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Tuesday, October 4, 2011

MANY AFIB PATIENTS NOT BEING PRESCRIBED ANTICOAGULANTS

MedPage Today (9/3, Susman) reported, "A first look at a massive international registry of treatment for atrial fibrillation indicates that a high percentage of individuals are not being prescribed anticoagulation treatment that can reduce their risk of stroke, researchers said" at the European Society of Cardiology meeting. Researchers found that "of the nearly 10,000 patients in the initial cohort of the Global Anticoagulant Registry in the Field (Garfield), CHADS2 scoring showed 55% of them to be eligible for anticoagulation therapy, but 33% of them didn't get it." MedPage Today pointed out that "guidelines call for treatment with anticoagulation to prevent strokes in patients with CHADS2 scores of 2 or higher."

POSTED BY STEVEN ALMANY, MD

Friday, September 30, 2011

RESEARCHERS SAY ITALIAN PREPARTICIPATION SPORTS SCREENING PROGRAM IS COST-EFFECTIVE

HeartWire (8/30, O'Riordan) reports that "the Italian model for a preparticipation sports screening program, one that includes a 12-lead electrocardiogram (ECG) for all individuals participating in athletics, is a cost-effective mass-screening program, according to researchers who performed the analysis," which was presented at the European Society of Cardiology 2011 Congress. HeartWire points out that "the cost of widespread screening, as well as the risk of false-positive ECGs that might prevent healthy individuals from participating in sports and the battery of unnecessary tests they will face, have limited the adoption of mass-screening programs in other countries. In the US, the American College of Cardiology and the American Heart Association limit screening to a physical examination and medical history."

POSTED BY STEVEN ALMANY, MD

Tuesday, September 27, 2011

CHOCOLATE CONSUMPTION MAY BE LINKED TO REDUCED RISK OF HEART DISEASE, STROKE

ABC World News (8/29, story 10, 0:30, Sawyer) reported that "chocolate may be a kind of secret weapon against heart disease."

Bloomberg News (8/30, Torsoli) reports that "regular consumption" of chocolate "may slash the risk of developing heart disease by a third, according to research published in the British Medical Journal and presented...at the European Society of Cardiology's conference in Paris."

The Los Angeles Times (8/30, Stein) "Booster Shots" blog reports that investigators analyzed data from "seven studies looking at the link between eating chocolate and a reduction in heart disease that included 114,009 people."

The Time (8/30, Melnick) "Healthland" blog reports, "Five of the seven studies showed some benefit to eating chocolate. Overall, people with the highest chocolate consumption levels had 37% lower risk of heart disease and a 29% lower risk of stroke than those who ate the least chocolate."

The CNN (8/30) "The Chart" blog points out that "the studies, notably, did not differentiate between dark or milk chocolate and included consumption of different types of chocolate (bars, shakes, etc.)."

MedPage Today (8/30, Neale) reports that one of the researchers "noted that most commercially available chocolate products are high in fat, sugar, and calories, and that overindulging could counteract any of the potential benefits, a sentiment echoed by Janet Wright, MD, vice president of science and quality for the American College of Cardiology." In an interview, Dr Wright said, "We tend to take a little bit of advice and think that more is better," but "in this case, more is probably not better because of the fat content and the calorie content."

Also covering the story were the UK's Telegraph (8/30, Adams), BBC News (8/30), the NPR (8/30, Shute) "Shots" blog, the Grand Rapids Press (8/30, Thoms), WebMD (8/30, Laino), HealthDay (8/30, Reinberg), HeartWire (8/30, O'Riordan).

POSTED BY STEVEN ALMANY, MD

Friday, September 23, 2011

EXPERTS PREDICT 165 MILLION AMERICANS WILL BE OBESE BY 2030

ABC World News (8/25, story 7, 2:00, Stephanopoulos) reported, "Tonight, sobering new numbers on America's struggle with obesity." A new series on obesity published in "the medical journal Lancet says if trends continue, half of all American men will be obese by 2030."

Bloomberg News (8/26, Gerlin) reports, "US health-care spending will rise by as much as $66 billion a year by 2030 because of increased obesity if historic trends continue," the study suggested. "Almost 100 million Americans and 15 million Britons are already considered obese, based on body-mass index, a ratio of weight to height, Y. Claire Wang, an epidemiologist at Columbia University's Mailman School of Public Health in New York, said yesterday at a London news conference." Yet "another 65 million American adults and another 11 million British adults would join them in the next two decades based on past trends, said Wang."

The Washington Post (8/26, Huget) "The Checkup" blog reported that a "four-part series by a number of international public health experts argues that the global obesity crisis will continue to grow worse and add substantial burdens to health-care systems and economies unless governments, international agencies and other major institutions take action to monitor, prevent and control the problem." The blog adds, "The series, which had support from the federal government and foundations, is published in advance of the first High-Level Meeting of the United Nations General Assembly focused on non-communicable disease prevention and control, which will take place in New York City Sept. 19 and 20."

According to CNN's (8/26, Cooper) "The Chart" blog, one report in the series "includes suggestions for ways governments can implement policies that it says will reduce obesity and save money. Proposals include a tax on unhealthy foods and beverages, school programs to promote good nutrition and physical activity, and cutting junk food advertising."

POSTED BY STEVEN ALMANY, MD

Tuesday, September 20, 2011

CALCIFICATION IN ARTERIES MAY BE LINKED TO FUTURE RISK OF DEMENTIA, STROKE

Medscape (8/26, Lowry) reports, "Arterial calcification in major vessel beds outside the brain, as shown with magnetic resonance imaging (MRI), is associated with vascular brain disease and may be linked to future risk for dementia and stroke, a new study shows." Investigators "used computed X-ray tomography (CT) scans to measure calcification in the coronary arteries, aortic arch, and extracranial and intracranial carotid arteries. They also used brain MRI scans to assess cerebral infarcts, microbleeds, and WMLs, which are considered important markers of vascular brain disease." Altogether, 885 patients were involved in the study.

HealthDay (8/26, Preidt) reports, "The researchers found that calcium build-up in each of the four arteries was associated with white matter lesions and small strokes in the brain, and that the amount of calcified plaque in the vessels closest to the brain (carotid arteries) was most strongly linked with signs of vascular brain disease." The study, published in Arteriosclerosis, Thrombosis and Vascular Biology, found that "the strongest associations were between intracranial carotid calcification and the volume of white matter lesions, and extracranial carotid calcification and small strokes."

MedPage Today (8/26, Gever) reports, "The researchers cautioned, however, that the clinical implications may be limited. They noted that the problem of radiation exposure raises questions about the practicality of large-scale CT screening of neurologically healthy people."

POSTED BY STEVEN ALMANY, MD

Friday, September 16, 2011

STUDY SUGGESTS EXCESSIVE TV WATCHERS MAY HAVE SHORTER LIFE SPANS

WebMD (8/16, Warner) reports that watching six hours or more of television daily "could shorten the average life expectancy by nearly five years," according to a study in the British Journal of Sports Medicine. TV watching "time may have adverse health consequences that rival those of lack of physical activity, obesity and smoking," wrote study authors J. Lennert Veerman, of the University of Queensland, Australia, and colleagues.

HealthDay (8/16, Reinberg) reports that the researchers analyzed data on "11,000 people aged 25 and older from the Australian Diabetes, Obesity and Lifestyle Study" and looked at national "population and mortality figures." The study team found that in 2008, "Australian adults watched a total of 9.8 billion hours" of TV; and individuals who watched "more than six hours of TV were in the top 1 percent." The statistics indicated too much TV watching "may be as dangerous as smoking and lack of exercise." For example, the researchers said smoking "can shorten of life expectancy by more than four years after the age of 50. That represents 11 minutes of life lost for every cigarette and that's the same as half an hour of TV watching." They concluded that for every hour of TV watched "after age 25, lifespan fell by 22 minutes

POSTED BY STEVEN ALMANY, MD

Tuesday, September 13, 2011

DEPRESSION MAY RAISE WOMEN'S STROKE RISK

USA Today (8/12, Manning) reports, "A study published Thursday in Stroke: Journal of the American Heart Association reports that women with a history of depression have a 29% greater risk of having a stroke than non-depressed women, and those who take antidepressants, particularly selective serotonin reuptake inhibitors, or SSRIs...face a 39% higher risk."

According to the Huffington Post (8/12, Pearson), depression "can cause certain physiological and hormonal changes in the body that in turn increase stroke risk." John Lynch, of the NIH's National Institute of Neurological Disorders and Stroke, who was not associated with the study, explained, "Depression may be contributing to increased risk through a number of mechanisms, including brain hormone pathways, or an increased prevalence of poor health behaviors or medical disorders associated with stroke in depressed individuals."

HealthDay (8/11, Mann) reported that after following "80,574 women aged 54 to 79 who took part in the Nurses' Health Study from 2000 to 2006 and had no prior history of stroke," researchers also found that "depressed women were more likely to be single, smoke and be less physically active than their non-depressed counterparts." In addition, the depressed women were "slightly younger, had a higher body mass index and more coexisting conditions, such as high blood pressure, heart disease, and diabetes."

WebMD (8/11, Doheny) reported that the "use of antidepressants is not thought to be linked with stroke risk." Study author An Pan, PhD, a research fellow at the Harvard School of Public Health, explained that the "'medication use could be a marker for depression severity.' The most depressed were probably most likely to be on the medicine." MedPage Today (8/12, Walsh) and Medscape (8/12, Lowry) also cover the story.

POSTED BY STEVEN ALMANY, MD

Friday, September 9, 2011

USE OF WARFARIN AMONG AFIB PATIENTS MAY BE INSCONSISTENT

MedPage Today (8/3, Kaiser) reported that, "among atrial fibrillation patients who were candidates for warfarin therapy, only about half were on the drug, with rates ranging widely across practices," according to an analysis which used data from "the American College of Cardiology's National Cardiovascular Data Registry (NCDR) Practice Innovation and Clinical Excellence (PINNACLE) program." While just "55.1% of patients were taking warfarin, the mean CHADS2 score for all patients -- on warfarin or not -- was 2.5, 'suggesting an almost random pattern of treatment.'" Meanwhile, "the treatment rate differed significantly at the practice level, ranging from 25% to 80%." The research is published online in the American Journal of Cardiology.

POSTED BY STEVEN ALMANY, MD

Friday, August 12, 2011

MEDIA CLIPS: 5-HOUR ENERGY- WWJ and DR. STEVEN ALMANY

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Tuesday, August 9, 2011

DOCTORS SAY MICHIGAN HIGH SCHOOL PHYSICALS ARE "OUTDATED," DON'T SCREEN FOR SERIOUS HEALTH DEFECTS

DETROIT (WXYZ) - High School athletes suddenly collapsing and dying on the court or on the field; It’s happened dozens of times in Michigan during the last decade.

In Michigan, the only pre-screening for sports that your kids have to have is a physical. The type of physical, the tests that are run, and the questions http://www.blogger.com/img/blank.gifthat are asked are entirely up to you and your doctor. And that has a lot of physicians and families asking – should more be done to keep your children safe?


CLICK HERE FOR THE 4 PAGE MHSAA PHYSICAL FORM


The game winning shot quickly turned into tragedy. In March, 16-year-old Wes Leonard – star of the Fennville High School basketball team – collapsed on the court, and later died. Doctors said the High School Junior died from cardiac arrest due to an enlarged heart. According to the American Heart Association, the vast majority of sudden deaths in young athletes are due to severe heart deformities that have been present since birth – but usually go undetected.

“Miss her every day, and I think about her every day. It left a big hole in our family,” said Randy Gillary.

Gillary knows all too well the pain of losing a child to cardiac arrest. His 15-year-old daughter, Kimberly, died during a water polo match at Groves High School.

“We basically lost her on the pool deck,” said Gillary.

Gillary believes high school athletes need more screening to detect heart defects and he’s helped push the Michigan High School Athletic Association, or MHSAA, to adopt new, more detailed guidelines for student physicals. Since 1999, 47 students in Michigan have died from cardiac arrest.

“If we would’ve had more effective screening, substantial number of those kids could have been saved,” said Gillary.

The MHSAA is a non-profit organization that runs post-season tournaments for sports at about 1540 Michigan high schools and middle schools. When it comes to pre-screening athletes – the only requirement that the MHSAA has is that students must have a yearly physical. The physical can be done by a doctor, nurse practitioner or physician’s assistant, and there is no standardized medical history form that all students must use.

For decades, the MHSAA offered a simple two-sided card that medical professionals now call “outdated.” It asks about things like polio and scarlet fever – no detailed questions about heart problems or family medical history.

So after more than a year of meetings with health professionals – the MHSAA just created a new, more specific medical history form. It asks about chest pain, irregular heartbeats, fainting, and high cholesterol. Doctors say the dozens of new questions are great – but using the form is still just optional.

15-year-old Rebecca Krause says many of her family members have had heart attacks, so when she needed her physical to join the Track and Field Team for Chippewa Valley High School – Rebecca’s doctor sent her for additional heart screening. Rebecca says using the more detailed medical history form would give her peace of mind.

“It’s a smarter decision to ask more questions, and be aware of what your body limits are. And be able to do the things you love, without worrying about, ‘Oh, am I going to collapse on the field today,’” said Rebecca Krause.

St. John Pediatrician Dr. Marcus DeGraw says the MHSAA should make the new physical forms with additional heart health questions mandatory.

“Having everybody do the exact same questions with the exact same focus during the physical exam would allow you to catch a lot of these kids earlier,” said Dr. DeGraw.

John Johnson is the spokesman for the MHSAA.

“Is this organization doing enough to keep student athletes safe,” asked Catallo.

“There’s only so much you can do with a staff of two dozen people here in Lansing. It’s the schools that make the rules, schools that adopt the rules, schools that take care of the day to day activities of school sports,” said Johnson.

Johnson says districts barely have enough money to keep sports programs going – that’s why they don’t want to burden the schools by dictating what kind of physicals students should have.

“So it’s basically whatever a doctor will sign off on, and whatever a parent will allow their doctor to sign off on for their kid, and then the school to accept that,” said Johnson.

“I have a huge problem that it’s optional. I think it should be mandatory. And I think in a lot of states you’ll see it will become mandatory,” said Dr. Steven Almany.

Dr. Almany is the Chief of Cardiology at Beaumont Hospital. In 2007, Dr. Almany and his collegaues started Beaumont’s Healthy Heart Check Screening Program. Channel 7 has partnered with them to provide free EKG and echocardiogram heart checks for more than 5,000 student athletes. While there is no one test that can catch every heart problem, Dr. Almany says other countries mandate EKG’s and other tests for all athletes.

“About 90% of the issues that might cause sudden death, we can probably pick up with an exam,” said Dr. Almany.

So who pays for the additional heart screening? The schools? Parents? While the debate about that continues -- Randy Gillary says the answer is tragically simple.

“How do you put a value on your son or daughter’s life? I would have paid anything to get our daughter back,” said Gillary.

Doctors tell us that typically, if you don’t have insurance an EKG test can cost anywhere from $30 to $150. If that test picks up a problem, your child may need the more expensive echocardiogram ultrasound of the heart, and that can run more than $400.

Even though the new MHSAA physical form that will soon be sent to schools isn’t mandatory, if parents want an even more detailed questionnaire, they can download a 4 page physical form on the MHSAA website.

Kimberly Gillary’s family started a non-profit organization after her death. The Kimberly Ann Gillary Foundation raises money to donate Automated External Defibrillators (AEDs) to every school in Michigan. An AED can help restart a heart after cardiac arrest.

POSTED BY STACIE BATUR, MICHIGAN HEART GROUP