HEALTH : Hormones and Other Matters of the Heart
Cardiovascular disease has been the leading killer of Americans every year since 1918. But researchers are trying hard to alter that.
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During this week’s annual American Heart Assn. meeting, which concluded Thursday in Anaheim, more than 3,000 studies were presented.
Besides a major announcement that cholesterol-lowering drugs can dramatically reduce heart attacks, scientists also presented these important findings:
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Estrogen replacement therapy appears effective in helping post-menopausal women remain healthy after undergoing surgery to unclog blocked coronary arteries. The reclosing of the arteries after surgery is the “main problem right now,” said Dr. Eric Peterson of Duke University. Estrogen “seems to prevent proliferation of cells in the blood vessel lining in response to injury,” he said.
Of the common procedures used to clear blocked arteries, estrogen seemed to have more of an effect on the women who had atherectomy, contrasted with women who underwent balloon angiopathy.
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In another sign that hormones play a significant role in heart disease in women, researchers at the University of California, San Diego, presented a study showing that women who have hysterectomies but retain their ovaries have the same risk of heart disease as a naturally menopausal women, regardless of age. But women who have the ovaries removed have a greater risk of heart disease.
Ovaries are often removed during a hysterectomy to eliminate the risk of ovarian cancer.
But, said UC San Diego researcher Donna Kritz-Silverstein: “The results of our study suggest that [removal of both ovaries] may have negative effects that don’t become apparent until many years after surgery.”
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A rare genetic disease that causes abnormal heartbeats and can lead to sudden death appears to become more severe in successive generations, said doctors at Harvard Medical School.
Long QT syndrome is sometimes diagnosed after episodes of fainting or seizures. But often it is silent until it produces sudden death. Several genes related to the disorder were recently identified. Because any child born into a long QT family has a 50-50 chance of inheriting a faulty gene, it’s important that carriers are identified. The irregular heartbeat can be controlled with medications.
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If you want to learn CPR but never find the time to take a class, the solution may be to learn the technique at home.
Researchers have reported success in teaching CPR using a 30-minute self-instruction video. “We have found so far that people who watch the video do as well on almost every measure as people who take a four-hour CPR class,” said Harvard researcher Robert Brennan.
A home instruction video kit may become available as early as next year.
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The bad news for middle-aged men is that your waist is likely going to expand no matter how much exercise you do.
Investigators at the Lawrence Berkeley Laboratory measured weight and waist circumference in 4,769 male runners, ages 18-50. The body mass index, a measure of girth, increased with age regardless of how far the men ran weekly. The study suggests middle-age weight gain is partly physiological.
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Panic attacks can look like heart attacks, producing chest pain and shortness of breath. But doctors are far better at identifying an actual heart attack than diagnosing panic disorder.
According to a new study from the Montreal Heart Institute, panic disorder goes undiagnosed in 98% of patients who report to emergency rooms with chest pain. Of 441 such patients, 24.5% had panic disorder, but only 2 of these 109 patients were correctly diagnosed by a cardiologist. The study is particularly distressing since a quarter of the patients with panic disorder had suicidal thoughts in the week preceding their ER visit.
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Children who are born to HIV-infected mothers but do not acquire the disease congenitally are still at higher risk for other health problems, researchers at Children’s Hospital in Boston report.
In a study of infants born to HIV-infected mothers, a significant number were diagnosed with heart abnormalities.
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Many elderly heart attack patients are not receiving medications that could prevent further development of coronary heart disease or heart failure, Yale University scientists say.
Researchers examined the records of Medicare patients discharged from the hospital after a heart attack. Among 5,490 patients, only 76% were discharged on aspirin therapy. And of 1,452 patients assessed and found to be ideal candidates for medications called ACE inhibitors, only about half were actually put on the therapy.
“The lack of ongoing aspirin therapy for these patients is of special concern, since our findings suggest that it affects vast numbers of patients nationwide,” said Dr. Harlan M. Krumholz. “Aspirin may provide the best opportunity for secondary prevention after [heart attack] because of its effectiveness, low cost, safety and relative lack of side effects.”
