People with higher levels of Omega-3 have lower risk of dying

A 16-year-old study of older adults  has revealed that those with higher blood levels of omega-3 polyunsaturated acids had a lower risk of dying.

Smoked Salmon

Omega-3 fatty acids are abundant in oily fish, such as salmon, sardines and mackerel, have already  been linked to a number of health benefits, including a lower risk of cardiovascular disease.

The study included 2,692 US men and women aged 65 years or older who took part in the Cardiovascular Health Study between 1989 and 1993.

Researchers questioned them about their eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake. Blood samples obtained during 1992-1993 were also analysed for plasma phospholipid EPA, DHA and docosapentaenoic acid (DPA).

Over sixteen years of follow-up, 1,625 deaths occurred, including 359 caused by coronary heart disease (CHD) and 130 resulting from stroke. But the men and women whose total omega-3 fatty acids were among the top one-fifth of participants had a 27% lower risk of dying than those whose levels were among the lowest fifth.

When omega-3 fatty acids were individually analysed, those among the top fifth of EPA, DPA and DHA levels were found to have a 17%, 23% and 20% lower risk. The risk of dying of heart disease was 35% less among those whose total omega-3 levels were highest, and arrhythmic cardiac deaths were lowered by 48%. On average, having an omega-3 fatty acid level among the top fifth conferred 2.2 extra years of life in comparison with whose level was lowest.

When the relationship between omega-3 fatty acid intake and plasma levels was examined, the largest effect was seen with an intake of up to 400 milligrams per day.

Research lead author, Professor Dariush Mozaffarian, of the Harvard School of Public Health said: “The findings suggest that the biggest bang-for-your-buck is for going from no intake to modest intake, or about two servings of fatty fish per week. They support the importance of adequate blood omega-3 levels for cardiovascular health, and suggest that later in life these benefits could actually extend the years of remaining life.”

CoQ10 taken with selenium reduces cardiovascular death in human trial

Stockholm: A four-year trial of CoQ10 and selenium has revealed a significant reduction in the risk of dying from cardiovascular disease among supple- mented men and women.

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The study, published in the International Journal of Cardiology, also uncovered a reduction in the cardiac N-terminal proBNP (NT-proBNP), a biomarker of cardiomyocyte wall tension, which is elevated in congestive heart failure and left ventricular dysfunction.
In a double-blinded trial, 228 Swedish citizens received a placebo or 200 micrograms of selenium per day plus 100 milligrams of CoQ10 twice daily for 48 months. 
Over 5.2 years of follow-up (which included the four-year treatment period), 5.9% of the supplemented group and 12.6% of the placebo group died of cardiovascular causes, which indi- cated a 54% adjusted risk reduction. Those in the treatment group also had lower levels of NT-proBNP compared to placebo, and better cardiac function as determined by echo- cardiography.
The authors Urban Alehagen and colleagues remark that selenium is essential for the optimal activity of TrxR1, a protein necessary for the effectiveness of CoQ10, which, in turn, is active in several metabolic pathways in the heart. The conclusion is that insufficient levels of either nutrient increases the risk of cardiovascular events.
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US diet pill ban over heart attack and stroke risk?

The US watchdog, the Food and Drug Administration, has yet to decide whether diet pill, Meridia, should stay on the market after a report revealed that it may cause heart attack and strokes in some individuals.

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Meridia, also known as sibutramine, was first approved in the US in 1997, but a large study released last November shows that people who took the drug had an 11% risk of cardiovascular events, while those who took a placebo had a 10% risk.

The study, called the SCOUT trial, prompted regulators to order the drug off the market in Europe. And demands for it be banned in the US are now being made.


Meridia: Risks vs. Benefits

Meridia has been shown to reduce weight in many patients – on average 4% more body weight below what they might lose with a placebo, an amount considered a modest benefit. About one-fifth of patients lose more. But the drug also causes increases in heart rate and blood pressure, both of which pose a danger to patients with cardiovascular disease.

Patients with known cardiovascular disease are not meant to be prescribed teh drug. But experts said they were troubled that many patients with undiagnosed disease could be at greater risk if they use the drug to lose weight.

The FDA’s own monitoring linked 14 deaths to the use of Meridia.The patients who died were in their 40s 71% were women.

Conflicting Viewpoints

The Public Citizen Health Research Group,in the US, which first petitioned FDA to ban Meridia in 2002, says the drug poses a “deadly tradeoff” between modest weight loss and the danger of heart attack and stroke.

Others say Meridia can be made safe by closely monitoring things like patients’ pulses and blood pressure readings.

Abbott, which manufactures Meridia, had pledged step up warnings and educational efforts for doctors and patients if the drug is allowed to stay on the market.

Meridia’s popularity has plummeted in recent years, particularly since the release of the Scout trial’s data in November. Only an estimated 280,000 prescriptions were filled last year in the US.

The FDA now has to decide if the clear benefits of even modest weight loss to most patients is worth a rise in cardiovascular risk in some of them. The FDA will also likely consider what vital signs doctors should monitor, and how often they should monitor them, to minimize the drug’s risks.


Aspirin does reduce heart and stroke attack risks, say US experts


New York: Aspirin should be recommended to reduce the risk of heart attack in men aged 45 – 79 and to reduce the risk of stroke in women aged 55 – 79 who do not have heart disease, the US Preventive Services Task Force (USPSTF) has recommended.(1)

The USPSTF(2) states that men aged 45 – 79 should be encouraged to take aspirin when the potential benefit of a reduction in the risk of a heart attack outweighs the potential harm of an increase in gastrointestinal bleeding; women aged 55 – 79 should be encouraged to take aspirin when the potential benefit of a reduction in the risk of ischaemic stroke outweighs the potential harm of an increase in gastrointestinal bleeding.

The recommendations are based on the latest evidence of the benefits of aspirin. If implemented in Europe, they would greatly increase the number of people taking aspirin to prevent heart attack or stroke.

Taking aspirin to prevent heart attack or stroke by people who are not known to have heart disease is known as primary prevention. An individual’s risk is estimated from their sex, age, smoking status, blood pressure and cholesterol level. European guidelines recommend primary prevention with aspirin when the risk of a heart attack exceeds 10% per year;(3) in the UK, primary prevention is recommended for people over 50 years old when the 10-year risk exceeds 20%.(4) Aspirin is universally recommended for people who have already had a heart attack or stroke (secondary prevention).

The USPSTF provides estimates of the numbers of cardiovascular events avoided by primary prevention with aspirin and the risk of gastrointestinal bleeding and stroke. Assuming aspirin reduces heart attacks by 32%, its benefits for men aged 45 – 79 outweigh the risks when the 10-year risk of a heart attack is 4%. For women aged 55 – 59, the benefit:risk ratio becomes favourable when the 10-year risk of stroke is 3%. The USPSFT says the benefits of aspirin are not proven for men or women in younger age groups, among people aged 80 or over, or for reducing the risk of heart attack among women.(1)

The decision to take aspirin should be made jointly between doctors and patients, the USPSFT emphasises, but the recommendation should be stronger as the potential benefit increases.

Depression increases heart attack risk in women


New York: Women who suffer from clinical depression are more than twice as likely to die of a heart attack

A US study of more than 63,000 women suggested this could be because unhappy women are more likely to smoke, have high blood pressure and eat unhealthily.

The more depressed a woman is, the higher her risk of death from a sudden heart attack or chronic heart disease.

The most severe type of depression, clinical depression, is associated with a more than 100 per cent increased risk of a sudden cardiac death. The risk was even higher among women on antidepressant drugs – but this may be because these medicines are prescribed to the most depressed women.

Study leader Dr William Whang, of Columbia University, said: “It’s important for women with depression to be aware of the possible association with heart disease, and work with their healthcare providers to manage their risk for coronary heart disease.

“A significant part of the heightened risk for cardiac events seems to be explained by the fact that coronary heart disease risk factors such as high blood pressure, diabetes, elevated cholesterol, and smoking were more common among women with more severe depressive symptoms.’

In the Journal of the American College of Cardiology, Dr Sanjiv Narayan commented: “These data indicate the link between depression and serious heart rhythm problems may be more complex than previously thought. It raises the question of whether this association may have something to do with the antidepressant drugs used to treat depression.’

Western diet cause of most heart attacks


New York: A Western diet rich in fried foods, salt and meat accounts for 35 per cent of heart attacks worldwide, researchers say.

They said their findings support evidence that animal fat and junk food can lead to heart attacks.

“This study indicates that the same relationships that are observed in Western countries exist in different regions of the world,” says the study’s senior author, Salim Yusuf, a professor of medicine at McMaster University in Hamilton.

The study published in the current issue of the journal Circulation, examined 16,000 people in 52 countries, and analysed 5,761 cases of heart attack.

Participants gave blood samples and filled in detailed diaries on what they ate between February 1999 and March 2003. Depending on what participants reported, they were divided into three dietary groups.

The report found that:

* People who consumed the “prudent” diet of more fruits and vegetables had a 30 per cent lower risk of heart attack compared with people who ate few or no fruits and vegetables.
* People who consumed the “Western” diet had a 35 per cent greater risk of having a heart attack compared with people who consumed few fried foods and little meat.
* The “Oriental” diet, which is loaded with tofu but also high in salty soy sauce, showed no relationship with heart attack risk.

The results clarify that it’s the eating of Western food that drives up the risk of heart attacks, rather than other lifestyle factors such as lack of exercise, Yusuf and his colleagues say.

“Diet is serious for the individual, but also if we can make population-level changes, we can prevent a lot of heart attacks, using, you know, relatively simple measures,” said study author Dr. Sonia Anand, a medical professor at McMaster.

Also on Monday, a series of reports published in the medical journal the Lancet concluded that worsening diets and unhealthy habits in China are contributing to a looming health crisis in the increasingly wealthy country.

“The pace and spread of behavioural changes including changing diets, decreased physical activity, high rates of male smoking and other high-risk behaviours has accelerated to an unprecedented degree,” one report says.

The journal said 177 million Chinese adults suffer from hypertension, which it blamed in part on high salt consumption.

“People don’t want to eat boring when they eat healthy,” says Julie Lau of the B.C. Heart and Stroke Foundation in Vancouver. Lau consults with large restaurant chains to help them offer healthier choices.

“They want to have lots of flavour, so we tried to recreate the flavour without using a lot of salt, without using a lot of fat.”

Yusuf’s study was funded by the Canadian Institutes of Health Research; the Heart and Stroke Foundation of Ontario; the International Clinical Epidemiology Network; and unrestricted grants from several pharmaceutical companies.

Red Bull stroke and heart attack risk


Sydney: Australian scientis have found that just one can of the energy drink Red Bull, can raise the risk of stroke or heart attack.

In a study of university students it was found that drinking one can of the sugar-free version of the energy drink made blood “sticky” – similar to that of a patient with cardiovascular disease.

Researcher Dr Scott Willoughby, of the Cardiovascular Research Centre at the Royal Adelaide Hospital,said the the blood become abnormal about one hour of drinking Red Bull.

He warned that for people at risk of cardiovascular disease – stress or high blood pressure – this could be potentially deadly.’

Dr Willoughby, said he was ‘alarmed’ at the results and would not drink Red Bull himself.

Those with underlying heart or circulatory problems should think twice before buying the caffeine-loaded drink, he said.

Red Bull is already banned in Norway, Uruguay and Denmark because of health fears, but the company last year sold 3.5 billion cans and bottles in 143 countries.

Dr Willoughby said drinking Red Bull caused the blood ‘to become sticky’
The Australian researchers said that two of the drink’s ingredients – caffeine and the amino acid taurine – may have dangerous consequences for the heart when taken together.

Dr Willoughby said: ‘Caffeine and taurine – both of these individually point towards being beneficial but maybe there’s something quirky about the effect of the combination of the two that is causing this reaction, that is what we need to look at next.’

Formulated by the marketing director of an Austrian toothpaste company in the 1980s, one can contains 80 mg of caffeine, around the same as a cup of filter coffee, or two cups of instant.

The warning on the cans advises people not to drink more than two a day.

Red Bull Australia spokeswoman Linda Rychter said: ‘The study does not show effects which would go beyond drinking a normal cup of coffee.”

Seaweed gel helps ailing hearts


Tel Aviv: Iraeli scientists have made a gel from brown seaweed that can help heart attack sufferers survive.

The liquid gel is injected onto the area damaged by an attack. Then it solidifies, allowing a thick laywer of scar tissue to grow.This helps the heart to continue working normally.

Usually the repair scar tissue is too thin and can lead to more attacks and heart failure.

So far tests have only validated the gel on animals. In trials, 90 per cent of animals injected with the gel survived a heart attack compared to just 40 per cent who received no treatment at all.

Human trials have started in Germany, Belgium and Israel. Experts hope the substance could become available by 2011.

The gel, which is made from ordinary brown seaweed, is injected into the heart using a catheter fed through a vein in the groin.

B vitamins may be harmful to heart patients

Oslo: A Norwegian study of around 4,000 heart attack survivors who were given high doses of vitamins B6, B12 and folic acid increased their risk of a second attack or stroke, it has been found.

B vitamins are one of the most popular health products on the market and taken by many to boost health and immune system. They are also thought to be helpful with premenstrual syndrome and other female problems. The Bs are also recommended to reduce homocysteine a substance found in the blood and linked to a number of health problems including heart disease, stroke and Alzheimer’s disease.

But the Norwegian study found no clear benefit, even after three years of treatment. Volunteers who took all three supplements faced a considerably higher risk of further heart attacks or strokes.

For those who took the full trio of supplements, the risk was 22 per cent higher, compared to a rise of up to 14 per cent for those who took vitamin B6 alone or a combination of B12 and folic acid.

Professor Kaare Harald Bonaa, of the University of Tromso, told a medical conference in Atlanta that some doctors were treating patients with B vitamins despite a paucity of supporting evidence.

‘Such therapy may even be harmful and should not be recommended,’ he said.

His conclusions were strengthened by a second study on the B vitamins also presented at the conference. A team of Canadian researchers gave more than 5,500 volunteers from 13 countries either a placebo or supplements of vitamin B6, B12 and folic acid.

The supplements in both studies were in doses at least double that available over the counter.

Although the vitamins in the Canadian study reduced levels of homocysteine, they did not cut the risk of heart attacks and strokes. In some cases, the supplements seemed to aggravate other health problems, lead researcher Dr Eva Lonn, of McMaster University in Ontario, said. Homocysteine is an amino acid produced by the body and found in the blood.

It was thought it could cause fatal blockages in the heart and brain by damaging the lining of the arteries and making blood more likely to clot.

But following the latest research – which will appear in the New England Journal of Medicine later this week – scientists believe it may be a sign, rather than a cause, of heart disease.

Magic bullet will drain world health budgets

Rotterdam:Treating everyone, or those at only moderate risk of cardiovascular disease, with the polypill would not save any money at all, even if the drug cost nothing to make, finds research in the Journal of Epidemiology and Community Health.

The “magic bullet” could drain global health budgets, unless it is carefully targeted and very cheap to manufacture, suggest the authors.

The formulation has not been tested out on large numbers of people, and how the various constituents will interact is as yet unknown, say the authors.

But in theory, the polypill, which combines aspirin, a statin, three blood pressure lowering agents, and folic acid into one tablet, has the potential to slash the risk of coronary artery disease by 88% and stroke by 80% in those aged between 55 and 64.

To calculate potential costs of widespread treatment with the polypill, the authors looked at differing levels of risk of developing coronary artery disease in different age groups, and medical and treatment costs.

They used data from the US Framingham Heart Study, which involved over 5,000 people aged between 28 and 62, who were monitored for heart disease and stroke in two year periods for almost half a century.

And they also used data from the Framingham Offspring Study, which involved monitoring the children and spouses of those in the original study every four to eight years.

Even if the polypill cost nothing, it would not save anything at all if given to everyone, irrespective of their risks of developing cardiovascular disease, or if given to those only at moderate risk, say the authors.

Giving the polypill to everyone over the age of 60 would produce the greatest health gains, the authors say. It would prevent between 76 and 179 heart attacks, and between 11 to 33 strokes, per 1000 people in this age group.

But to be cost effective, the annual expense of the polypill would have to be no more than £208 (€302) for those aged 50 and no more than £282 (€410) for those aged 60 at high risk of coronary artery disease, say the authors.

And this cost would need to be around three times lower for those at lower risk, they add.

The authors point out that irrespective of its value, treatment with the polypill “implies the medicalisation of a large section of the population,” as well as the risk of exposing healthy people to the risk of side effects.

Winter illnesses increase risk of heart attack

London: New research reveals that the risk of heart attack and stroke increases as a result of winter infections.

The joint study sponsored by the British Heart Foundation, the Medical Research Council and the Wellcome Trust discovered thatbronchitis can increase the risk of a heart attack by five times.The risk of having a stroke also trebles within the first few days of falling ill, according to researchers.

They found that the increased danger was caused not just by chest illnesses but other infections such as cystitis.

They believe inflammation may have something to do with it – either by helping to form the plaques that block arteries or by contributing to their rupture and causing heart attacks or strokes.

Around 300,000 people have heart attacks in Britain each year, 117,000 of them fatal. Every year more than 130,000 people in England and Wales suffer a stroke.

The latest study, published today in the New England Journal of Medicine, confirms that common infections play a part in triggering acute heart and circulatory problems.

The researchers examined the medical records of more than 40,000 people and discovered that the risk of heart attack was five times higher than normal in the first three days after a respiratory tract infection such as bronchitis or pneumonia.

The risk of stroke was found to be three times higher during the same period. The same applied to urinary tract infections such as cystitis.

However, in the following weeks after illness the risk of having a heart attack or stroke gradually decreased.
Professor Patrick Vallance, a researcher on the project at University College London, said: ‘The work shows that the timing of a heart attack is not random.’

He said the finding was important because it showed showed a surge in risk following a range of infections – not just chest infections, as might be expected.

Dr Liam Smeeth from the MRC, lead researcher on the project, said ‘This knowledge will open up new avenues for research and discovery.

‘Armed with the information we have found, we can begin to develop new strategies to reduce the occurrence of heart attacks and strokes.’

The BHF advised people to protect their hearts this winter by staying warm, eating a good diet, having a flu jab and being alert for unusual symptoms.

The researchers also investigated whether vaccinations, including flu and tetanus jabs, increased the risk of heart attacks or strokes. They found no increased risk associated with the vaccines, confirming their safety record.