Women More Likely To Die After Heart Attack
March 17, 2010
WebMD
By: Charlene Laino
Better heart treatment of women could help close the gender gap in heart deaths. Women would be more likely to survive a heart attack if they were treated more like men, French researchers say.
In a study of more than 3,500 people admitted to the hospital for a heart attack, women were far less likely than men to get angiography to visualize heart artery blockages or angioplasty to open up blocked arteries.
Women were about twice as likely to die within a month of having the heart attack, according to the study, presented at the American College of Cardiology’s annual meeting.
The higher death rate in women “is related to the fact that they don’t get the same treatments as men,” says Maria Rosa Costanzo, MD, an American Heart Association spokeswoman who was not involved with the study.
“If women had the same access to procedures and medication as men, they would derive the same benefit,” says Costanzo, of Midwest Heart Specialists in Naperville, Ill.
Study researcher Francois Schiele, MD, chief cardiologist at the University Hospital of Besancon in France, says that when possible, “women should be treated with all recommended strategies, including invasive ones.”
Closing the Gender Gap
Costanzo tells WebMD that it’s been known for some time that women fare worse after a heart attack than men, but it’s been unclear why. Some studies point to biological differences such as women’s smaller blood vessels that raise the risk of complications during angioplasty, she says.
Also, women tend to be older and have poorer overall health when they have heart attacks, and wait longer to seek medical care than men, research suggests.
But other studies suggest that women are undertreated, Costanzo says.
The new study attempted to level the playing ground by using statistical techniques that took into account women’s and men’s different characteristics and treatments when they had heart attacks.
The researchers analyzed data from a regional registry that included more than 3,500 patients, about a third of whom were women, treated for a heart attack between January 2006 and December 2007.
Women were, on average, nine years older than men, had more health problems, and received fewer effective treatments for heart attack. They were nearly twice as likely to die, both during the initial hospital stay and over the following month.
When the analysis was adjusted to take into account the differences in the women’s ages, blood pressure, kidney function, and other characteristics as well as the treatments they received, there was no difference in death rates, either in the hospital or at 30 days.
“Once they compared apples to apples, it shows women get the same benefit from [procedures to open blocked arteries] and medication as men,” Costanzo says.
Drugmakers GlaxoSmithKline, Novartis, and Sanofi-Aventis helped fund the registry.
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New Jersey Mom Aspires to be World’s Fattest Woman
March 16, 2010
Fox News
Meet Donna Simpson. She’s going to cost you. A lot.
Simpson, of Old Bridge, N.J., is 42 years old, has two kids and a boyfriend, and she weighs 602 pounds. That’s right … 602 pounds.
She’s on a diet, of course, because she has a goal in mind:
She wants to weigh 1,000 pounds.
That’s right … 1,000 pounds. It’s a nice, extra-round figure — almost as big as what her unhealthy choices will ultimately cost taxpayers.
Simpson claims she is normal and healthy, and she has a right to eat what she wants and weigh what she wants.
“I love eating and people love watching me eat,” she says. “It makes people happy, and I’m not harming anyone.”
But she needs to use a motor scooter when she goes grocery shopping, because she can’t walk more than 20 feet. The human body, after all, is not designed to scarf down 12,000 calories a day in the quest to weigh half a ton.
Simpson is definitely harming someone — herself, says Dr. Carla Wolper, a registered dietitian and research faculty member at the New York Obesity Research Center at St. Luke’s-Roosevelt Hospital in New York.
And you, the taxpayer, could wind up paying for it.
“We don’t know her medical history, but one of the most dangerous health issues she faces is an increased risk of sudden death from having a heart attack due to electrical problems in the heart,” Wolper said.
Other possible causes of death for Simpson include stroke, immobility, breathing problems, congestive heart failure, diabetes, and inflammation of heart tissue. Each year, nearly 300,000 Americans die from heart failure.
Simpson, experts say, is putting herself at risk for all these medical conditions, and those conditions have a hefty pricetag.
“The baseline cost for someone like to go to the emergency room is $993 for one visit,” Daniel Emmer, public relations manager of Horizon Blue Cross Blue Shield, the largest health insurance provider in New Jersey, told FOXNews.com.
Simpson’s main source of income to support herself financially is by appearing on a Web site where men pay to watch videos of her gorging on food and showing off her hundreds of pounds of extra bulge in a bikini.
But it’s anyone’s guess whether her revenue from Web videos will cover the cost of her inevitable health risks.
“Someone with diabetes costs $11,744 more per year to provide health care, which is twice as much as the average person,” Emmer said.
It is unclear what type of insurance Simpson has, if any. But there is no question that whatever her health care position is, it could come at a high cost.
“Obesity causes a minimum $1,429 increase, or 42 percent in medical costs,” Emmer said. “Research shows lifestyle choices and behaviors drive 87.5 percent of the cost for health care claims.”
“When people are very, very overweight, they are at an increased risk for a condition called prolonged QT syndrome,” Wolper told FoxNews.com.
Prolonged QT syndrome is a heart rhythm disorder that can potentially cause fast, chaotic heartbeats, the Mayo Clinic says on its Web site. In some cases, the heart may beat erratically for so long that it can cause sudden death.
“Another problem this woman faces is related to the circulatory system,” Wolper said. “When people are that big, circulation is often impaired in the legs. This can cause blood to pool in the legs leading to formation of blood clots. This leaves morbidly obese people at an increased risk for a pulmonary embolism.”
A pulmonary embolism occurs when one or more arteries in the lungs become blocked. In most cases, pulmonary embolism is caused by blood clots that travel to your lungs from another part of your body — most commonly, your legs, according to the Mayo Clinic. One of the major risk factors is excess weight, which increases the risk of blood clots, especially in women who smoke or have high blood pressure.
“The work of the heart is tremendously increased when someone is that big because there’s so much more blood in the body,” Wolper said. “When this happens, the heart has to pump against the pressure of all that fat that is pressing against the blood vessels, and as a result the heart enlarges, and not in a good way.”
As Simpson’s appetite increases, so will the cost of health care for the severe medical conditions that she is likely to have — conditions that are preventable by healthier lifestyle choices. Whereas her $750-a-week grocery bill is merely gastronomical, her hospital bills will be astronomical — and the taxpayers of New Jersey may well have to pay her tab.
Meanwhile, in her effort to boldly go where no woman has gone before, Simpson says she tries to stay sedentary, so she burns as few calories as necessary.
She consumes five times more than the recommended daily calories for a woman her age.
“My favorite food is sushi. But unlike others I can sit and eat 70 big pieces of sushi in one go,” she told the Daily Mail.
“I do love cakes and sweet things, doughnuts are my favorite.”
The current record for fattest woman is held by a woman also from New Jersey, who weighed an unbelievable 1,800 pounds when she died in 2008. She was 49 years old.
Simpson is proud of the Guinness World Record she holds now for the world’s fattest mother, and her boyfriend is proud of her too.
Philippe, 49, supports her thousand-pound goal, even if that is nearly seven times his own weight of 150 pounds.
“I think he’d like it if I was bigger,” Simpson said. “He’s a real belly man, and completely supports me.”
Someday, the experts say, we all may support her.
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FDA Adds Boxed Warning To Plavix On Effectiveness
March 15, 2010
Reuters
By Lisa Richwine and JoAnne Allen
The Food and Drug Administration said it was adding a new boxed warning to Plavix, an $8-billion-a-year drug sold by Bristol-Myers Squibb Co and Sanofi-Aventis SA.
The new language will “warn about reduced effectiveness in patients who are poor metabolizers of Plavix,” the FDA said in a notice on its website.
Poor metabolizers are people whose bodies do not effectively convert Plavix to its active form.
“Because the patient makes less of the active form there is less anti-platelet effect in the blood and the patient may not receive the full benefit of Plavix treatment,” Mary Ross Southworth of the FDA’s Center for Drug Evaluation and Research told reporters in a teleconference.
An estimated 2 percent to 14 percent of the population are poor metabolizers of Plavix, the FDA said.
Bristol said published studies suggested the percentage of poor metabolizers is approximately 3 percent. “Patients should continue taking Plavix unless told to do otherwise by their healthcare professional,” the company said in a statement.
The new warning will advise doctors of genetic tests that can identify those patients and to consider alternatives for them.
The length of time it takes to get results of the genetic tests and costs will vary depending on the laboratories used, but the tests are expected be priced under $500, FDA officials said.
Plavix is the second-best selling drug in the world. It loses patent protection in 2012.
Researchers have been studying an alternative drug for patients who cannot benefit from Plavix and details of their findings are expected to be released at a meeting of heart specialists next week.
Plavix reduces the risk of heart attack, unstable angina, stroke, and cardiovascular death in patients with heart disease by making platelets less likely to form blood clots.
Plavix does not have its anti-platelet effects until it is metabolized into its active form by the liver enzyme, CYP2C19.
Information about poor metabolizers and diminished effectiveness was first included in the Plavix label in May, 2009, officials said.
“Since that label was approved, further evidence has accumulated to support evidence of an association between CYPC219 type, Plavix exposure and poor treatment outcomes,” Southworth said.
“After reviewing all of that data, we felt like we probably needed to strengthen the warning to include that the provider should consider alternative treatment strategies.”
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The Healthy Should Not Take Aspirin to Avoid Heart Attack
March 3, 2010
telegraph.co.uk
By Rebecca Smith
Millions of people take a low dose of aspirin daily, as it is known to reduce the risk of having a heart attack or stroke in people who have already had one attack.
It is seen as a ‘just in case’ measure and, because aspirin has been available for around 100 years, it is considered safe by the majority of people.
However, aspirin increases the likelihood of major bleeding, in the brain, stomach or elsewhere in the body, and experts warned that the beneficial effects must be weighed against the risk of harm.
Aspirin, which thins the blood, has been hailed as a wonder drug because it is wide range of uses including reducing the risk of a second heart attack or stroke, increasing evidence that it may prevent some cancers and may have an affect on dementia.
Research carried out in Scotland and published in the Journal of the American Medical Association found that aspirin taken by people who have no outward symptoms of heart disease did not reduce the risk of a heart attack when compared to those on a dummy pill.
Those on aspirin were at almost twice the risk of suffering a bleed, although the overall risk was small, the study found.
Professor Peter Weissberg, Medical Director of the British Heart Foundation, said: “We know that a small daily dose of aspirin can reduce the risk of a heart attack in people with angina and in those who’ve had a heart attack. In these cases, this potential benefit outweighs the risk of internal bleeding, which is a side effect of aspirin.
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Strokes Up Among the Young, Down Among the Old
February 26, 2010
WebMD
By Charlene Laino
Strokes are on the rise among younger people, a group not traditionally considered at high risk for the debilitating condition, researchers report.
A total of 7.3% of stroke victims were younger than age 45 in 2005, up from 4.5% in 1993, says Brett M. Kissela, MD, of the University of Cincinnati Neuroscience Institute.
The most likely culprits: rising rates of obesity, high blood pressure, and diabetes — the major risk factors for stroke — among younger people, Kissela tells WebMD.
The average age of stroke patients dropped from 71 in 1993 to 68 in 2005, he says.
Even among people under 45, strokes are still a relatively uncommon event, striking 25 of every 100,000 whites and 55 of every 100 blacks in 2005, he says.
The findings were presented at the American Stroke Association’s (ASA) International Stroke Conference 2010.
So why would strokes be increasing in younger people, while decreasing in older people?
Kissela says it’s probably because stroke prevention efforts aimed at controlling high blood pressure, diabetes, and obesity have largely been aimed at older people. And they’ve been successful, he says.
Because stroke is thought of as an older person’s disease, younger people fell through the cracks, Kissela says.
“If we don’t reverse this trend, there will be many years of productive life lost. Not just years of work lost; it can be as simple as a young mother no longer being able to hold her baby,” he tells WebMD.
So what’s the answer?
First, younger people need to be aware that they too are at risk, Kissela says.
Also, younger people tend to skip an annual exam if they’re feeling OK, he says. “Everyone should be checked regularly for treatable problems.”
Finally, you’ve heard it before, but Kissela says it’s worth repeating: The best way to ward off strokes, heart attacks, and a host of other diseases is to eat right, exercise, and refrain from smoking.
For the study, the researchers examined data from five counties in the greater Cincinnati and northern Kentucky region, which includes about 1.3 million people.
But the results apply to the entire U.S. population, says American Stroke Association spokesman Brain Silver, MD, a neurologist at Henry Ford Hospital in Detroit.
Silver tells WebMD that he and colleagues nationwide are treating “a lot more patients in their 30s and 40s.”
Plus, rates of obesity and diabetes, the factors fueling the disturbing trend, are increasing throughout the country, Kissela says.
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H1N1 Shot Blamed For Rare Disorder
February 23, 2010
AOL News
A Calgary woman regrets getting the H1N1 shot after her doctor told her it likely caused a rare and painful disorder.
Norma Goldring said she felt compelled to get an H1N1 vaccine because she is diabetic and has had a heart attack, two factors that Alberta Health noted as putting people at higher risk for serious complications from swine flu.
But soon after getting the shot last winter, Goldring felt ill.
“My body was aching and I was throwing up. Then I developed a spot on my leg,” she said.
The rash spread quickly and Goldring ended up in hospital on Christmas Day. “By the time I got to emergency, it spread pretty bad and turned to blisters.”
Her kidneys were shutting down. Doctors eventually diagnosed it as vasculitis, an inflammation that destroys blood vessels.
Her doctor, who asked not to be named, concluded it was probably connected to the H1N1 shot. Goldring, according to her doctor, is one of only 31 people since 1974 to have had this type of reaction to a flu shot.
Won’t get shot again, says Goldring
Now, even using a walker to get from her living room to her kitchen causes her excruciating pain. She is on pain killers and steroids.
“It was like I was put through a fire. It was like someone lit me on fire,” she said.
Goldring said she won’t get a flu shot again. Desmond Fordyce, her partner, said he is worried the vaccine wasn’t tested properly before widespread public vaccinations began.
“I think they’re killing you more than giving you something for making you better,” he said.
Dr. Glen Armstrong, head of the microbiology and infectious diseases department at the University of Calgary, said the H1N1 vaccine is safe. “It’s very clear that the benefits of having people get vaccinated, far, far outweigh the risks of the very small number of adverse reactions to the vaccine.”
So far, 25 million doses of the vaccine have been distributed across Canada. Nearly 6,000 H1N1 shots resulted in an adverse reaction, of which more than 200 were considered serious. Health officials are investigating 13 post-shot deaths.
Alberta health officials told CBC News they have talked to Goldring’s doctor and will continue to investigate what happened in her case.
The province has seen 1,276 people hospitalized with H1N1 since April 2009 and 71 deaths have been connected to the virus.
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Call for Diabetes Drug Avandia to Come off Market
February 22, 2010
Reuters
The Food and Drug Administration will again ask an advisory panel to consider the risks of the drug, Glaxo’s second biggest-selling product before questions about a possible link to heart attacks emerged in 2007.
Senators Max Baucus and Charles Grassley meanwhile released a report saying evidence suggested Glaxo knew of possible cardiac risks associated with Avandia years before the issue became public.
“I await the recommendations of the advisory committee,” FDA Commissioner Margaret Hamburg said in a statement.
“Meanwhile, I am reviewing the inquiry made by Senators Baucus and Grassley and I am reaching out to ensure that I have a complete understanding and awareness of all of the data and issues involved,” she said.
In an October 2008 memo released by the senators, FDA reviewers David Graham and Kate Gelperin concluded “the risks of (Avandia) are serious and exceed those for” Takeda Pharmaceutical Co’s competitor Actos.
They said there was “strong evidence that (Avandia) confers an increased risk of” heart attack and heart failure when compared to Actos. They estimated that 500 more heart attacks and 300 cases of heart failure were occurring every month with use of Avandia instead of Actos, based on levels of use at the time of their memo.
Graham, an outspoken critic of the FDA’s handling of drug risks, had argued to an advisory panel in 2007 that Avandia sales should be stopped. The panel voted 22-1 to urge the FDA to keep the drug on the market.
Glaxo said in a statement “the scientific evidence simply does not establish” that Avandia increases risks of cardiovascular problems such as heart attacks.
Sales of Avandia, known generically as rosiglitazone, topped $3 billion in 2006 but fell to $1.2 billion in 2009.
The FDA decided in November 2007 Avandia should carry a warning saying a review of 42 studies associated the drug with an increased risk of a heart attack or chest pain compared with a placebo. But it said overall data were “inconclusive.”
Concerns about Avandia emerged in May 2007 when Cleveland Clinic researchers published a study saying there was a link between the drug and heart attacks.
FINDINGS MISREPRESENTED?
The senators’ report said evidence reviewed by investigators on the Senate Finance Committee, which Baucus chairs, showed Glaxo “knew for several years prior to this study that there were possible cardiac risks associated with Avandia.”
Glaxo executives “attempted to intimidate independent physicians, focused on strategies to minimize or misrepresent findings that Avandia may increase cardiovascular risk and sought ways to downplay findings that a competing drug might reduce cardiovascular risk,” the report said.
Committee staff reviewed more than 250,000 documents provided by Glaxo, the FDA and others, the report said. Anonymous whistleblowers provided hundreds of other pages.
The New York Times first reported on the memo from FDA reviewers and the senators’ report on Friday night on its website.
Glaxo said it rejected the report’s conclusions. The company said the report “cherry-picks information from documents, which mischaracterizes GlaxoSmithKline’s comprehensive efforts to research Avandia and communicate those findings to regulators, physicians and patients.”
Glaxo said it had rigorously studied Avandia’s safety and “consistently shared this data with regulators around the world.” The company said it “does not condone any effort to silence scientific debate.”
FDA spokeswoman Karen Riley said on Saturday an advisory panel, a group of outside experts, will be asked “to provide advice about safety issues” with Avandia. The FDA usually follows panel recommendations.
Glaxo spokeswoman Mary Anne Rhyne said the company was told the panel would review results of a Glaxo-sponsored study called Record. That study showed Avandia was not associated with an increase in cardiovascular-related hospitalization or death compared to older diabetes drugs, she said.
The company has asked the FDA for permission to include those results in Avandia’s prescribing instructions, she said.
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Chocolate Helps Prevent Stroke
February 15, 2010
Telegraph
By Richard Alleyne
A study of nearly 50,000 people found that those eating chocolate were 22 per cent less likely to suffer a stroke than those that didn’t.
And those who did suffer a stroke but had indulged in chocolate were 46 per cent less likely to die as a result.
The reason is believed to be that the food is rich in flavanoids, a healthy anti-oxidant, although researchers at the University of Toronto are keen to carry out extra studies.
Sarah Sahib, the study author of the University of Toronto in Canada, said: “More research is needed to determine whether chocolate truly lowers stroke risk, or whether healthier people are simply more likely to eat chocolate than others.”
She worked alongside colleague Dr Gustavo Saposnik and they found that 44,489 people who ate one serving of chocolate per week were 22 per cent less likely to have a stroke than people who ate no chocolate.
A second study found that 1,169 people who ate 50 grams of chocolate once a week were 46 percent less likely to die following a stroke than people who did not eat chocolate.
The researchers found only one additional relevant study in their search of all the available research. That study found no link between eating chocolate and risk of stroke or death.
However, Dr Saposnik warned: “Eating too much chocolate can make you fat as chocolate also contains saturated fats.
“Further investigation needs to be done. We need to study specific chocolate consumption.”
The findings are due to be presented at the American Academy of Neurology’s 62nd Annual Meeting in Toronto.
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Study Reveals Chocolate Could Help Prevent Stroke
February 12, 2010
USA Today
By Mary Brophy Marcus
Just in time for Valentine’s Day, research out this week suggests eating chocolate may have a positive impact on stroke. Don’t go buying too many heart boxes just yet, though, say the study authors.
A new analysis, which involved a review of three prior studies, suggests eating about a bar of chocolate a week can help cut the risk of stroke and lower the risk of death after a stroke. But the evidence is still limited, says study author, neurologist Gustavo Saposnik at St. Michael’s Hospital, University of Toronto.
“This is something that requires further investigation,” Saposnik says.
One study they looked at found that 44,489 people who ate one serving of chocolate per week were 22% less likely to have a stroke than people who ate no chocolate. Another study found that 1,169 people who ate 50 grams of chocolate once a week were 46% less likely to die following a stroke than people who didn’t eat chocolate.
The research appears in this week’s Neurology and will be presented at the American Academy of Neurology’s 62nd annual meeting in Toronto in April.
Saposnik says future studies need to address which component in chocolate, the amount, and what kind — white, milk or dark — makes a difference.
New chocolate-stroke studies should also take into account age and gender of consumers, says Italo Mocchetti, a professor in the Department of Neuroscience at Georgetown University Medical Center. Mocchetti, who has studied flavonoids, says this chemical, which is found in cocoa, is linked to anti-inflammatory and anti-cancer properties.
The chocolate-health connection is something many clients are interested in, says Katrina Markoff, owner of the premium chocolate line Vosges.
“We get a lot of customers that come in who only want to eat dark chocolate because they believe that it helps their health — everyone speaks in cocoa percentages now,” Markoff says. “This generation is really interested in super foods.”
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Margarine Found to Lower IQ of Children
February 12, 2010
Natural News
By David Gutierrez
A recent study on dietary influences on IQ turned up a surprising connection: children who ate margarine regularly scored significantly lower on intelligence tests than their peers.
The study was conducted by researchers from Auckland University in New Zealand and published in the journal Intelligence.
Researchers studied the dietary intake and intelligence scores of children born in the mid-1990s.
“We found a number of dietary factors to be significantly associated with intelligence measures,” the researchers said. “The association between margarine consumption and IQ scores was the most consistent and novel finding.”
After adjusting for other factors that might influence IQ, including socioeconomic status, the researchers found that children who ate margarine daily scored three points lower on IQ tests by the age of three-and-a-half than children with lower margarine consumption.
By the age of seven, the average IQ scores of some margarine eaters were six points below those of their peers. This occurred only in children who had been born underweight, suggesting that disadvantaged brains might be more vulnerable to diet-induced problems.
Because the study was correlational, researchers were unable to determine what exactly caused the IQ gap between the two groups of children. They suspect, however, that the culprit may be transfats, also known as partially hydrogenated oils.
Formed by adding hydrogen atoms to unsaturated vegetable oils, transfats have a longer shelf life and are more solid at room temperature than natural vegetable oils. In the mid-1990s, margarines were made with up to 17 percent transfats. In recent years, however, scientists discovered that not only do transfats have no nutritional value, they also drastically increase the risk of heart attack and death in those who consume them.
Most margarines now contain approximately 1 percent transfats.
Sian Porter of the British Dietetic Association noted that while margarine tends to be healthier than butter, dietary consumption of both should be kept low.
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