministry of Health for approval. We have already started to make changes to streamline our operations and reduce operating costs. I am confident that, in the weeks and months ahead, our core values of stewardship and collaboration will help us find efficiencies and reduce operating costs, while working together to put patients first.

You can find out more about the provincial government’s 2010-2011 budget by visiting www.gov.sk.ca. As always, I welcome your comments and suggestions.

Maura Davies,
President and CEO
Saskatoon Health Region

Cardiac Intensive Care - second edition

The new edition of Cardiac Intensive Care, the only textbook dedicated to cardiac intensive care medicine, chronicles the progress made in the diagnosis, assessment, and treatment of patients with critical cardiac illness. Editors Allen Jeremias, MD, MSc and David L. Brown, MD present the landmark discoveries, greater understanding of syndromes, and technological advancements that have helped make clinical cardiology a progressive and interventional field. You'll get coverage of the plethora of noncoronary diseases in the CICU, as well as a complete compendium of up-to-date pharmacologic agents. The new full-color design and layout and nine new chapters give you the latest theoretical, technical, diagnostic, and therapeutic advances in an accessible and visually appealing format. Moreover, the full text is available online at expertconsult.com

Massachusetts General Hospital to create international registry for coronary optical coherence tomography (USA)

"Massachusetts General Hospital, together with a coalition of 20 international sites in five countries, will create the world's largest registry of patients who have had optical coherence tomography of the coronary arteries. OCT is an intravascular imaging technology that researchers hope will give doctors a better means to identify the dangerous vulnerable plaques that cause heart attacks and sudden cardiac death. When a vulnerable plaque in the coronary artery ruptures the result for the patient can be catastrophic. Ruptured plaques can block blood flow to the heart muscle, and cardiologists estimate they cause two-thirds to three-quarters of all fatal heart attacks. Standard imaging technologies are not able to identify the microscopic characteristics of vulnerable plaques. Twenty sites in five countries - Australia, China, Japan, Korea, and the United States - will collect data from 3,000 patients who have had OCT of the coronary arteries during a cardiac catheterization procedure and follow them for five years. MGH researchers will gather the data in a central database. Researchers hope the data will help determine the efficacy of OCT in identifying vulnerable plaques in patients as well as its benefits as a follow-up procedure to stent placement"

Canadian Health Measures Survey 2007-2009

"New data from the Canadian Health Measures Survey show that 41% of Canadian adults had a high total cholesterol level. In addition, 4% of Canadians aged 6 to 79, or just over 1.1 million people, were considered vitamin D-deficient. These findings are included in the second data release from the CHMS, which collected key information about the health of Canadians by means of direct physical measurements. The CHMS tested blood samples of participants for a number of lipids, which are a class of fats that include cholesterol and triglycerides, and for vitamin D and other nutrition markers" - Statistics Canada

China becomes world's new diabetes capital

"China now has more people with diabetes than any other country, a new report shows, making it clear that the nation's soaring economic growth is taking a toll on public health. According to the report, more than 92 million adults in China have diabetes, and nearly 150 million more are well on their way to developing it. The disease is more common in people with large waistlines and in those who live in cities, the report indicates. "For every person in the world with HIV there are three people in China with diabetes," said David Whiting, an epidemiologist with the International Diabetes Federation, who was not involved in the research. The Federation projected last year that some 435 million people would have diabetes by 2030. "With this new study, we're going to have to rerun our estimate," Whiting told Reuters Health. The report, published Thursday in the New England Journal of Medicine, is based on a nationally representative sample of more than 46,000 people who were tested for diabetes"

Beta-blockers 'cut cancer spread' (UK)

"Blood pressure drugs may be able to reduce the ability of breast cancer to spread around the body, researchers have told a European conference. A joint UK and German study found that cancer patients taking beta-blockers had a lower risk of dying. The drugs may block hormones that trigger the spread of cancer cells. However, experts stressed that more evidence from bigger studies would be needed before the drug could be given as part of routine treatment.

FDA panel approves cardiac therapy device (USA)

"A U.S. Food and Drug Administration advisory panel has approved a therapy to reduce mortality and heart failure risk in patients with mild cardiac disease. The FDA panel recommended the cardiac resynchronization therapy defibrillator be approved for use in patients with mild heart failure. The device was tested in a series of nationwide studies led by Dr. Arthur Moss, professor of medicine at the University of Rochester Medical Center. Developed by the Boston Scientific Corp., the defibrillator was previously approved to treat patients with severe heart failure. The FDA often, but not always, follows the recommendations of its advisory panels" - UPI

Zebrafish study could help heart attack sufferers - Duke University

Could zebrafish hold the key to helping people who suffer heart attacks? Possibly, according to Duke University Medical Center scientists who studied the tropical fish and their "amazing" heart muscles. Humans have very limited ability to regenerate heart muscle cells, which is a key reason why heart attacks that kill cells and scar heart tissue are so dangerous, according to Duke's news release. "Our hearts don't seem so complex that they shouldn't have the capacity to regenerate," said Dr. Kenneth Poss, senior author of the study and professor of cell biology at Duke. Poss is also an investigator in the Howard Hughes Medical Institute. The study appears in the March 25 issue of Nature

Galion Community Hospital cardiac rehab unit gets an upgrade thanks to golf tournament (USA)

Cardiac patients at Galion Community Hospital, Ohio, are keeping their hearts healthy with new aerobic equipment, thanks to the annual Walt Chambers Memorial Golf Outing. The $8,200 raised in 2009 purchased a rowing machine, two Schwinn Airdyne bicycles and one elliptical trainer in the Cardiac Rehab Department. "We have been supporting this unit for the last three years," hospital board member Linda Chambers said. Chambers, 69, was married to tourney namesake Walt Chambers, who suffered from multiple heart problems until his death in 2006 at age 70. In 2008, his family and friends started a golf event in his memory to benefit the department, where he was a patient for six years. The first year raised $12,000 that bought two new pieces of equipment. "The staff was wonderful to him," said Linda Chambers, who lives in Galion. "We felt we needed to bring some attention to this unit. Our kids and friends felt it would be good. Walt loved playing golf." Sponsors for the event at Galion Country Club include Aramark and Craig Smith Auto Group, which is donating a car for the hole-in-one prize. The Cardiac Rehab Department sees at least 65 patients, each three times a week. Because of the generosity of the community and the fundraiser's success, the department is moving to a larger space with windows and easier access for patients. "We're really looking forward to the move," said Cynthia Roesch, a nurse who has worked in the department for 10 years. "We hope to raise enough money this year to get a new weight machine." For details or to register for the July 22 event, call Linda Chambers at 419-468-4144 or the hospital's marketing manager, Linda Hearn, at 419-468-0567

CARG Newsletter - April 2010

The CARG Newsletter - April 2010 is now available for download or for reading below:

CMAJ - 23 March 2010, Volume 182, Issue 5

The Canadian Medical Association Journal - 23 March 2010, Volume 182, Issue 5, is now available online

FDA warns about increased risk of muscle injury with Zocor (USA)

"The U.S. Food and Drug Administration has warned patients and healthcare providers about the potential for increased risk of muscle injury from the cholesterol-lowering medication Zocor (simvastatin) 80 mg. Although muscle injury (called myopathy) is a known side effect with all statins, [today's] warning highlights the greater risk of developing muscle injury, including rhabdomyolysis, for patients when they are prescribed and use higher doses of this drug. Rhabdomyolysis is the most serious form of myopathy and can lead to severe kidney damage, kidney failure, and sometimes death"

Nobel Prize-winning scientist Sir James Black dies

Nobel Prize-winning scientist Sir James Black has died at the age of 85. Sir James was considered one of the great Scottish scientists of the 20th Century and is credited with having invented beta-blocker drugs in 1962. He was born in Uddingston, Lanarkshire, grew up in Fife, and studied medicine at St Andrew's University. In 1988 he won the Nobel Prize for medicine and was given the UK's highest honour, the Order of Merit, in 2000. Beta-blockers now play an essential role in the treatment of angina and heart attacks

Statement from American Heart Association CEO Nancy Brown on Publication of FDA Rule Prohibiting Sales and Marketing of Tobacco to Children (USA)

Washington, DC (March 18, 2010) - The new Food and Drug Administration rule is an important step towards breaking the cycle of addiction and preventing children from developing a deadly habit. Too often, children are swayed by insidious marketing campaigns from the tobacco industry that encourage them to adopt a destructive lifestyle. About 3,500 children a day smoke their first cigarette - more than the total population of many small towns and municipalities - and about 1,100 become new, regular daily smokers. This rule will prohibit the sale, distribution and marketing of cigarettes and smokeless tobacco to youth and put an end to certain marketing gimmicks used by the industry to sell and promote cigarettes and smokeless tobacco products to children. Cigarette advertising and promotional expenditures have more than doubled over the last decade and much of this increase has been used to reach children and teens in places such as convenience stores and magazines. Cigarette smoking dramatically increases the risk for heart disease and stroke with one-third of smoking related deaths linked to cardiovascular disease. Millions of children who begin a lifelong smoking habit will eventually die prematurely and put the health of their loved ones at risk. We're gratified that the regulation, which implements part of the Family Smoking Prevention and Tobacco Control Act, will help children lead healthier lives and curb the tobacco industry's campaign to recruit young smokers.

Contact: Suzanne Ffolkes, Director of Media Advocacy, 202-785-7929

Heart&Stroke Big Bike Saskatchewan on Facebook

"A vital fundraiser with impressive results, Heart&Stroke Big Bike continues to engage people across the province, and encourages generous support for critical Heart and Stroke Foundation research. Last year, 83 Big Bike rides helped raise more than $350,000 for research! That's helping us achieve even greater results that change the lives of not only heart and stroke patients - but all Canadians"

The Defib Centre (UK)

The Defib Centre Ltd, the Sussex-based sudden cardiac arrest information resource and authorised distributor of UK-manufactured HeartSine Automated External Defibrillators (AEDs) has just launched. According to the British Heart Foundation, sudden cardiac arrest kills more than 2,000 people in the UK every week. It is the UK's biggest killer, claiming more victims than lung cancer, breast cancer and AIDS combined. It is these appalling statistics that motivated Robin Shepherd, former Channel 5 and BBC1 Watchdog "back expert", to set up The Defib Centre. "A cardiac arrest will completely drain the life from someone within 10 minutes. But, instead of standing by and watching that happen, with a little training and an essential, affordable, easy-to-use piece of equipment, you can improve their chance of survival dramatically," says Shepherd

4th Annual Bridge City Boogie - Saskatoon, Canada

The Bridge City Boogie is a 2km, 5km and 10km wellness event with emphasis on fun, fitness and community. The Boogie is all inclusive with age categories reflecting the diversity of participants. Whether you're a seasoned runner or a first time walker, you'll have no trouble finding an event that suites your fitness goals. You'll be surprised by the beauty of the area and delighted by the runners and volunteers you'll meet on the course. To make the Boogie happen, there will be over 550 people volunteering their time before, during and after the race to help make your Boogie experience a positive one. Takes place June 13, 2010

Researchers identify method to help reduce fat in the blood (Canada)

Over 60 per cent of Canadians are classified as overweight or obese. This epidemic is a concern for experts around the world. One of the major problems is high levels of lipids in the blood, which can lead to cardiovascular disease, fatty liver disease and Type 2 diabetes. But a University of Alberta researcher has taken a major step in protecting people against these diseases. Richard Lehner and his research group found that decreasing the activity of an enzyme called triacylglycerol hydrolase, or TGH, in an animal model results in lowering the amount of fat in the blood and improves glucose metabolism. It also appears to keep fat from being deposited into organs that aren't meant to store fat, like the liver. A lack of TGH also showed to protect the beta cells in the pancreas that produce insulin and this can potentially protect from the development of diabetes in obese patients. The benefits don't end there. Animal models that lack the enzyme also showed to burn more fat and were more physically active compared to those who had the enzyme. This discovery shows that TGH could eventually be used as a target for pharmaceuticals to combat metabolic complications associated with obesity - Science Centric

Nearly two-thirds of seniors using five or more types of prescription drugs (Canada)

Almost two-thirds (62%) of Canadians age 65 and older living in the community in six provinces are using five or more classes of prescription drugs, according to a study released today by the Canadian Institute for Health Information. The study, Drug Use Among Seniors on Public Drug Programs in Canada, 2002 to 2008, examined public drug claims for more than one million Canadian seniors in Alberta, Saskatchewan, Manitoba, New Brunswick, Nova Scotia and Prince Edward Island. The study found that in 2008, slightly more than one in five (21%) of these seniors were using 10 or more types of prescription drugs, and just more than 1 in 20 (6%) were using 15 or more different classes of drugs. "Public-sector spending on prescribed drugs in Canada reached an estimated $11.4 billion in 2009, and we know that seniors account for a large portion of these expenditures," says Jean-Marie Berthelot, Vice President, Programs, CIHI. "With the aging of Canada's population, it is important to understand which drugs are being used most often by seniors and which account for the highest proportions of public drug program expenditure. This information helps to inform decisions about the future planning and delivery of public drug programs." Older seniors were more likely to be multiple-drug users, with about one-third (29%) of seniors age 85 and older submitting claims for 10 or more types of drugs in 2008, compared to fewer than one in five (17%) seniors age 65 to 74

New Ideas for Diabetes Management (CARG)

* Monday, April 26, 2010
* 8:00-10:30 am at the Field House
* For Cardiac Rehab participants with diabetes and a support person
* Topics to be covered:
- Getting the most out of home blood sugar checking
- Achieving the food "balance"
- What's new in diabetes management strategies

Pre-registration required. Space is limited - ask your exercise therapist to put your name on the registration list
Breakfast provided free of charge
Presented by Marlene Matiko, Diabetes Nurse Educator and Rochelle Anthony, Dietitian

Kraft Foods plans to reduce sodium in North American Products an Average of 10 percent by 2012

"Kraft Foods Inc. has announced plans to reduce sodium by an average of 10 percent across its North American portfolio over the next two years. This amounts to the elimination of more than 10 million pounds - or more than 750 million teaspoons - of salt from some of North America's most popular foods. "We are reducing sodium because it's good for consumers, and, if done properly, it's good for business," said Rhonda Jordan, President, Health & Wellness, Kraft Foods. "A growing number of consumers are concerned about their sodium intake and we want to help them translate their intentions into actions." The company's goals call for sodium to be lowered in a number of products up to 20 percent by the end of 2012. For example, Oscar Mayer Bologna is slated to reduce sodium by 17 percent and some flavors of Easy Mac Cups are scheduled to reduce sodium by 20 percent.

Cough Up: Balancing tobacco income and costs in society (UK)

"Smoking is the single, largest preventable cause of serious ill health and kills tens of thousands of people in England every year. It is a popular myth that smoking is a net contributor to the economy - our research finds that every single cigarette smoked costs the country 6.5 pence. In order to balance income and costs, tobacco duty should be progressively increased until the full societal cost of smoking is met through taxation." Cough Up is published by Policy Exchange in the UK

Blood vessels bounce back once smokers quit

Blood vessel function rapidly recuperates after smokers kick the habit, leading to a reduced risk of heart disease and heart attack, new research shows. The study included more than 1,500 people taking part in a clinical trial to help them quit smoking. Before and one year after the participants stopped smoking, doctors used ultrasound to measure the patients' flow-mediated dilation (FMD), a gauge of the health of the brachial artery, the main artery of the upper arm. The ability of the brachial artery to relax is closely related to the ability of the heart arteries to relax, and predicts risk for future heart and blood vessel disease, explained the University of Wisconsin researchers. They compared the FMD readings from patients who successfully quit with those who quit and then resumed smoking. "Individuals who quit smoking had improved blood vessel function, even though they gained weight, which is a common side effect of smoking cessation," study author Dr. James Stein, an associate professor of medicine at UW School of Medicine and Public Health, said in a university news release. "This confirms that quitting smoking is good for your blood vessels and reduces risk for heart attacks and cardiovascular disease." FMD improved by as much as 1 percent among patients who had quit smoking for a full year. That's a significant improvement, according to Stein. "It's statistically significant, but more important, it's also clinically relevant," he said. "A 1 percent change in FMD is associated with an approximately 14 percent lower rate of cardiovascular disease events. That means patients who permanently quit smoking are less likely to have a heart attack and heart disease." The study was presented this week at the American College of Cardiology annual meeting in Atlanta and published simultaneously in the Journal of the American College of Cardiology.

No quick drug fix for high diabetes risk

Two key treatments do not halt diabetes in people with early signs of the disease, a large study has found. Researchers said the results showed the only way to ensure future health in people at high risk of diabetes was exercise and a healthy diet. Trials in more than 9,000 people also found no reduction in future heart problems in people prescribed two drug treatments compared with dummy pills. Diabetes UK said 7m people in the UK were at risk of developing diabetes. Everyone taking part in the study, published in the New England Journal of Medicine, had been diagnosed with what doctors call "impaired glucose tolerance" - BBC

Cardiac rehabilitation helps survival time in heart patients receiving stent therapy

A team of Mayo Clinic researchers have found that cardiac rehabilitation is associated with significantly reduced mortality rates for patients who have had stents placed to treat blockages in their coronary arteries. The findings, presented at the annual meeting of the American College of Cardiology in Atlanta, found that patients who had coronary angioplasty (stent placement, also known as percutaneous coronary intervention) and afterwards participated in a cardiac rehabilitation program had a 45 to 47 percent decrease in mortality compared to those who did not participate in a cardiac rehabilitation program - PhysOrg.com

Impotence 'strong predictor' of heart attacks

"Impotence is a strong predictor of heart attack and death among high-risk patients, German researchers have said. The study of 1,519 men who already had cardiovascular disease found those who were also impotent had twice the risk of a heart attack or death as the rest. The University of Saarland report, published in the journal Circulation, suggests men with impotence should be checked for cardiovascular disease. Some experts want doctors to ask about impotence in over-40s health checks. Impotence is linked to inadequate blood flow in the penile arteries. These are much smaller than coronary arteries. So for some men, a persistent failure to get an erection might be an early sign that his arteries are narrowing. The study followed men from 13 countries who already had cardiovascular disease. It monitored whether they went on to have heart attacks or strokes. The participants were also asked about their erectile dysfunction at the start, after two years and after five years" - BBC

University of Florida researcher urges caution in reducing blood pressure in patients with diabetes, coronary disease

For patients with diabetes and heart disease, less isn't always more - at least when it comes to blood pressure. New data show an increased risk of heart attack, stroke or death for patients having blood pressure deemed too high - or too low, according to Rhonda Cooper-DeHoff, Pharm.D., an associate professor of pharmacy and medicine at UF. She reported her findings today (Sunday, March 14) at the American College of Cardiology's 59th annual scientific session in Atlanta. She recommends raising the systolic bar above 120 for blood pressure in patients with diabetes and coronary artery disease, saying that levels between 130 and 140 appear to be the most healthful. Based on hypertension treatment guidelines, health-care practitioners have assumed that with regard to blood pressure, "the lower, the better," Cooper-DeHoff said. But, The International Verapamil SR-Trandolapril study, known as INVEST, suggests that the range considered normal for healthy Americans may actually be risky for those with a combined diagnosis of diabetes and coronary artery disease. "Our data suggest that in patients with both diabetes and coronary artery disease, there is a blood pressure threshold below which cardiovascular risk increases," Cooper-DeHoff said. - EurekAlert

Plaque on CT scan is strong predictor of heart disease, worse long-term outcomes (USA)

The presence of plaque on an abdominal CT scan is a strong predictor of coronary artery disease and mortality, according to a Henry Ford Hospital study. Researchers found that patients are nearly 60 percent at risk of having coronary artery disease when the CT scan showed very high levels of abdominal aortic calcium, commonly known as plaque. High levels of the abdominal aortic calcium also increased their risk of dying, researchers say. Conversely, researchers found that the lack of abdominal aortic calcium, or AAC, was associated with a low risk of coronary artery disease, a chronic, progressive form of heart disease that results from a buildup of plaque in the arteries found on the surface of the heart. The study is being presented Sunday, March 14 at the 59th annual American College of Cardiology Scientific Sessions in Atlanta.

European Heart Journal - March 2010

European Heart Journal - March 2010 is now available online. Subscription required to read full articles

Mrs. Chicago educates women on heart health (USA)

From paramedic rigs and lifesaving equipment to tiaras and titles, Danielle Cortes DeVito has done it all with a lifesaving message from the heart. Named Mrs. Chicago 2009, DeVito says it was her 15 years in the emergency medical field - working as a Chicago paramedic and five years at the Cook County Hospital - that opened her eyes to the issue of women and heart disease. "I believe my work with the American Heart Association is important and well worth the effort," says the 35-year-old mother of three and owner/president of Heart Savers & Education, Inc., an approved American Heart Association community training center for cardiopulmonary resuscitation (CPR) and first aid. "Heart disease is the largest single cause of death for American women, accounting for one third of all deaths. Yet it is a statistic unfamiliar to most American women" - Daily Herald

Stock market dips 'linked to heart attack surge' (USA)

Doctors have found a relation between stock market fluctuations and heart attack frequency, a preliminary study by North Carolina's Duke University Medical Center has said. "In analyzing our local patient population... during the recent period of increased volatility in the stock market, we found that when stock market values decreased, heart attacks seemed to increase, and then decreased when stock trends improved," said the study's lead investigator Mona Fiuzat on Saturday. The results of the research were presented at the American College of Cardiology's 59th annual scientific conference held this weekend in Atlanta. "While more and larger studies are needed to examine the reason for these findings, it?s important for healthcare providers to be aware of social stressors that may potentially affect their patients," Fiuzat said. The study focused on patients registered at the Duke Hospital Catheterization Lab between January 2006 and July 2009, using data from the Duke Databank for Cardiovascular Disease

Cardiac Chronicles - Spring 2010 issue

Cardiac Chronicles - Spring 2010 issue - This semi-annual publication, from Rouge Valley Cardiac Care program, brings together the best minds and leaders in the field of cardiac rehabilitation from across Canada and shares their expertise with health professionals and patients

Moving on (The Stroke Association)

"Moving on is our joint campaign with the Chartered Society of Physiotherapy which is lobbying for better access to community based (post hospital) physiotherapy for stroke survivors. The evidence we hear from stroke survivors and respected institutions such as the National Audit Office and the Royal College of Physicians shows that, on the whole, the care stroke patients receive in hospital is now better now than ever. However, the picture is quite different when stroke survivors leave hospital. We believe that the improvements made in the hospital phase must now be replicated in what we call the 'life after stroke' phase"

FDA announces new boxed warning on Plavix (USA)

"The U.S. Food and Drug Administration has added a boxed warning to the anti-blood clotting drug Plavix (clopidogrel), alerting patients and health care professionals that the drug can be less effective in people who cannot metabolize the drug to convert it to its active form. Plavix reduces the risk of heart attack, unstable angina, stroke, and cardiovascular death in patients with cardiovascular disease by making platelets less likely to form blood clots. Plavix does not have its anti-platelet effects until it is metabolized into its active form by the liver enzyme, CYP2C19."

Ghanaian-born doctors perform first open-heart surgery in St Croix, Virgin Islands

"A team of doctors at Gov. Juan F. Luis Hospital have performed the first open-heart surgery in the U.S. Virgin Islands. The hospital's cardiac surgeon, Dr. Moses deGraft-Johnson, his brother, John deGraft Johnson, and a team of highly trained physicians and nurses performed the surgery on a female patient from St. Croix, according to a news release from the hospital. The release did not give the patient's name, nor did it specify what type of cardiac procedure was performed" - GhanaWeb

Variable blood pressure a new stroke risk factor?

Challenging established medical wisdom about blood pressure and stroke, new British research suggests that extremely variable blood pressure, and not just high blood pressure, can greatly increase a person's risk of stroke. "Some people have very stable hypertension, in which case simple hypertension is all that matters, but variability and episodic hypertension is very common and matters much more than mean blood pressure in some patients," said Dr. Peter Rothwell, a professor of neurology at the University of Oxford and lead author of four papers in the March 13 issues of The Lancet and The Lancet Neurology. One paper looked at high blood pressure and blood pressure variability in four groups of 2,000 people, each of who had minor strokes called transient ischemic attacks (TIAs), or "mini-strokes." These are warning signs of stroke risk. - HealthDay News

Go! New York: Heart Health Live Web Chat

"Have questions about heart health? Join CBS 2's Dr. Holly Phillips on Monday, March 15 when she hosts a live Web video chat featuring Dr. Joseph T. McGinn Jr. of the The Heart Institute Of New York. Dr. McGinn, who pioneered minimally invasive cardiac bypass surgery, will be here to answer all your heart-related questions beginning at 1 p.m., right here on WCBSTV.com. You can submit your questions through our online chat room and Dr. Phillips will select some of your submissions for Dr. McGinn"

Doctors often order heart test but no disease is found (USA)

"A big study says most patients without known heart disease who undergo coronary angiography don't have clogged arteries after all. In such patients angiograms reveal coronary disease only 40 percent of the time. Worse yet, another 40 percent have essentially clear coronaries. The upshot? Medicine's definitive test for diagnosing heart disease doesn't do a very good job in about 200,000 Americans who get it every year - at about $2,500 a pop. The results suggest the test may be used too often. To do an angiogram, or cardiac catheterization, doctors thread a thin tube from the groin up into the coronary arteries. Injecting a dye shows on x-rays whether arteries are gunked-up or clear. More than a million Americans get angiograms every year. One in five angiograms involves a patient without known heart disease - and often no symptoms. The new data come from the biggest study of the question so far - encompassing 400,000 patients with unknown coronary-artery status prior to their angiograms. It draws from a database of the American College of Cardiology, which funded the project. The findings were published in the current New England Journal of Medicine

Heart surgery first for East Lancashire (UK)

"Heart surgery specialists have made history by performing the first life-saving angioplasty operations in East Lancashire. Consultant cardiologists Dr Ravi Singh, Dr John McDonald and Dr Kanarath Balachandran carried out the procedures in the Royal Blackburn Hospital’s existing cardiac catheter laboratory. Until now patients who needed the operation had to travel to either Blackpool or Manchester. But the experts used new equip-ment, which will be housed in a new £3million laboratory by May, so the technique can be carried out routinely in the region. Peter South, 67, from Barley, was the first to undergo the procedure"

David Braley Cardiac Vascular and Stroke Research Institute (Canada)

Hamilton Health Sciences' main research priority is the development of a new research Institute at the Hamilton General Hospital, which will provide an additional 197,700 square feet of research space specializing in cardiac, vascular and stroke research. The David Braley Cardiac, Vascular and Stroke Research Institute will focus on:

* Building clinical research capacity in thromboembolism, obesity, metabolic diseases and surgery, through both clinical trials and longitudinal cohort studies
* Knowledge integration among healthcare providers and policy makers for optimal health care delivery
* Expanding population-based studies to include genomics and proteomics

The expansion will enable strategic space allocation to enhance our collaborative environment and optimal health care model. This new infrastructure will increase our ability to continue to attract world-class, highly qualified professionals to the Hamilton region. It will also create an opportunity to mentor and train new research leaders and health practitioners

CMAJ - 9 March 2010, Volume 182, Issue 4

The Canadian Medical Association Journal - 9 March 2010, Volume 182, Issue 4, is now available online

New method to grow arteries could lead to "biological bypass" for heart disease (USA)

A new method of growing arteries could lead to a "biological bypass" - a non-invasive way to treat coronary artery disease - Yale School of Medicine researchers and their colleagues report in the April issue of the Journal of Clinical Investigation. Coronary arteries can become blocked with plaque, leading to a decrease in the supply of blood and oxygen to the heart. Over time this blockage can lead to debilitating chest pain or heart attack. Severe blockages in multiple major vessels may require coronary artery bypass graft surgery, a major invasive surgery. "Successfully growing new arteries could provide a biological option for patients facing bypass surgery," said lead author of the study, Michael Simons, M.D., chief of the Section of Cardiology at Yale School of Medicine. In the past, researchers used growth factors - proteins that stimulate the growth of cells - in an attempt to grow new arteries, but this method was unsuccessful. Simons and his team studied mice and zebrafish to see if they could simulate arterial formation by switching on and off two signaling pathways: ERK1/2 and PI3K. "We found that there is cross-talk between the two signaling pathways. One half of the signaling pathway inhibits the other. When we disable the inhibitor mechanism, we are able to grow arteries," said Simons. "Instead of using growth factors, we stopped the inhibitor mechanism by using a drug that targets a particular enzyme called PI3-kinase inhibitor." "Because we've located this inhibitory pathway, this opens the possibility of developing a new class of medication to grow new arteries," Simons added. "The next step is to test this finding in a human clinical trial"

$5M project targets heart failure (Canada)

Scientists and physicians have launched an Alberta-wide research project to better identify and treat heart failure, a condition that affects 80,000 Albertans. The five-year Alberta Heart project will see 1,000 people - half in Calgary and half in Edmonton - participate in the study as volunteers. The research will focus on identifying and treating diastolic heart failure, a condition that affects 40 per cent of those diagnosed with heart failure. The Libin Cardiovascular Institute of Alberta, the Mazankowski Alberta Heart Institute and Health Solutions (funded by the Alberta Heritage for Medical Research Endowment Fund) have invested $5 million in the project. Dr. Todd Anderson, Alberta Heart co-leader and professor of medicine at the University of Calgary, said cardiologists are more adept at diagnosing heart failure when it's caused by the squeezing of the heart - called systolic heart failure. Diastolic heart failure occurs when the heart fails to relax properly between beats, so it doesn't fill up with the proper amount of blood to supply the body. Pictured are Todd Anderson, Alberta HEART co-leader, and professor of medicine, Faculty of Medicine, University of Calgary, and Murray Copot, an 86 year-old Calgarian with diastolic heart failure at Foothills Hospital in Calgary, Alberta Monday, March 8, 2010

AACVPR 25th Annual Meeting (USA)

The American Association of Cardiovascular and Pulmonary Rehabilitation Annual Meeting is a four-day event for healthcare practitioners to exchange knowledge regarding cardiovascular and pulmonary rehabilitation. The meeting program provides education and training on the scientific principles, the latest techniques and advances, and the new challenges affecting rehabilitation today. AACVPR Annual Meeting attendees typically include physicians; cardiac and pulmonary nurses; exercise physiologists; respiratory and physical therapists; behavioral scientists; registered dietitians; and other allied health professionals involved in the day-to-day care of cardiovascular and/or pulmonary rehabilitation patients - October 7-9, 2010 - Milwaukee, Wisconsin

Drinking sugar-sweetened beverages daily linked to diabetes, cardiovascular disease, increased healthcare costs

More Americans now drink sugar-sweetened sodas, sport drinks and fruit drinks daily, and this increase in consumption has led to more diabetes and heart disease over the past decade, researchers reported at the American Heart Association's 50th Annual Conference on Cardiovascular Disease Epidemiology and Prevention. Using the Coronary Heart Disease (CHD) Policy Model, a well-established computer simulation model of the national population age 35 and older, researchers estimate that the increased consumption of sugar-sweetened beverages between 1990 and 2000 contributed to 130,000 new cases of diabetes, 14,000 new cases of coronary heart disease (CHD), and 50,000 additional life-years burdened by coronary heart disease over the past decade. Sugar-sweetened soda, sport and fruit drinks (not 100 percent fruit juice) contain equivalent calories, ranging from 120 to 200 per drink, and thus play a role in the nation’s rising tide of obesity, researchers said. Previous research has linked daily consumption of these sugary beverages to an increased risk of diabetes, even apart from excessive weight gain - AHA

Lean at 18 means longer lives, free of disease for women: Study

Being obese in middle age lowers a woman's chance of being alive and free of chronic diseases after age 70 by nearly 80 per cent, according to new data from the landmark U.S. Nurses' Health Study. The findings suggest every bit of weight gain between ages 18 and 50 lowers a woman's odds of being a "healthy survivor" - living to age 70 or older, free from 11 major chronic diseases as well as physical, cognitive and mental impairment. For every one kilogram of weight gain since age 18, the odds of healthy survival decreased by five per cent, the study found. The worst odds for a long and healthy life were among women who were overweight at 18 - with a body mass index greater than 25 - and who gained 10 kilograms or more by mid-life. But even a higher BMI at 18 alone was associated with "moderately, albeit significantly" reduced odds of healthy survival at much older ages. "It's really important, at least for women, to maintain a healthy weight in the very beginning of adulthood to maximize the chance of enjoying a healthy and long life," says Dr. Qi Sun, a research associate in the department of nutrition at the Harvard School of Public Health in Boston - Canwest

Researcher ready to test new diabetes treatment (USA)

A longtime diabetes researcher at University of Texas Southwestern Medical School is setting up human tests for a new treatment he says might have fewer side effects than standard insulin therapy. Dr. Roger Unger, chairman of diabetes research at the school, is quick to warn a novel method that worked in mice with Type 1 diabetes may not help people. "You can't make any claims until the tests have been done," he said. The tests using leptin, a natural hormone produced by fat cells, would build on results of experiments performed by Unger's research team and published recently in a major scientific journal, Proceedings of the National Academy of Sciences. The paper, titled "Leptin monotherapy in insulin dependent type 1 diabetes," describes studies done on diabetic mice. The journal cites the new paper as "reporting findings of exceptional interest." The new work is a follow-up to a paper published in 2008 by Unger's team that reported about diabetic mice and rats that were genetically modified to produce extra leptin and thrived without insulin. The 2008 paper was the research equivalent of a talking dog - startling even to experts, whether or not it said anything practical. - Capital Gazette

New heart procedures introduced at Barnet and Chase Farm hospitals (UK)

New heart procedures at Barnet and Chase Farm Hospital NHS Trust will provide a "better all-round service" to patients. Implantable Cardioverter-defibrillator (ICD) implantation and coronary angioplasty will be introduced to the cardiology department this summer. The first involves implanting a small defibrillator under the skin, which is connected to the heart by leads. The device automatically monitors heart rhythm, detects when a patient is experiencing a sudden cardiac arrest and delivers an electrical shock directly to the heart as needed to correct the problem. The second procedure is used to treat narrowed heart arteries, which is achieved by inflating a balloon within the artery to crush fatty deposits. Cassandra Bombata, principal cardiology manager, said: "The cardiology department is very excited about the new procedures we will be able to offer our patients." "It will provide a better all-round service to our cardiology patients locally" - Enfield Independent

Workplace wellness programs work (USA)

"Workplace wellness programs help employees lose weight and reduce their risk of heart disease, a new study shows. U.S. researchers followed 757 hospital workers who took part in a voluntary 12-week, team-based wellness program that focused on diet and exercise. Data on the participants' weight, lifestyle behavior and heart disease risk factors were collected at the start of the study, at the end of the wellness program and a year after the program ended. At the start of the study, 33 percent of participants were overweight (body mass index, or BMI, of 25 to 29.9) and 30 percent were obese (BMI of 30 or more). The researchers found that obese participants lost the most weight - 3 percent at 12 weeks and 0.9 percent at one year - and were most likely to reduce their intake of dietary sugar. Overweight participants did almost as well, with an average weight loss of 2.7 percent at 12 weeks and 0.4 percent at one year. All participants had similar improvements in levels of physical activity, along with lower cholesterol and blood pressure levels, and reduced waist circumferences at program end and at one year, the findings showed. "Voluntary wellness programs can successfully address weight loss and lifestyle behaviors for employees in all weight categories, but more work is needed to improve long-term changes," the Massachusetts General Hospital researchers concluded. The study was to be presented Tuesday at the American Heart Association's Nutrition, Physical Activity and Metabolism Conference in San Francisco"

New report finds major benefits to the health of the nation from increasing tobacco taxes (UK)

"Following an extensive economic evaluation of the benefits of increasing tobacco prices on the health of the nation, ASH: Action on Smoking and Health, has today published its report The Effects of Increasing Tobacco Taxation. Produced by independent economist Howard Reed, the report shows that raising tobacco prices through taxation by 5% above inflation will:

* lead to a reduction in the number of smokers by 190,000
* save the NHS over £20 million a year by reducing the cost of treatment of smoking-related diseases
* reduce smoking-related absenteeism in the work place saving over £10 million a year
* increase government tax revenues by over £500 million a year; a total of £2.6 billion in the first five years
* result in wider economic benefits in the first five years of over £270 million per year.

Based on these results ASH, supported by 49 other public health organisations including the British Heart Foundation, Cancer Research UK and the Foundation for the Study of Infant Deaths, has called on the government in its pre-Budget submission to the Treasury to increase the price of tobacco through taxation by 5% above inflation in the impending Budget and by a minimum of the rate of inflation in subsequent years. Launching the report, Deborah Arnott Chief Executive of ASH said:
'Smoking is a childhood addiction and not an adult choice. By increasing tobacco taxation we help to discourage children from buying cigarettes. An above-inflation rise would also help adults stop smoking.'"

Cardiac disease on the rise in young Bruneians

Cardiac-related diseases have haunted Bruneians in their twenties and thirties due to a changing lifestyle that makes them prone to developing heart problems, a top cardiologist said yesterday. "(In the past) people above the 40-45 age bracket were vulnerable to cardiac-related diseases. Nowadays, people below 30 are also suffering from cardiac problems, and such cases are on the rise," said Singapore Association president Dr Patrick Ang, who is also a consultant cardiologist and director of the Invasive Cardiac Laboratory at Gleneagles JPMC Sendirian Berhad. Dr Ang conducted a health talk at the Singapore High Commission yesterday. Organised by the Singapore Association of Brunei Darussalam, the public health talk was held to address the increasing number of heart attack cases in Brunei. The talk was titled "Heart Attack! The Number One Killer in Brunei. How can we Prevent It?"

Heart failure on rise as population gets older (Canada)

"So, you used to be able to walk eight blocks with no problem and now you can barely walk two blocks without getting out of breath. Don't brush it off, assuming you're just getting old and out of shape: it's the most common sign of heart failure. In fact, it's what prompts many visits to the doctor - which is a good thing, because heart failure, by the numbers, is very scary. Of 100 people with heart failure today, less than half will be alive in five years; and less than 25 per cent will be around five years after that. That 100 people includes those who have been diagnosed and treated, not diagnosed and not treated, and diagnosed but not complying with treatment, says cardiologist Michael Chan. Heart failure is a serious condition and often leads to death, he says. It's not curable, but can be managed with the right medications in correct doses, if people follow their prescribed treatment and make some lifestyle changes. An estimated 10,000 Edmontonians and 600,000 Canadians are walking around with heart failure, which means their hearts don't function properly" - Edmonton Journal

Heart&Stroke Insider Prevention Edition - March 2010

Heart&Stroke Insider Prevention Edition - March 2010 is now available online or below:

Previous editions are here

Secondary prevention through cardiac rehabilitation

"Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic stable heart failure. The present position paper aims to provide the practical recommendations on the core components and goals of CR intervention in different cardiovascular conditions, to assist in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and consumers in the recognition of the comprehensive nature of CR"

Pre-diabetes awareness not happening (USA)

Most people are not aware if they are pre-diabetic and most who know they are are not doing anything about it, U.S. health officials found. Study leader Linda Geiss of the Centers for Disease Control and Prevention in Atlanta said survey data indicates almost 30 percent of U.S. adults age 20 and older had pre-diabetes, a metabolic syndrome - but only 7.3 percent were aware of their pre-diabetes status. - UPI

Secondhand smoke ups teen vessel damage (Finland)

Exposure to secondhand smoke has been linked to an increased risk of hardened arteries in 13-year-olds, researchers in Finland said. The study, published in Circulation: Cardiovascular Quality and Outcomes, associated higher levels of exposure to secondhand smoke between the ages of 8-13 to a significant increase by age 13 of blood vessel wall thickness and vessel functioning problems - both precursors to hardened arteries. The researchers also found greater exposure to tobacco smoke associated to another risk factor for heart disease - higher levels of apolipoprotein B - a component of low-density lipoprotein or LDL, the "bad" cholesterol. "Although previous research has found that passive smoke may be harmful for blood vessels among adults, we did not know until this study that these specific effects also happen among children and adolescents," lead author Dr. Katariina Kallio of the University of Turku said in a statement. The study participants - 494 children - had been recruited as infants beginning in 1990 into Finland's ongoing prospective randomized Special Turku Coronary Risk Factor Intervention Project, which aims to lower children's risks of heart disease by controlling their exposure to known environmental dangers

'Heart risk' at football stadiums (Europe)

"Too many football grounds in Europe do not have the right equipment and plans to save the lives of fans who have heart attacks, a study has found. The poll of 187 stadiums found over a quarter did not have defibrillators and many did not have emergency plans. The Sweden-led study, carried out by a group of club doctors, stressed more had to be done as it was not always easy to get ill fans to hospital. Researchers said there should be mandatory rules covering the issue. At the moment, it is simply considered good practice to have defibrillators at sports grounds. But in recent years many governments - including the authorities in the UK - have been doing more to increase the availability of the life-saving equipment in public spaces. Defibrillators work by delivering a controlled electric shock through the chest wall to the heart to restore a normal heartbeat" - BBC

Hospital suspends heart surgery after child deaths (UK)

An Oxford hospital has suspended child cardiac surgery pending the results of an external investigation into the deaths of four children over the past three months. Twenty six children are awaiting heart surgery at the hospital. Those who need urgent treatment will be offered operations elsewhere. A hospital statement said the four children had been "very sick." It read: "Paediatric cardiac surgery outcomes are nationally validated and the data is published. Oxford has been within normal outcome ranges." The statement added that it was "right that we take a pause while we look in to the individual cases, to see if there is anything to learn from them." The four children had congenital heart problems and had been receiving care at the hospital before their operations." - Reuters

Scientist turns skin cells into heart cell (USA)

A University of Houston scientist says he has developed a stem cell technique that might lead to new treatments for Alzheimer's, diabetes and other diseases. Professor Robert Schwartz, head of the university's Center for Gene Regulation and Molecular Therapeutics, said he devised a method that allows the reprogramming of ordinary human skin cells into heart cells that are similar to embryonic stem cells. Schwartz and his colleagues said the cells could be implanted and grown into fully developed beating heart cells, reversing the damage caused by previous heart attacks. The new cells would replace the damaged cardiac tissue that weakens the heart's ability to pump, develops into scar tissue and causes arrhythmias. The researcher said early clinical trials using reprogrammed cells on actual heart patients could begin within one or two years - UPI

Don Hambleton - Obituary

Don Hambleton: April 27, 1949 to March 1, 2010. "We are deeply saddened to announce the death of Don Hambleton after a long, courageous and bravely fought battle with heart disease. He leaves to grieve his beloved wife, Alice (nee Taillefer); his dear children, son, Chris (Elsa Johnston) of Regina; his daughter, Jana (Rob Klenz) of Saskatoon; his sister, Myna Hambleton (Ross McLeod) of Stewiacke, NS; his step-son, Tyson Williams of North Battleford; his step grand-daughter, Kiera Williams; his mother-in-law, Flora Taillefer of Prince Albert; his sister-in-law, Lorraine Clyesdale (Gordon) of Warman; brother-in-law, Gerry St. Pierre (Dorine) of Barrhead, AB; and nephews, Donny (Leah) Hebden of Cape Breton and Scott (Tabitha) Hebden of Georgia, USA. He also leaves to mourn aunts, Esther (Calvin Beddome), Delphine Ruszkowski and Ruth Jenic, all of Prince Albert; and uncle, Gerald (Shirley ) Campbell of Victoria, BC; as well as many cousins. Don was born in Prince Albert and attended school at Riverside and obtained his Bachelor of Education at U of S. In his youth, he was an avid softball, football, and hockey player. Before his teaching career he worked for the Forestry department where he developed a great love of trees, the North and fishing; spending many happy days in the Prince Albert National Park. He taught at various schools in Prince Albert until 1996 and during that time he also successfully ran commercial greenhouses and a market garden near St. Louis. He and Alice moved to Saskatoon in 1999. Don took great pride in his children's accomplishments but also achieved many outstanding accomplishments himself. After his teaching career was over, he spent many hours volunteering at Yarrow Youth Farm, at the U of S and various horticulture events. He became a Master Gardener and spent countless hours planning and designing people's yards as well as his and Alice's acreage. In honour of his volunteering, he was so proud to have received the Saskatchewan Centennial Medal from Linda Haverstock in 2005. Don learned about gardening at his Granny Campbell's knee, and everywhere he lived, he created his own little Garden of Eden. As well as horticulture, Don was an accomplished wood worker, sculptor, and painter. He had a remarkable eye for detail and the patience to make anything he worked at perfect. His motto was always leave a place better than what it was when you arrived. Don was predeceased by his father, Frederick in 1977; his mother, Margaret in 2006; uncles and aunts, Jack Ruszkowski, Max Jenic, Sandy and Lorna Taylor, Jean London, Henry and Irene Olson; grandparents, Bill and Elsie Campbell. A Funeral Service will be held on Friday, March 5th, 2010 at 1:30 p.m. at Hillcrest Funeral Home (east on 8th Street, turn right before railway crossing). Interment will follow at Hillcrest Memorial Gardens. In lieu of flowers, please send donations to the Electrophysiology department at the Royal University Hospital (103 Hospital Drive, Saskatoon, SK. S7N 0W8). Arrangements entrusted to Kenneth Scheirich"

First Hyper Acute Stroke Unit opens at The Royal London (UK)

"Barts and The London's acute stroke service has been formally accredited to provide regional stroke thombolysis and to go live as a Hyper Acute Stroke Unit (HASU) from April 2010 - the first trust in London to achieve full accreditation, following an external evaluation of the service in late January 2010. The accreditation of the HASU at The Royal London Hospital follows a London-wide review of stroke services last year, in which the Trust's stroke service was selected to be one of eight HASUs across the capital. The Trust's stroke service offers significantly lower than average mortality rates - 12% compared with 20% nationally - along with lower rates of long-term disability requiring institutionalisation for people who have suffered a stroke - 3% compared with 11% nationally. As well as The Royal London, hyper-acute stroke centres will be located at Northwick Park Hospital, Charing Cross Hospital, University College Hospital, St George's Hospital, King's College Hospital, The Princess Royal University Hospital and Queen's Hospital"

The 2010 DiabetesMine™ Design Challenge

The 2010 DiabetesMine™ Design Challenge is an online competition to encourage creative new tools for improving life with diabetes

Menopause increases heart risk (USA)

Women entering menopause need to be aware of their increasing risk of heart disease, a U.S. doctor advises. Dr. Vera Rigolin of Northwestern Memorial Hospital in Chicago says women need to know their symptoms of heart attack may differ from those of men. Men often experience chest discomfort while women commonly may have other, more subtle symptoms - such as fatigue, nausea, shortness of breath, jaw pain or abdominal discomfort. "In some women, plaque can build in the smallest blood vessels called the microvascular circulation. These blockages do not show up in an angiogram," Rigolin says in a statement. "In these cases, we often use magnetic resonance imaging with medication to visualize blood flow within the small blood vessels when other standard tests do not provide us answers." Menopausal women can lower their risk of heart disease by adopting a healthy lifestyle, Rigolin says. "If you are a smoker, quit immediately and avoid secondhand smoke. Eat a diet rich in fruits and vegetables and exercise at least three times per week to maintain a healthy body weight," she says. Rigolin urges visiting a healthcare provider at least yearly to have blood pressure, blood sugar and cholesterol checked

Watch out for infection if taking cholesterol drug simvastatin

"New research published in the Journal of Leukocyte Biology suggests that simvastatin negatively impacts the immune system's ability to clear infection and control inflammation in the presence of bacteria. Simvastatin might help us control our cholesterol, but when it comes to infection, it's an entirely different story says a new research study published in the Journal of Leukocyte Biology. In the research report, scientists from Italy show that simvastatin delivers a one-two punch to the immune system. First it impairs the ability of specialized immune cells, called macrophages, to kill pathogens. Then, it enhances production of molecules, called cytokines, which trigger and sustain inflammation. 'Statins are key drugs in the primary and secondary prevention of cardiovascular disease,' said Cosima T. Baldari, Ph.D., a scientist from the Department of Evolutionary Biology at the University of Siena in Siena, Italy, who was involved in the research. 'Our understanding of how these drugs affect the immune system should help maximize the benefits of these excellent drugs.'"

New research shows innovative respiratory stress test can quickly detect significant coronary artery disease in a noninvasive setting

"Newly published data shows using a Respiratory Modulation Response (RMR) is a novel, non-invasive measure to quickly and accurately detect the presence of significant coronary artery disease (sCAD). Patients in the study with sCAD had a lower RMR compared to patients without, regardless of their risk factors or clinical history of angina, previous myocardial infarction (MI), or angioplasty. These data, published in the current issue of Euro Intervention Journal, demonstrate that RMR was lower in patients with significant CAD compared to those with non-significant CAD (P<0.0011), regardless of their risk factors or clinical history of angina, previous MI, or angioplasty"

First Abu Dhabi Cardiac & Vascular Disease Conference

Sheikh Khalifa Medical City (SKMC), managed by Cleveland Clinic organizes the first annual cardiac and vascular disease conference on 11 and 12 March 2010 at the Beach Rotana Hotel, Abu Dhabi. SKMC is owned and operated by SEHA, the Abu Dhabi Health Services Company, which is responsible for the curative activities of all the public hospitals and clinics in the Emirate of Abu Dhabi. The two-day conference is targeted to Internists, General Practitioners, Cardiologists and Neurologists and more than 300 physicians are expected to attend

Antacids taken with heart drugs increase risk of another attack (Canada)

"A drug combination prescribed to thousands of heart attack survivors increases the risk of a repeat heart attack, Canadian researchers are warning. In a major study spanning nearly six years, Toronto researchers who followed more than 13,000 patients found those given the blood thinner Plavix in combination with certain acid suppressants are 40 per cent more likely to have another heart attack in the first three months after leaving hospital. 'There are so many people at potential risk here it’s difficult to understate the importance of the findings,' says Dr. David Juurlink, head of the division of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre, and lead author of the study released Wednesday by the Canadian Medical Association Journal"

International Multidisciplinary Forum on Palliative Care

The International Multidisciplinary Forum on Palliative Care conference will be held on November 11-14, in Budapest, Hungary. Palliative care is an important part of the treatment of every patient with a life threatening illness. It is provided from the moment of diagnosis throughout the trajectory of the illness in order to improve symptom control and quality of life of the patients and their families. If you are a family medicine physician, oncologist, geriatrician, neurologist, nephrologist, pediatrician, a pain and palliative physician, nurse, social worker, psychologist, physical therapist, chaplain or any other paramedical professional, interested in improving your palliative care skills and knowledge - do not miss this event

Obese children show signs of heart disease

Obese children as young as three years old show signs of future heart disease, say US researchers. A study of 16,000 children and teenagers showed the most obese had signs of an inflammatory marker which can predict future heart disease. In all, 40% of obese three-to-five-year olds had raised levels of C-reactive protein compared with 17% of healthy weight children, Pediatrics reported. But more work is needed to prove the link with heart disease in later life. The study, carried out by a team at the University of North Carolina (UNC), looked at children aged one to 17. Overall, nearly 70% were a healthy weight, 15% were overweight, 11% were obese and 3.5% were very obese. In the older age groups, the proportion of those in the very obese category with high levels of C-reactive protein (CRP) increased even further. By age 15-17, 83% of the very obese had increased CRP compared with 18% of the healthy weight children - BBC