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Wednesday, April 25, 2012

HEALTHY HEART NEWS


Stress May Be Tougher on Women's Hearts Than Men's: Study
Preliminary research found blood flow doesn't rise in women, possibly raising their cardiac risk.





Heart blood flow increases in men when they experience mental stress, but does not change in women, a small new study suggests. The finding may explain why women are more likely than men to have heart trouble when they suffer emotional distress, the Penn State College of Medicine researchers said.

The investigators measured heart rate, blood pressure and heart blood flow in 17 healthy adults -- a near-equal mix of men and women -- at rest and while they did three minutes of mental arithmetic. In order to increase the stress of doing the math task, the researchers urged the participants to hurry up or informed them they were wrong even when they gave the right answer.

At rest, men and women showed little difference in heart rate, blood pressure and heart blood flow. During the math task, all the participants had increases in heart rate and blood pressure. Heart blood flow also increased in men during the stressful task, but did not change in women.

The study was slated for Tuesday presentation at the Experimental Biology meeting, in San Diego.

The findings suggest that women may be more susceptible to heart problems while under stress and could explain why women tend to have more heart troubles after stressful events, such as losing a spouse, study leader Chester Ray said.

The results also underscore how mental stress can affect health.

"Stress reduction is important for anyone, regardless of gender, but this study shines a light on how stress differently affects the hearts of women, potentially putting them at greater risk of a coronary event," Ray said in an American Physiological Society news release.

He added that further research on the mechanism behind this difference between women and men could someday lead to more targeted treatments and prevention efforts for women at risk of coronary artery disease.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

 (SOURCE: American Physiological Society, news release, April 24, 2012)


Study Explores Fish Oil's Healthy Effect on Heart
Researchers rule out one possible explanation.






A small new study may rule out one possible mechanism behind omega-3 fatty acids' healthy effects on the heart.

It's been established that omega-3 fatty acids, found in foods such as fish oil, help prevent cardiovascular disease (conditions of the heart and blood vessels), as well as heart attacks and strokes in people who already have cardiovascular disease.

The evidence is so strong that the American Heart Association recommends eating fish or taking fish oil as a preventive measure both for healthy people and cardiovascular-disease patients.

The ways in which omega-3 fatty acids provide these heart-healthy benefits, however, aren't known.

In the new study, researchers from the Penn State College of Medicine investigated if omega-3s might improve cardiac diastolic function -- the ability of the heart to relax and refill with blood at each beat. This ability declines with age.

The researchers used echocardiograms to assess heart structure and function in 11 healthy men and women with an average age 66 at the start of the study. The participants took daily omega-3 supplements for 12 weeks, and then had another echocardiogram.

The results showed that taking the omega-3 supplements did not change diastolic function in the participants. This suggests that the benefits of omega-3 fatty acids may occur in other areas of heart function, the researchers said.

The findings, scheduled for presentation Tuesday at the Experimental Biology 2012 meeting in San Diego, should not discourage people from taking fish oil or other omega-3 supplements for heart health, researcher Kevin Monahan said in a Federation of American Societies for Experimental Biology news release.

"I don't think there's any reason to stop taking fish oil based on our data," he said in the release. "From a big-picture standpoint, we know that consumption of fish and fish oil reduces cardiac disease risk and mortality. Just because omega-3 supplements don't improve diastolic function over 12 weeks in this population doesn't mean that these nutrients don't exert other important cardiac effects."

The American Heart Association offers advice about heart-healthy nutrition .




Pacemakers, Defibrillators Sources of Deadly Infections: Study
As implanted heart devices increase, so do serious complications, research says.















Life-saving implantable pacemakers or defibrillators pose a risk for developing deadly infections, a new study suggests.

More than 4.2 million people in the United States had a permanent pacemaker or defibrillator implanted between 1993 and 2008, and heart-device infections increased 210 percent during that time, according to the study.

"These infections tend to occur in very vulnerable patients who have other medical conditions that may partially contribute to developing an infection," said study author Dr. Andrew Wang, a cardiologist at Duke University Hospital in Durham, N.C.

Pacemakers help control abnormal heart rhythms. Defibrillators use shocks to help manage life-threatening heart-rhythm abnormalities that can cause sudden cardiac death.

The findings appear in the April 25 issue of the Journal of the American Medical Association.

Heart-device-related infections, which are caused by bacteria, grow more dangerous when they spread to the heart valve or other organs. Treating these infections requires prolonged antibiotic therapy, removal of the device and possibly device reimplantation, but repeat surgeries also can be risky. Hospital charges for this complication are at least $146,000, the authors said.

Researchers set out to determine how common and lethal these infections are, and which heart patients are at greatest risk. Using data from 61 centers in 28 countries, they found that of 2,760 people with an infection of the heart's lining or valves (endocarditis), an implantable heart device was the cause in 177 cases.

Endocarditis carries an increased risk of death compared to other heart-device-related infections.

Overall, device-related infections were more common in older men, who were about 71 on average. The infection reached the heart valve in 66 people in the study. Other complications included heart failure and persistent blood infections.

Factors such as longer hospital stays and medical procedures unrelated to the implantable device also increase the likelihood of infection. Health-care-associated infection was seen in 81 of the patients with an implantable cardiac device, the study showed.

Device removal sometimes carries more risks than benefits. "It comes down to a decision as to whether the device infection can be cleared without having to remove it," Wang said. "In general, most experts feel removing the device is necessary."

Infections are more likely to be fatal when the valve is involved, but those people who have the infected device removed at the time of the initial infection do live longer, the study showed.

Preventing these infections is a challenge, Wang said. Knowing the signs and symptoms can help identify device infections early. There may be skin inflammation if it is an infection of the pacemaker leads or wires. There also are systemic signs of infection, including low-grade fever, weight loss and night sweats. Earlier detection lowers risk of infection spreading to a valve, but some strains of bacteria are stealthier than others, he said.

This risk is "real and sobering," said Dr. Gregory Crooke, a cardiac surgeon at Maimonides Medical Center in New York City. "It is not insignificant. Catch it as early as possible and intervene as early as possible."

Hardware removal is preferable to antibiotics, Crooke said.

"Removal of the infected device is simpler than open heart surgery, which is what will be needed if the infection spreads to the valve," he said.

Crooke said prevention starts when the device is first implanted. Doctors need to take all precautions to make sure it is done in a sterile and hygienic environment.

Dr. Ranjit Suri, director of the Electrophysiology Service and Cardiac Arrhythmia Center at Lenox Hill Hospital in New York City, agreed. "We should do everything in our power to prevent these infections starting with using pristine sterile techniques," he said.

"We should try and limit our exposure to pathogens in the hospital by prevention techniques, including hand washing and shortening a patient's stay in the hospital," Suri said. "The longer they stay in the hospital, the higher their risk of infection."

If a patient does develop an infection, "there is clearly a survival advantage with removal of the whole system," Suri added. "Antibiotics themselves won't sterilize the infection."

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