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

Scientists find 'switch' that holds promise for future treatment of vascular diseases ... Researchers at the Gladstone Institute of Cardiovascular Disease (GICD; San Francisco, California) say they have discovered a key switch that makes stem cells turn into the type of muscle cells that reside in the wall of blood vessels. According to the researchers, the switch might be used in the future to limit growth of vascular muscle cells that cause narrowing of arteries leading to heart attacks and strokes, limit formation of blood vessels that feed cancers, or make new blood vessels for organs that are not getting enough blood flow. In a study published recently in the journal Nature, the researchers found that a tiny RNA molecule, called microRNA-145, not only had all the information necessary to turn a stem cell into a vascular smooth muscle cell (VSMC), but could also affect VSMCs in the adult artery.

Study reveals one third of teens at risk for heart disease ... A new study has revealed that almost a third of 14-year-olds face an increased risk of heart disease, Type 2 diabetes and stroke in later life. The report, published this week in The Medical Journal of Australia (MJA), also found a quarter of 8-year-olds were at an increased risk of obesity. The study examined a group of 14-year-olds and found 29% had fallen into the high-risk category for metabolic syndrome, a combination of disorders that enhances the prospect of suffering a heart attack, stroke or Type 2 diabetes. A separate study, also in the MJA, revealed that the proportion of boys age 7-15 who were overweight or obese had more than doubled from 11% in 1985 to 23.7% in 2007. The data, presented by the Heart Foundation (Westlake Village, California), was collected from three recent surveys measuring the weight and height of Australian children.

Scientists identify stem cells that form three major cell types in the heart ... Researchers say the earliest master stem cells that form the three major cell types in the human heart have been identified and isolated. Reporting online in Nature, Kenneth Chien, MD, PhD, of the Harvard Stem Cell Institute and Massachusetts General Hospital (both Boston) and his colleagues described the process of isolating and purifying islet progenitor cells — called ISL1+ progenitors — from human embryonic stem cells. These cells expand and then differentiate into heart muscle, smooth muscle, and endothelial cells during early cardiogenesis, a process that Chien says hadn't been well understood previously. The Harvard Stem Cell Institute and the Leducq Foundation (Paris, France) supported the study. Advanced Bioscience Resources (Alameda, California) provided the human fetal tissues that were used in the study.

New research links anger to heart disease ... In the mid 1970s the benchmark Framingham Heart Study found that suppressed anger could help predict the incidence of heart disease within eight years. Now, a recent government study shows that men with problems controlling anger have three times the risk of heart disease than those who control their anger well. Some older studies found that people with "Type A" personalities — those who are described as compulsive, driven overachievers — have a much higher rate of getting heart disease and having heart attacks within five to eight years than "Type B" personalities (relaxed, less aggressive). Other studies did not support this theory though. So researchers went back and tried to isolate the trait in Type A behavior that was most linked with heart disease. The new study pointed to anger as one of the main culprits. When comparing angry people to more even-tempered types, angry people are more likely to have lower good-to-bad cholesterol ratios, higher fat levels, and higher blood pressure that may rise even higher in the three years following a major anger incident.

No improvement seen in survival rates of elderly CPR patient ... A study of elderly patients receiving CPR in the hospital shows that survival rates did not improve from 1992 to 2005. During that period, the proportion of hospital deaths preceded by CPR rose, and the proportion of patients who were successfully resuscitated and later discharged home fell. The researchers found that 18.3% of the Medicare beneficiaries age 65 and older who underwent in-hospital CPR survived to discharge. According to the study, elderly black patients were more likely to receive CPR, but less likely to survive, partially because they were more likely to be treated in hospitals with lower rates of post-CPR survival and perhaps more likely to request that resuscitation be attempted. The adjusted odds for survival for black elderly patients were 23.6% lower than for similar white patients, according to the report, which was published in the New England Journal of Medicine. Older age, being a man, having more co-existing chronic illnesses, and residing in a skilled nursing facility before hospitalization also lessened the chances of survival, according to the study's authors. The report notes that higher income did not improve survival.

Study highlights importance of good blood sugar control ... A new study highlights the importance of good long-term control of blood sugar in people with diabetes. The study found that poor long-term blood sugar control in diabetics is associated with a substantial increase in the risk of dying from ischemic heart disease — the type of heart disease characterized by restricted blood flow to the arteries of the heart. According to the researchers, with reasonably good blood sugar control, the risk of death from ischemic heart disease is comparable to that seen in people without diabetes. In a 20-year follow up study, researchers from the Norwegian University of Science and Technology (Trondheim) compared death rates from ischemic heart disease in 205 patients newly diagnosed with diabetes and 205 matched subjects without diabetes at the outset. The study was published in the European Heart Journal.

'Mini-stroke' patients better off at hospitals with stroke services ... According to the results of a survey published in the Medical Journal of Australia, patients who suffer from transient ischemic attack (TIA), sometimes called "mini-strokes", are more likely to receive rapid assessment and care if they attend a hospital which has organized stroke care services. Christopher Price of the National Stroke Foundation and his co-authors surveyed 74 hospitals on their current services for TIA patients. TIA is caused by a temporary cut in blood supply to part of the brain and places patients at greater risk of a stroke or heart attack. Price said the survey found that only 5% of sites involved stroke specialists in the initial assessments of patients with suspected TIA, and only 60% of hospitals commenced treatment or modified existing treatment during the initial consultation. The presence of a stroke unit in a hospital was associated with improved processes of care for patients with TIA, according to the authors.

— Compiled by Amanda Pedersen, MDD Staff Writer