SNORING MEN GET HEART BENEFITS WHEN BRETHING MASK IMPROVES SLEEP IN STUDY

A face mask used to treat a nighttime breathing disorder called obstructive sleep apnea can reduce a patient’s blood pressure, cholesterol and stomach fat, potentially improving their heart health, researchers found.

The condition affects as many as 18 million Americans, primarily men, and is often first recognized by the patient’s partner. It is marked by a brief collapse of the airway, which leads the patient to stop breathing for a few seconds until the brain sends a signal to wake up. The result is a fractured night’s sleep, daytime drowsiness and a host of health issues.

Standard treatment is a mask attached to a continuous positive airway pressure, or CPAP, machine. The machines can be cumbersome, leading many to quit using them within a year. The results should help persuade patients to stick with the therapy, said Surendra Sharma, lead author of the study released today by the New England Journal of Medicine.

“These patients need to be properly counseled for regular use of CPAP machines,” because compliance is associated with greater benefits, said Sharma, head of the department of internal medicine at the All India Institute of Medical Sciences in New Delhi, in an e-mailed response to questions. “In a real- life situation, the machine will be used for a longer period and more benefits will be observed.”

Pfizer Inc. funded the trial through an investigator- initiated research grant. The New York-based company, the world’s largest drugmaker, doesn’t manufacture or sell (PFE) devices for sleep apnea and wasn’t involved in the design, conduct or analysis of the study, the researchers said.

Growing Market
The global market to diagnose and treat patients with sleep apnea is about $2.9 billion and growing, with CPAP devices accounting for about one-third of the total, according to Global Industry Analysts Inc., a market research firm based in San Jose, California. Amsterdam-based Royal Philips Electronics NV (PHIA), ResMed Inc. (RMD) of Poway, California, and Fisher & Paykel Healthcare Corp. of Auckland, dominate the industry.

The study involved 86 patients recruited from the sleep laboratory at the All India Institute of Medical Sciences. They were treated with either a legitimate CPAP machine or a doctored device that included an airflow-restricting connector and tiny escape holes. Patients used each of the machines, which looked the same, for three months, with a one-month break between treatment.

Blood Pressure
After treatment, patients’ systolic blood pressure, measured during heart contractions, dropped an average of 3.9 millimeters of mercury or mmHg, while their diastolic blood pressure, when the heart fills with blood, fell by 2.5 mmHg. Previous studies of drug treatment found a 5 mmHg decline cut heart disease risk by 15 percent and strokes by 42 percent.

The CPAP machines also reduced total cholesterol by 13.3 mg per deciliter and artery-clogging bad cholesterol by 9.6 mg per deciliter, the study found. Benefits also were seen in abdominal fat content, weight loss and improved hemoglobin levels, the researchers said.

A constellation of heart risk factors, known as the metabolic syndrome, also appeared to reverse in 11 of the 86 patients after CPAP treatment. Those who were most adherent to the therapy showed a reduction in plaque buildup in the walls of the arteries leading to the brain, the study found.
“These results suggest a significant clinical benefit that will lead to a reduction in cardiovascular risk,” the investigators concluded.

ANTICOAGULANT MONITORING, DOSING MANAGED BY PATIENTS AT HOME MAY BE SAFE

MedPage Today (12/1, Phend) reports, "Anticoagulant monitoring and dosing managed by patients at home is safe and decreases clotting risk," according to a meta-analysis published online in The Lancet. Investigators found that "major bleeding event and mortality rates actually tended to favor self-management over usual care, although not significantly so (hazard ratios 0.88 and 0.82, both P=0.18)." Meanwhile, "thromboembolic events were nearly halved by self-monitoring (HR 0.51, P=0.01), with even greater benefits in patients younger than 55 and in those with mechanical heart valves."

HealthDay (12/1, Reinberg) reports, "Among older patients, who are at risk for major bleeding, self-monitoring reduced the risk of dying and didn't increase the risk of complications.

POSTED BY: Steven Almany M.D.

HOLIDAY SCHEDULE 2011

Please make sure to get all your prescriptions filled at least one week prior to the holiday to ensure you have them in time.

Christmas:
CLOSED- Monday December 26

New Years:
CLOSED- Monday January 2

LONG-TERM STATIN USE MAY BE SAFE

ABC World News (11/22, story 8, 0:30, Stephanopoulos) reported that research published in The Lancet suggests that statins' "benefits increase the longer someone takes them with no long-term risks such as cancer."

Reuters (11/23) reports that investigators looked at data from the Heart Protection Study (HPS), which included approximately 20,000 patients.

The Forbes (11/23) reports, "The main results of the HPS, published in 2002, showed a significant 23% reduction at 5.3 years in major vascular events associated with simvastatin treatment among the...patients with coronary disease enrolled in the trial." For the new research, "the HPS investigators report the followup results after a mean of 11 years."

HealthDay (11/23, Gordon) reports, "The 11-year study found that simvastatin (brand name Zocor) reduced the risk of cardiovascular disease by almost one-quarter." The investigators also "found no increase in illness or deaths from cancer or other non-vascular causes."

MedPage Today (11/23, Fiore) reports, "In an accompanying editorial, Payal Kohli, MD, and Christopher Cannon, MD, of Brigham and Women's Hospital...said the results, 'provide contemporary and confirmatory evidence that extended use of statins is safe with respect to possible risk of cancer and non-vascular mortality.'" The editorialists "noted that the original concerns about statin safety were from observational data, which were likely 'heavily confounded.'" Also covering the story are the UK's Telegraph (11/23, Smith) and AFP (11/23).

POSTED BY: Steven Almany M.D.

MICHIGAN HEART GROUP DISCOVERS TWITTER!!!!

Attention Twitter followers.....MHG is now on Twitter

I'm not a Tweeter...so I'm new at this, however if you are on Twitter, please follow us. Our new website will also have a link to our twitter acct. Hoping to have the new website launched in the next couple days at the latest.....STAY TUNED!!!

STACIE BATUR
Physician Liaison

COLCHICINE MAY HELPL PREVENT AFIB AFTER HEART SURGERY

MedPage Today (11/19, Susman) reported, "The oral agent colchicine -- a drug almost as old as the hills-- appears to offer a new way to prevent atrial fibrillation (Afib) after heart surgery," according to a study presented at the American Heart Association meeting and published in Circulation. Investigators found that "the relative risk of developing postop Afib was reduced 42.1% if patients were treated with colchicine rather than placebo (P=0.002)." The researchers found that "the incidence of atrial fibrillation at 12 months was 8.9% in patients given colchicine compared with 21.1% among patients randomized to placebo."

POSTED BY: Steven Almany M.D.

HOLIDAY SCHEDULE 2011

Please make sure to get all your prescriptions filled at least one week prior to the holiday to ensure you have them in time.

Christmas:
CLOSED- Monday December 26

New Years:
CLOSED- Monday January 2

PANEL COVENED BY NHLBI RECOMMENDS CHOLESTEROL TESTING FOR KIDS

In a front-page story, the Wall Street Journal (11/12, A1, Winslow, Dooren, Subscription Publication) reported that experts now say that all kids should undergo testing for high cholesterol at some point between the ages of 9 and 11, and then again sometime between the ages of 17 and 21.

The Washington Post (11/14, Stein) "The Checkup" blog reports that "the recommendation comes from by a 14-member expert panel convened by the National Heart, Lung and Blood Institute [NHLBI] and endorsed by the American Academy of Pediatrics, which will publish the panel's report (pdf)...in the journal Pediatrics."

The Los Angeles Times (11/12, Roan) reports, "Such guidelines already exist to address heart disease risk in adults, but until now there has been none outlining what works best for children." Also covering the story were the AP (11/14, Marchione, Tanner), the NPR (11/12, Shute) "Shots" blog, the Boston Globe (11/12, Kotz), HeartWire (11/14, O'Riordan), MedPage Today (11/14, Phend), WebMD (11/14, McMillen), and HealthDay (11/14, Preidt).

POSTED BY: Steven Almany M.D.

HOLIDAY SCHEDULE 2011

Please make sure to get all your prescriptions filled at least one week prior to the holiday to ensure you have them in time.

Christmas:
CLOSED- Monday December 26

New Years:
CLOSED- Monday January 2

FEW PHYSICIANS FOLLOW GUIDELINES FOR SCREENING YOUNG ATHLETES FOR HEART TROUBLE

The Los Angeles Times (11/14, Roan) "Booster Shots" blog reports that while "the deaths of high school athletes who collapse suddenly during practice or a game have led to new" American Heart Association (AHA) "guidelines for screening prep athletes for hidden heart problems before the start of a season," research presented at the AHA meeting "shows that the vast majority of doctors charged with such screenings don't follow the recommendations."

HealthDay (11/14, Mann) reports that researchers found that "less than half of physicians and only 6 percent of high school athletic directors in Washington state were aware of the life-saving guidelines -- potentially leaving many young athletes at risk." The association's "screening guidelines call for eight specific medical-history questions and four key elements in a physical exam, all designed to help doctors understand whether an athlete is at risk."

POSTED BY: Steven Almany M.D.

HYPERTENSION IN EARLY ADULTHOOD MAY BE LINKED TO FUTURE HEART PROBLEMS

The Los Angeles Times (11/22, Roan) "Booster Shots" blog reports that "high blood pressure in early adulthood spells future heart problems and that it shouldn't be ignored," according to a study published in the Journal of the American College of Cardiology. Investigators "followed almost 19,000 male students from Harvard who had their blood pressure measured when they entered college between 1914 and 1952." Participants "also responded to a health questionnaire mailed in the 1960s when they were an average age of almost 46."

HealthDay (11/22, Preidt) reports that "the researchers then looked at death certificates issued for participants until the end of 1998."

MedPage Today (11/22, Ullman) reports that participants "with prehypertension and stage 1 and 2 hypertension had an elevated risk of all-cause mortality, cardiovascular disease mortality, and coronary heart disease mortality." The investigators found that, "even after adjusting for middle-age hypertension, researchers found that the mortality risk was 'somewhat attenuated,' but the pattern remained."

HeartWire (11/22, Wood) reports that "One surprise, however...was that stroke mortality was not significantly increased among those with elevated blood pressure decades earlier."

POSTED BY: Steven Almany M.D.

HOLIDAY SCHEDULE 2011

Please make sure to get all your prescriptions filled at least one week prior to the holiday to ensure you have them in time.

Christmas:
CLOSED- Monday December 26

New Years:
CLOSED- Monday January 2

MICHIGAN HEART GROUP'S PHYSICIAN LIAISON IS HERE TO HELP YOU

Michigan Heart Group has a Physician Liaison on staff to assist with questions, concerns or problems you, your staff or your patients may have with our office.

Stacie Batur is available Monday through Thursday at (248) 267-5050 (x6509). She is often between two buildings or visiting referring physician offices. If you get her voice mail, please leave a message and she will call you back shortly. If you need to speak to her immediately you can reach her on her cell phone at (248) 765-4466.