Keeping you up to date on recent headlines in cardiovascular healthcare:

Vitamin D deficiency in women linked to hypertension ... Vitamin D deficiency in premenopausal women may increase the risk of developing systolic hypertension 15 years later, according to research reported at the American Heart Association's 63rd High Blood Pressure Research Conference. Researchers examined women enrolled in the Michigan Bone Health and Metabolism Study and analyzed data from 559 Caucasian women living in Tecumseh, Michigan. The ongoing study began in 1992 when the women were 24 to 44 years old with an average age of 38 years. Researchers took blood pressure readings annually throughout the study. They measured vitamin D blood levels once in 1993, and then compared their systolic blood pressure measurements taken in 2007. Premenopausal women who had vitamin D deficiency in 1993 had three times the risk of developing systolic hypertension 15 years later compared to those who had normal levels of vitamin D, researchers said. "This study differs from others because we are looking over the course of 15 years, a longer follow-up than many studies," said Flojaune Griffin, co-investigator of the study and a doctoral candidate in epidemiology at the University of Michigan School of Public Health (Ann Arbor, Michigan). "Our results indicate that early vitamin D deficiency may increase the long-term risk of high blood pressure in women at mid-life."


Study finds black patients less likely to survive in-hospital cardiac arrest ... According to a study published in the Sept. 16 issue of JAMA, black patients who have an in-hospital cardiac arrest are significantly less likely to survive to hospital discharge compared with white patients, although much of this survival difference was associated with the hospital in which black patients received care, the study noted. "Survival following in-hospital cardiac arrest represents a unique opportunity to examine racial disparities in medical care and outcomes. In-hospital cardiac arrest is an emergency condition tightly linked to processes of care and for which there is little debate regarding clinical appropriateness of treatment in eligible patients," according to the article. "Racial differences in survival have not been previously studied after in-hospital cardiac arrest, an event for which access to care is not likely to influence treatment." Paul Chan, MD, of Saint Luke's Mid America Heart Institute (Kansas City, Missouri), and colleagues used data from the National Registry of Cardiopulmonary Resuscitation to examine whether racial differences exist in survival for patients with in-hospital cardiac arrest. The study included 10,011 patients from 274 hospitals who underwent defibrillation for a cardiac arrest. The average age in the study population was 67 years, 6,021 were men (60.1%), and 1,883 were black (18.8%). According to the study, several patient and hospital factors differed by race, including white cardiac arrest patients being older and more likely to be male; black patients were more likely to have ventricular fibrillation as their initial presenting arrest rhythm, were sicker at the time of cardiac arrest, and were more likely to be admitted to a hospital unit not monitored, to a hospital with greater than 500 beds, and in the southeastern U.S. The researchers found that black patients had a 27% lower overall rate and a 12% lower absolute rate of survival compared with white patients. "These unadjusted survival differences by race were, in large part, attributable to black patients being more likely to receive treatment at hospitals with worse outcomes," the authors noted. According to the researchers, the findings suggest that strategies to eliminate racial disparities in survival after in-hospital cardiac arrest are not likely to succeed unless they are accompanied by successful identification and implementation of interventions that improve resuscitation survival in those poorly performing hospitals in which black patients are more likely to receive care.

Tryton Side Branch Stent used in 250 procedures ... Tryton Medical (Durham, North Carolina) reported that the Tryton Side Branch Stent has been used in 250 procedures to treat atherosclerotic lesions at a bifurcation in patients with heart disease. "Bifurcation lesions have presented a challenge for cardiologists since the earliest days of angioplasty," said Prof. David Foley of Beaumont Hospital (Dublin, Ireland). "Current approaches to treating these cases entail adaptation of available stents, leading to complexity and increased risk of peri-procedural complications and late restenosis. The Tryton Side Branch Stent offers a straightforward approach to first securing the side branch, while enabling trouble-free stenting of the main vessel using either a drug eluting or bare metal stent."


Research finds more Americans at risk for heart disease ... After two decades of improvement, the percentage of Americans without major heart disease risk factors is dropping, according to a report in Circulation, the journal of the American Heart Association (Dallas). "From a preventive health point of view, it's important that individuals achieve as many of these goals as possible, and it's disappointing that less than 10% of Americans are meeting them all," said Earl Ford, MD, lead author of the study and medical officer of the U.S. Public Health Services at the Centers for Disease Control and Prevention (CDC; Atlanta). "Our analysis suggests that achieving low risk status for most U.S. adults remains a distant and challenging goal. Unfortunately, the limited strides that were made towards this goal during the 1970s and 1980s were eroded by the increases in excess weight, diabetes and hypertension during more recent decades." Researchers tracked data on adults aged 25-74 in four national surveys, examining several low-risk criteria: Never or former smoker; Total cholesterol below 200 milligrams per deciliter (mg/dL) and not using cholesterol-lowering drugs; Blood pressure below 120/80 millimeters of mercury (mmHg) without using blood pressure-lowering medication; Not overweight or obese, as reflected in a body mass index (BMI) less than 25 kg/m2; and Never diagnosed with diabetes. In the National Health and Nutrition Examination Surveys: 4.4% of adults had all five of the low-risk factors in NHANES I, 1971-1975; 5.7% had all five in NHANES II, 1976-1980; 10.5% of adults rated low risk on all factors in NHANES III, 1988-1994; and only 7.5% of adults rated low risk on all factors in the 1999-2004 survey. "Until the early 90s, we were moving in a positive direction, but then it took a turn and we're headed in a negative direction," Ford said. "When you look at the individual factors, tobacco use is still headed in the right direction and so are cholesterol levels, although that has leveled off. The problem is that blood pressure, BMI and diabetes are all headed in the wrong direction." An imbalance in the amount of energy consumed in food and the amount expended in physical activity is likely a major culprit in the negative risk factor trends, Ford said.

Study suggests cardiac CT helps detect heart disease ... Radiologists have developed a way to gain better insight into signs of heart disease by using cardiac CT scans that detect narrowed arteries and low blood flow, according to a new study published Sept. 15 in the journal of the American College of Cardiology (Washington). CT scans use X-rays to create cross-sectional images of the body's internal anatomy. The scans can detect blockages in coronary arteries, but it's hard to tell if they're actually preventing blood from flowing to the heart, the authors noted. In the study, researchers at Massachusetts General Hospital (Boston) explained how to gain more detailed pictures of what is going on inside the body, potentially giving doctors more information about the best treatment. The research, based on tests in 34 cardiac patients, "is among the first demonstrations of the use of cardiac CT to detect both coronary artery stenosis and resulting myocardial ischemia simultaneously in a single examination," Ricardo Cury, MD, a cardiac imaging specialist at the hospital's Heart Center and the study's principal investigator, said in a hospital statement. Though other scanning technologies, including nuclear perfusion imaging, provide information that can help guide patient treatment, such methods can lead to either false-negative or false-positive findings, Cury said the new technique "could improve diagnostic accuracy while potentially reducing costs and radiation exposure." He acknowledged, however, that the study was relatively small and said the approach needs to be tested in a larger multicenter trial.

—Compiled by Amanda Pedersen, MDD

amanda.pedersen@ahcmedia.com