TIME IT TAKES TO RUN ONE MILE IN MIDDLE AGE MAY HELP PREDICT RISK OF FUTURE HEART PROBLEMS

The New York Times (5/24, Parker-Pope) "Well" blog reports that, "for people in midlife," the amount of time it takes to run one mile "may help predict their risk of heart problems as they age." In two different studies, one published in the Journal of the American College of Cardiology and the other published in Circulation, "researchers from the University of Texas Southwestern Medical School and the Cooper Institute in Dallas analyzed fitness levels for more than 66,000 people" Altogether, "the research showed that a person's fitness level at midlife is a strong predictor of long-term heart health, proving just as reliable as traditional risk factors like cholesterol level or high blood pressure.

Posted by Steven Almany, MD

REVIEW FINDS NO EVIDENCE OF INCREASED RISK OF MI ASSOCIATED WITH USE OF ARB'S

HeartWire (4/27, Nainggolan) reported that "a new review of 37 randomized trials including almost 150 000 patients has found no evidence of an increased risk of MI associated with the use of angiotensin-receptor blockers (ARBs). For the review, investigators "included all randomized clinical trials comparing ARBs with controls (placebo or active treatment), with follow-up of at least one year, at least 100 participants, and reporting any of the following outcomes -- MI, death, CV death, angina, stroke, heart failure, or new-onset diabetes -- published until August 2010." The investigators found that, "when compared with controls, ARBs were not associated with an increase in the risk of MI (relative risk 0.99, 95% CI 0.92-1.07), death, cardiovascular death, or angina pectoris." The research is published online in BMJ.

Posted by Steven Almany, MD

7 HEALTH EDGE HEART CHECK

A big THANK YOU to Michigan Heart Group Drs. Almany, Ajluni and Bowers for volunteering their time last weekend to screen over 6000 student athletes at Milford High school. For more information on how you can get your child athlete screened by Beaumont Cardiologist, please call (800) 633-7377.

7 HEALTH EDGE HEART CHECK

If you would like more information about how to get your student athlete a Free Heart Check by one of these Michigan Heart Group Cardiologist or another top rated Beaumont Cardiologist, please call (800) 633-7377.

ONE IN EVERY 44,000 COLLEGE ATHLETES MAY BE AT RISK FOR SUDDEN CARDIAC DEATH

The Seattle Times (4/4, Wong) reported, "College athletes across the nation suffer from sudden cardiac death up to seven times more frequently than previously reported," according to a study published Monday by in the journal Circulation. The analysis of "400,000 athletes who participate in National Collegiate Athletic Association sports every year," also indicated that women college athletes are at a "far higher risk than previously believed."

According to the AP (4/4), the researchers tracked an "NCAA database of athlete deaths, news media reports and insurance records" and found "45 heart-related deaths over five years among these elite student-athletes, an average of nine a year." The risk equates to "one death among roughly every 44,000 NCAA athletes," noted study author Dr. Kimberly Harmon from the University of Washington.

The Los Angeles Times (4/4) "Booster Shots" noted that incidence "varied dramatically by sport." The highest rate was in "Division 1 basketball, with one death per 3,146 players per year." The study was also covered by WebMD (4/4, Hendrick) and HeartWire (4/4, Miller).

Posted by Steven Almany M.D.

ANGIOGRAPHY THROUGH RADIAL ARTERY GAINING FAVOR

The Los Angeles Times (4/5, Maugh) reports, "Performing angioplasty and angiography through the radial artery of the arm is as effective as the traditional method of entering through the femoral artery of the groin, but has fewer complications and is more comfortable for the patient," according to findings presented at the American College of Cardiology meeting. "And for rescue operations performed while the patient is suffering a heart attack caused by a complete blockage of a coronary artery," the researchers said using the "radial artery is superior."

According to MedPage Today (4/4, Neale), the "30-day rate of death, MI, stroke, or non-CABG-related major bleeding occurred was 3.7% in the radial group and 4% in the femoral group." The findings from the "7,000-patient RIVAL trial" were published in The Lancet on the same day they were presented at the ACC meeting. The study was also covered by the Wall Street Journal (4/4, Winslow, subscription required) and HeartWire (4/4, O'Riordan). For a clinical perspective on this article, go to CardioSource.org.

Posted by Steven Almany M.D.

TOM IZZO GIVES A SHOUT OUT TO OUR VERY OWN DR. ALMANY FOR PIONEERING THIS LIFE-SAVING PROGRAM THAT IS MAKING HISTORY ALL OVER MICHIGAN....

Michigan State basketball coach Tom Izzo Praises 7 Health Edge Heart Check Program

ANTIDEPRESSANTS ASSOCIATED WITH ACCELERATED ATHEROSCLEROSIS IN MIDDLE-AGED MEN

Bloomberg News (4/3, Cortez) reported, "Antidepressants may narrow the arteries of middle-aged men, potentially putting them at risk for heart attacks and stroke," according to a study presented at the American College of Cardiology meeting in New Orleans. In "a study involving 513 male twins, with an average age of 55, found those who took medications like Forest Laboratories Inc.'s Lexapro [escitalopram], Eli Lilly & Co.'s....Cymbalta [duloxetine], or Pfizer Inc.'s Zoloft (sertraline) had thicker blood vessel walls." What's more, "the increase, a measure of fatty-plaque buildup linked to atherosclerosis, was seen regardless of what type of antidepressant the men were taking."

The Los Angeles Times (4/2, Maugh) reported, "Overall, when the researchers adjusted for age, diabetes, blood pressure and other factors, they found that the intima-media thickness of men taking antidepressants was 37 microns (about 5%) thicker than that of men not taking the" medications. "When the team looked at 59 twin pairs in which one twin was taking the drugs and the second was not, the artery was 41 microns thicker in the twin taking" antidepressants.

HealthDay (4/2, Reinberg) reported, "Since each additional year of life is associated with a small increase in intima-media thickness, a brother taking antidepressants is physically four years older than the brother not taking antidepressants," the researchers "contended. They also said that even a small increase in intima-media thickness can increase the risk of a heart attack or stroke by 1.8 percent." Also covering the story were AFP (4/3), HeartWire (4/2, O'Riordan), Reuters (4/3, Berkrot, Pierson), and MedPage Today (4/3, Phend).

Posted by Steven Almany M.D.

RENAL DENERVATION TEATMENT MAY HELP REDUCE BLOOD PRESSURE IN PATIENTS WITH DRUG-RESISTANT HYPERTENSION

HealthDay (3/29, Salamon) reported that "a technique that interrupts nerve signals between the kidneys and brain dropped blood pressure to normal levels in 39 percent of patients with drug-resistant hypertension, according to a small new study" presented at the Society of Interventional Radiology's annual scientific meeting. For the study, carried out "at 24 international sites, 106 patients with uncontrolled high blood pressure (hypertension) randomly received either oral medication or renal denervation treatment, a procedure that uses a catheter-based probe emitting high-frequency energy near the renal artery to deactivate nearby nerves." Researchers found that, "six months later, the patients who received the nerve block procedure had experienced an average systolic blood pressure drop of 32 mm Hg and a diastolic blood pressure drop of 12 mm Hg."

Posted by Steven Almany M.D.

PREDICTORS OF NEW-ONSET DIABETES IN PATIENTS TREATED WITH ATORVASTAIN: RESULTS FROM 3 LARGE RANDOMIZED CLINICAL TRIALS

Date Posted: March 28, 2011
Authors: Waters DD, Ho JE, DeMicco DA, et al.
Citation: J Am Coll Cardiol 2011;57:1535-1545.

Study Question:
What are the incidence and clinical predictors of new-onset type 2 diabetes mellitus (T2DM) within three large randomized trials with atorvastatin?

Methods:
The investigators used a standard definition of diabetes and excluded patients with prevalent diabetes at baseline. They identified baseline predictors of new-onset T2DM and compared the event rates in patients with and without new-onset T2DM. Major cardiovascular events in patients with and without new-onset T2DM were assessed with an extensive time-dependent Cox proportional hazard analysis.

Results:
In the TNT (Treating to New Targets) trial, 351 of 3,798 patients randomized to 80 mg of atorvastatin and 308 of 3,797 randomized to 10 mg developed new-onset T2DM (9.24% vs. 8.11%; adjusted hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.94-1.29; p = 0.226). In the IDEAL (Incremental Decrease in End Points Through Aggressive Lipid Lowering) trial, 239 of 3,737 patients randomized to atorvastatin 80 mg/day and 208 of 3,724 patients randomized to simvastatin 20 mg/day developed new-onset T2DM (6.40% vs. 5.59%; adjusted HR, 1.19; 95% CI, 0.98-1.43; p = 0.072). In the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial, new-onset T2DM developed in 166 of 1,905 patients randomized to atorvastatin 80 mg/day and in 115 of 1,898 patients in the placebo group (8.71% vs. 6.06%; adjusted HR, 1.37; 95% CI, 1.08-1.75; p = 0.011). In each of the three trials, baseline fasting blood glucose, body mass index, hypertension, and fasting triglycerides were independent predictors of new-onset T2DM. Across the three trials, major cardiovascular events occurred in 11.3% of patients with and 10.8% of patients without new-onset T2DM (adjusted HR, 1.02; 95% CI, 0.77-1.35; p = 0.69).

Conclusions:
The authors concluded that high-dose atorvastatin treatment compared with placebo in the SPARCL trial is associated with a slightly increased risk of new-onset T2DM.

Perspective:
This study suggests that the use of high-dose atorvastatin is associated with a slight increase in the risk of new-onset T2DM, although the strongest predictors of new-onset T2DM remain baseline fasting glucose and other features of the metabolic syndrome. The mechanism underlying the small increase in new-onset T2DM in patients treated with statins is unknown. It is possible that statins decrease insulin sensitivity in liver or muscle, but there is no direct experimental evidence to support this. Although any potential increased risk of new-onset T2DM with atorvastatin warrants careful monitoring, the benefits of atorvastatin clearly outweigh the risks in patients with coronary or cerebrovascular disease, and it remains uncertain as to whether new-onset T2DM itself increases risk.

Posted bySteven Almany M.D.

FIBRATE, FENOFIBRATE USE INCREASING IN US DESPITE EVIDENCE THEY PROVIDE LITTLE BENEFIT

The Los Angeles Times (3/22, Maugh) "Booster Shots" blog reported that "the use of fibrates and fenofibrates to reduce cholesterol levels has grown sharply in the United States over the past decade, despite mounting evidence that the drugs provide little benefit," according to a study published in the Journal of the American Medical Association. The study also found that "physicians are increasingly prescribing brand-name versions of the drugs, such as TriCor and Trilipix, despite the fact that published evidence so far shows a benefit only for generic forms of the drugs, such as gemfibrozil." HeartWire (3/22, O'Riordan), HealthDay (3/22, Goodwin), and MedPage Today (3/22, Gever) also covered the story. For a clinical perspective on this article, go to CardioSource.org.

Posted by Steven Almany M.D.

INDIVIDUALS WITH ASTHMA MAY HAVE HIGHER RISK OF DEVELOPING HEART DISEASE, DIABETES

HealthDay (3/20, Holohan) reported that individuals "with asthma may have a higher risk of developing diabetes and heart disease, according to a new study that looked at the relationship between asthma and four other inflammatory conditions." To reach that conclusion, researchers "looked at medical records from the late 1960s through the early 1980s," and "found higher rates of diabetes and heart illness among asthmatics than other people." However, the investigators "found that people with asthma were not at greater risk of developing inflammatory bowel disease or rheumatoid arthritis." The research was presented at a meeting of the American Academy of Allergy, Asthma & Immunology.

Posted by Steven Almany M.D.