Keeping you up to date on recent headlines in cardiovascular healthcare:
Fall in CVD death rates in Australia . . . . Deaths from cardiovascular disease (CVD) and coronary heart disease have been declining since the late 1960s in Australia, according to a report by the Australian Institute of Health and Welfare (Canberra). In 2006, an estimated 187,000 Australian lives would have been lost to CVD, rather than the 45,670 actual deaths, representing a "saving" of around 140,000 Australian lives in that year alone, according to the institute. It reports that around 3.7 million Australians (19% of the population) have a "long-term" cardiovascular condition.
'Massive' decline in coronary deaths in Iceland . . . . Similar to the report from "down under," Iceland has seen a decline in heart disease deaths. Dr Thor Aspelund and colleagues from the Icelandic Heart Association (Reykjavik) and the University of Iceland (H sk li slands) applied the IMPACT mortality model to Icelandic death statistics, national quality registers, published trials and meta-analyses, clinical audits and a series of national population surveys. They found that from 1981 to 2006 mortality rates from coronary heart disease (CHD) in Iceland decreased by a remarkable 80% in men and women aged between 25 and 74 years. The researchers say that about 75% of the decrease was attributable to reductions in cholesterol (36%), smoking (20%) and systolic blood pressure (26%) and an increase in physical activity (5%). The study is being presented at EuroPRevent 2009 in Stockholm, May 6-9.
Computer-based phone calls increase BP awareness, control . . . . An automated feedback system made hypertension patients more aware of their potentially fatal or disabling disease and helped them significantly lower their high blood pressure (BP), according to a report in Circulation: Cardiovascular Quality and Outcomes. In a one-year study of patients in the Montreal region, the system telephoned participants at least once a week, and a voice-recognition program asked for the most recent BP reading they had recorded. The information was automatically relayed to patients' physicians and pharmacists, who could intervene if a reading indicated problems. Somewhat more than 12% of the intervention participants and about 7% of the controls were hospitalized during the study, both non-significant differences. Researchers attributed the success of the program to the positive impact of regular feedback.
CPAP may improve outcomes after cardiac surgery . . . . Research out of Germany suggests that patients undergoing cardiac surgery may benefit from the postoperative use of continuous positive airway pressure (CPAP). Outcomes in 232 cardiac surgery patients who received standard postoperative treatment, including 10 minutes of CPAP every four hours, and 236 cardiac surgery patients who received prophylactic CPAP for at least 6 hours after surgery showed that prophylactic CPAP significantly improved arterial oxygenation without altering heart rate or mean arterial blood pressure. The study is published in the May issue of CHEST.
OSA found to thicken blood vessels . . . . Obstructive sleep apnea, (OSA) has been found to thicken a person's blood vessels, thus becoming a key factor in leading to vascular and heart disease, according to researchers at Emory University (Atlanta). The researchers identified the enzyme NADPH oxidase as important for the effects OSA has on blood vessels in the lung. Cyclically depriving mice of oxygen, to simulate OSA, gives them pulmonary hypertension and forces the blood vessels in the lung to make more NADPH oxidase. NADPH oxidase is responsible for making superoxide, a reactive free radical that interferes with nitric oxide, a signal that allows blood vessels to relax. The researchers found that the mice with NADPH oxidase are immune to the effect of hypoxia. The results appear in the May 1 issue of the American Journal of Respiratory Cell and Molecular Biology.
Study finds cardio disease, depression link . . . . Researchers at Rush University Medical Center (Chicago) have done a study showing that depression is linked with the accumulation of visceral fat, the kind of fat packed between internal organs at the waistline, long been known to increase the risk of cardiovascular disease and diabetes. The study included 409 middle-aged women, about half African-American, half Caucasian, participating in the Women in the South Side Health Project (WISH) in Chicago, a study of menopausal transition. The researchers found a strong correlation between depression and visceral fat, particularly among overweight and obese women. They speculated that depression triggers the accumulation of visceral fat by means of chemical changes, such as the production of cortisol and inflammatory compounds. The study is posted online and will be published in the May issue of Psychosomatic Medicine.
Learning/attention problems found in hypertensive children . . . . Children who have high blood pressure are more likely to have learning disabilities and attention deficit hyperactivity disorder (ADHD) than children who are not hypertensive. They are also more likely to have a higher body mass index (BMI), according to researchers at the University of Rochester Medical Center (Rochester, New York), The study followed 201 children, 10 to 18 years old. Of these, 100 were diagnosed with hypertension and 101 were determined to either not have hypertension or having "white coat" high BP. Almost 28% of children with hypertension had a learning disability; 20% had ADHD. Some of those children had both a learning disability and ADHD; in total, 40% with hypertension had a learning disability and/or ADHD. The study was presented as an abstract at the recent meeting of the Pediatric Academic Society (The Woodlands, Texas) in Baltimore.
Simulator makes for echocardiogram training . . . . Physicians at Beth Israel Deaconess Medical Center (Boston) report that a "first-in-the-world" simulator can help teach the performance of transesophageal echocardiogram (TEE) procedures, routinely used in cardiac procedures, and help attending physicians can brush up on the use of the procedure. The simulator, developed British anesthesiologists, currently features only normal heart structures so trainees can become more proficient before encountered real patients with disease. Kevin Cummisford, MD, an anesthesia fellow training on the simulator, said, the simulator improves on echo imaging. With the simulator "you have a good image of what normal is and it's easy to add on the abnormal that we see every day."
ASH launches hypertension accreditation education program . . . . The American Society of Hypertension (ASH; New York) has unveiled the ASH Hypertension Accreditation Program to improve the understanding of hypertension among allied health professionals and pharmaceutical sales representatives. The program, to begin in June, is based on ASH's Clinical Hypertension Review Course for physicians, emphasizing state-scientific principles and evidence-based clinical practice. Daiichi Sankyo (Parsippany, New Jersey) collaborated with ASH on the concept and will be the first pharmaceutical company to have its sales force considered for the new program.
— Compiled by Don Long, MDD National Editor