Male Heart Disease May Be Linked to Mom's Lifetime Nutrition Risk associated, in part, with mother's body size, placenta size and shape at birth, researchers say

Male Heart Disease May Be Linked to Mom's Lifetime Nutrition Risk associated, in part, with mother's body size, placenta size and shape at birth, researchers say By Alan Mozes THURSDAY, June 2 (HealthDay News) -- A man's heart disease risk after the age of 40 may be linked, at least in part, to his mother's body size and placenta size when he was born, a new study suggests. "Chronic disease is the product of a mother's lifetime nutrition and the early growth of her child," study lead author Dr. David Barker, a professor of clinical epidemiology at the University of Southampton in the United Kingdom, said in a news release from the European Society of Cardiology. "It is not simply a consequence of poor lifestyles in later life. Rather, it is a result of variations in the normal processes of human development." The finding is reported online June 1 in the European Heart Journal by Barker, who is also a professor in cardiovascular medicine at Oregon Health and Science University, and colleagues. Indications of the maternal influence on the heart disease risk of male offspring stem from an analysis involving nearly 7,000 Finnish men who were born in Helsinki between 1934 and 1944. At that time, birth records included notations on the baby's size, the placental surface size, and other information on the mother's weight, height and age, and previous pregnancies. (The placenta -- a temporary organ that lines the uterus and feeds the baby in the womb -- is expelled at birth.) The investigators found that male heart disease risk in late adulthood appeared to rise among: Men whose mothers were short, pregnant for the first time and had relatively oval placentas (indicating that the placental development had been disrupted). Men whose mothers were tall and heavy and had relatively small placentas (which might have restricted the infants' growth mid-gestation). Men whose mothers were tall with a lower-than-normal body mass index and whose placentas were heavy relative to birth weight (the mothers' BMIs suggest that their nutrition was poor during pregnancy, Barker explained). Regardless of which combination was in play, those men with the greatest likelihood for developing heart disease as adults had tended to be relatively thin at birth. This fact, the authors suggested, was an indication that malnourishment was a factor at the time of birth. "We have been able to show for the first time that a combination of the mother's body size and the shape and size of the placental surface predicts later heart disease," Barker said. Going forward, the research team intends to study abnormal development of the heart by examining pregnant women's nutritional habits and body characteristics alongside prenatal growth patterns and placenta sizes at birth.

Younger Docs More Likely to Prescribe Drugs for Heart Disease: Study But their patients are not better off than those of older docs who stress lifestyle changes

Younger Docs More Likely to Prescribe Drugs for Heart Disease: Study But their patients are not better off than those of older docs who stress lifestyle changes By Robert Preidt MONDAY, May 23 (HealthDay News) -- Older doctors are more likely to recommend lifestyle changes for patients with heart disease risk factors, while younger doctors are more likely to prescribe medications, a new study finds. But despite seeing doctors that prescribed more medications, the patients of younger doctors had no better control of their heart disease risk factors, according to the study by Italian researchers in the June issue of the International Journal of Clinical Practice. "Although younger doctors prescribed more drugs, this did not result in significantly better control of their patients' major CV [cardiovascular] risk factors, suggesting that other factors have an important role to play in the clinical management of CV risk, including lifestyle changes," Professor Massimo Volpe from the Faculty of Medicine at Sapienza University in Rome said in a journal news release. Volpe and his colleagues looked at the attitudes and prescribing habits of 1,078 family physicians, cardiologists and diabetes specialists, along with data from nearly 10,000 of their outpatients, whose average age was 67. The study found that 75 percent of the patients had high blood pressure, making it the most common cardiovascular disease risk factor. That was followed by abnormal lipid levels (cholesterol and/or fat in the blood), which affected 59 percent of patients, and diabetes (37 percent). Blood pressure drugs were the most commonly prescribed medications -- by 83 percent of doctors younger than 45, 78 percent of doctors aged 46-55, and 80 percent of doctors over 55. Younger doctors were also more likely to prescribe diabetes drugs, lipid-lowering and anti-platelet agents than older doctors. Older doctors were most likely to recommend lifestyle changes. For example, doctors over 55 were most likely to tell patients to quit smoking and doctors aged 46 to 55 were most likely to recommend a healthier diet and exercise. "We believe these findings have important implications for the ongoing professional education of doctors treating patients with CV risk," Volpe added. SOURCE: International Journal of Clinical Practice, news release, May 16, 2011

Younger Docs More Likely to Prescribe Drugs for Heart Disease: Study But their patients are not better off than those of older docs who stress lifestyle changes

Younger Docs More Likely to Prescribe Drugs for Heart Disease: Study But their patients are not better off than those of older docs who stress lifestyle changes By Robert Preidt MONDAY, May 23 (HealthDay News) -- Older doctors are more likely to recommend lifestyle changes for patients with heart disease risk factors, while younger doctors are more likely to prescribe medications, a new study finds. But despite seeing doctors that prescribed more medications, the patients of younger doctors had no better control of their heart disease risk factors, according to the study by Italian researchers in the June issue of the International Journal of Clinical Practice. "Although younger doctors prescribed more drugs, this did not result in significantly better control of their patients' major CV [cardiovascular] risk factors, suggesting that other factors have an important role to play in the clinical management of CV risk, including lifestyle changes," Professor Massimo Volpe from the Faculty of Medicine at Sapienza University in Rome said in a journal news release. Volpe and his colleagues looked at the attitudes and prescribing habits of 1,078 family physicians, cardiologists and diabetes specialists, along with data from nearly 10,000 of their outpatients, whose average age was 67. The study found that 75 percent of the patients had high blood pressure, making it the most common cardiovascular disease risk factor. That was followed by abnormal lipid levels (cholesterol and/or fat in the blood), which affected 59 percent of patients, and diabetes (37 percent). Blood pressure drugs were the most commonly prescribed medications -- by 83 percent of doctors younger than 45, 78 percent of doctors aged 46-55, and 80 percent of doctors over 55. Younger doctors were also more likely to prescribe diabetes drugs, lipid-lowering and anti-platelet agents than older doctors. Older doctors were most likely to recommend lifestyle changes. For example, doctors over 55 were most likely to tell patients to quit smoking and doctors aged 46 to 55 were most likely to recommend a healthier diet and exercise. "We believe these findings have important implications for the ongoing professional education of doctors treating patients with CV risk," Volpe added. SOURCE: International Journal of Clinical Practice, news release, May 16, 2011

Heart Disease in Women

Heart Disease in Women Although many people think of heart disease as a man's problem, women can and do get heart disease. In fact, heart disease is the number one killer of women in the United States. It is also a leading cause of disability among women. The most common cause of heart disease is narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself. This is called coronary artery disease and happens slowly over time. It's the major reason people have heart attacks. Prevention is important: two-thirds of women who have a heart attack fail to make a full recovery. The older a woman gets, the more likely she is to get heart disease. But women of all ages should be concerned about heart disease. All women can take steps to prevent it by practicing healthy lifestyle habits. NIH: National Heart, Lung, and Blood Institute

Health Tip: The Dangers of Having High Cholesterol It raises your risk of a host of diseases

Health Tip: The Dangers of Having High Cholesterol It raises your risk of a host of diseases By Diana Kohnle (HealthDay News) -- High cholesterol usually refers to above-normal levels of LDL (low-density lipoprotein), the so-called "bad cholesterol" that can build up in your arteries and lead to heart disease. A bad heart may not be the only downside to high cholesterol, however. The Cleveland Clinic says high LDL also increases your risk of: Stroke. Peripheral vascular disease (PAD), which occurs when fatty deposits build up in arteries outside the heart and brain, most often in the legs and feet. Type 2 diabetes. High blood pressure, since the heart has to work harder to pump blood through clogged arteries.

Researchers pool data to search for genetic risks in heart disease

Researchers pool data to search for genetic risks in heart disease
American Heart Association Rapid Access Journal Report

Study highlights:
An international consortium analyzing pooled data from all published whole-genome studies of heart attack and coronary artery disease (CAD) has found multiple genetic mutations, including one that increases heart attack risk by 29 percent.
The collective gene data could provide 10 times more subjects and controls than the largest CAD study to date.

DALLAS, Oct. 5, 2010 — In an unprecedented international project, researchers have found multiple genetic mutations that play a role in heart attack or coronary artery disease (CAD) risk.

The Coronary ARtery DIsease Genome-wide Replication And Meta-Analysis (CARDIoGRAM) — published in Circulation: Cardiovascular Genetics, an American Heart Association journal — consists of data from every published whole-genome study on genetic mutations in heart attack or CAD risk. Researchers are also pooling data from several unpublished genome-wide association studies to see if any new mutations can be uncovered.

The consortium will analyze the complete genetic profiles of more than 22,000 people of European descent with CAD or a heart attack history, and 60,000 healthy people — 10 times more than in the next largest whole-genome study to date.

Investigators have examined an average 2.2 million single nucleotide polymorphisms (SNPs) in each of the whole-genome studies included in the review. SNPs, or “snips,” are genetic variants at specific locations on individual chromosomes. Sometimes these variants manifest themselves as a disease or susceptibility to a disease. Modern technology allows hundreds of thousands of SNPs to be scanned in a person.

“Only a small proportion of the inheritability of CAD has been explained,” said Heribert Schunkert, M.D., a professor of medicine at the University of Lübeck in Germany and a spokesman for CARDIoGRAM. “We have to accept that almost all persons of European ancestry carry multiple small genetic defects that mediate some coronary artery disease risk. The main aim of the consortium is to identify new disease mechanisms to improve risk prevention.”

The task is challenging because of the complex nature of atherosclerosis, with multiple genetic factors contributing in small ways to the disease, he said.

Genome-wide association studies provide an unprecedented sensitivity to detect genetic variants affecting disease risk, and researchers rely on the studies’ sample size. However, in a typical genome-wide association study with about 1,000 patients and controls, the power to detect a SNP with a significant effect is low.

“Collectively, our consortium increases the power of these findings 10-fold,” Schunkert said. “By pooling all of the published and unpublished data, we hope to make discoveries that might have been overlooked. Given that up to 2.5 million comparisons are carried out, in parallel, for each whole-genome scan, distinguishing between true and false associations has been difficult.”

The data will be maintained in a central database, and each SNP that appears related to heart disease will be subjected to replication studies to confirm its significance. Numerous SNPs and the proteins they express increase risk of CAD or heart attack. But it’s unknown whether they’re acting alone or with other genetic variables, Schunkert said.

Heart Bypass Surgery Rates Drop Dramatically, Study Finds But researchers say it's still the best option for certain patients

Heart Bypass Surgery Rates Drop Dramatically, Study Finds
But researchers say it's still the best option for certain patients

(Healthlinne News) -- The number of heart patients getting bypass surgery fell by nearly 40 percent between 2001 and 2008, new U.S. research finds.

The drop likely reflects several factors, including a decline in smoking rates, which has led to less coronary artery disease, said senior study author Dr. Peter Groeneveld, an assistant professor of medicine at the University of Pennsylvania School of Medicine.

Also, better and more aggressive treatment of coronary artery disease risk factors, such as high blood pressure, high cholesterol and diabetes, means fewer patients progress to needing surgery.

Another factor is that many patients with blocked arteries instead undergo percutaneous coronary intervention (PCI), also called balloon angioplasty, in which a doctor threads a catheter into the artery and inflates a balloon at the tip. Usually, a wire mesh structure called a stent is left behind to prevent the artery from narrowing again.

Though PCI is an excellent option for many patients, researchers stressed that bypass surgery -- officially called coronary artery bypass graft, or CABG -- may be the best option for some patients with certain severe blockages, including those with triple blockages or left main coronary artery stenosis, Groeneveld said.

"Patients need to be aware that CABG can be a good treatment option, and it's gotten better," Groeneveld said. "There have been several innovations that have made the recovery time much less than it used to be." In CABG, a new artery or vein is grafted, or connected, to the blocked artery to restore blood flow.

The study is published in the May 4 issue of the Journal of the American Medical Association.

Groeneveld and his colleagues analyzed data on a national sample of patients who underwent procedures to clear blockages at U.S. hospitals between 2001 and 2008. Most of the procedures were scheduled, though some were for emergency situations such as heart attacks.

During that period, there was a 15 percent overall decrease in procedures to clear coronary blockages, the investigators found.

Most of that reduction was because of a decline in annual CABG surgeries, which dropped by 38 percent. PCI, in contrast, held mostly steady with a 4 percent dip.

When the figures were projected to the entire U.S. population, there were an estimated 130,000 fewer CABG surgeries in 2008 compared with 2001, according to the study.

Dr. Debabrata Mukherjee, chief of cardiology at Texas Tech University Health Sciences Center, said even though PCI popularity has risen (the number of hospitals offering PCI increased by 26 percent during the study period, compared to about 12 percent for CABG), technological advances have made fewer PCI surgeries necessary.

In 2003, the U.S. Food and Drug Administration approved drug-eluting stents, which come with an immunosuppressant coating that helps prevent scarring and inflammation around the stent. The improved stents, which were in widespread use by 2005, reduced the need for redoing procedures because of scarring, Mukherjee said.

Prior to the innovation, about one-third of PCI patients needed a re-do within six months, he said. "Now, 5 percent, maybe 10 percent at most, need to come back," he said. "There has been a marked decrease in repeat procedures. So even as cardiologists are taking on more complex, multi-vessel cases, the overall volume of PCI hasn't gone up."

Groeneveld raised another possibility for the decline in CABG: Interventional cardiologists can do PCI, while only cardiac surgeons do bypass surgery.

Since most people see a cardiologist who would refer them to a cardiac surgeon if necessary, it's possible some patients who might be better off getting bypass surgery are being offered PCI instead, Groeneveld said.

"My hunch is cardiologists are referring fewer [patients] onto surgeons and treating more with interventional cardiology," he said. "The worry is there are patients who really who should be getting CABG that aren't getting it."

While bypass procedures used to involve cutting through the chest, technological advances now allow surgeons to do the procedure much less invasively. Innovations include doing the surgery through a small incision and using fiber-optic cameras, or even robotic surgery.

Despite the improvements, it's possible old perceptions die hard. Given the choice between doing PCI on the spot or waiting to see a surgeon and getting bypass surgery that comes with a longer recovery time, many patients may opt for the PCI, Groeneveld said.

"Patients are sometimes put in positions to make decisions while lying on a cath lab table with a cardiologist leaning over them," Groeneveld said, referring to the catheterization lab, where cardiologists perform PCIs.

"Patients should be made aware that there are alternatives to PCI, and those conversations about whether PCI is the right thing should be happening before the patient goes into the cath lab," he added.

SOURCES: Peter W. Groeneveld, M.D., assistant professor, medicine, University of Pennsylvania School of Medicine, Philadelphia; Debabrata Mukherjee, M.D., chief, cardiology, Texas Tech University Health Sciences Center, El Paso; May 4, 2011, Journal of the American Medical Association

Health Tip: Risk Factors for Peripheral Artery Disease When plaque builds up in the blood vessels

Health Tip: Risk Factors for Peripheral Artery Disease
When plaque builds up in the blood vessels

By Diana Kohnle


(Healthlinne News) -- Peripheral artery disease (PAD) occurs when thick plaque accumulates in the arteries (most often in the legs) and restricts blood flow to the heart, brain, other organs and limbs.

The National Heart, Lung and Blood Institute mentions these risk factors for PAD:
Being a smoker.
Being older.
Having diabetes or a common precursor, metabolic syndrome.
Having high blood pressure or high cholesterol.
Having coronary heart disease.
Having a family history of stroke.