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Medical News: Recovering Stroke Patients at High Risk for a Fall - in Geriatrics, Strokes from MedPage Today

Welcome to Mayo Clinic podcast. Our topic today is heart attack symptoms in women — are they different from men? I'm your host, Rich Dietman...........CLICK FOR FULL STORY

Erectile dysfunction: A sign of heart disease?

Heart health and erectile function share several important connections. Understanding these connections may help you recognize the symptoms of cardiovascular disease sooner — and improve your chances of maintaining your sexual ability.

Atherosclerosis. This damaging process, which reduces blood flow to your heart and contributes to coronary artery disease, could also affect the blood vessels to the penis, keeping you from sustaining an erection. Conversely, if you're having trouble with erections, it could be a sign that your heart is also at risk.

Medications. Some prescriptions that men take to protect their hearts can cause erectile dysfunction. Additionally, medications that are often prescribed for erectile dysfunction may not be safe when combined with certain heart medications.

Anxiety and depression. Erectile dysfunction itself can be a significant source of anxiety for men. Add to that a fear that sexual activity could cause a heart attack, and your love life could take a plunge. Depression frequently affects men with heart disease. Both the condition itself and some of the medications used to treat it can lead to erectile dysfunction.

Atherosclerosis: Where erectile dysfunction and heart disease meet

If atherosclerosis has made your coronary arteries narrow and stiff, that means arteries elsewhere in your body are probably also affected. Atherosclerosis can prevent enough blood flow from reaching your heart, legs, brain and penis. When atherosclerosis affects blood flow to your penis, the blood can't sufficiently fill the penis to allow a suitable erection.

In one study, 64 percent of men who'd had heart attacks had erectile dysfunction before they knew they had cardiovascular disease. Some experts suggest that if you haven't been diagnosed with heart problems, consider erectile dysfunction a wake up call. It could be a warning sign that the blood vessels feeding your heart might also be in trouble.

The same factors that raise your risk of atherosclerosis in the arteries in your penis also increase your chances of coronary artery disease. Because the arteries supplying your penis are smaller than the ones to your heart, symptoms may first show up as erectile dysfunction.

Risk factors for cardiovascular disease and can contribute to erectile dysfunction include:

Diabetes. Men who have diabetes have more problems getting an erection than do men who don't have diabetes. The problem is partially due to the diabetes-related damage to blood vessels that supply the penis.

Obesity. Overweight men are more likely to have erectile dysfunction.

High cholesterol. A high level of low-density lipoprotein (LDL, or "bad") cholesterol contributes to atherosclerosis in blood vessels, raising the risk of erectile dysfunction.

Smoking. Smoking cigarettes raises your risk of developing atherosclerosis. Not only does smoking increase your chances of heart disease, but it can make you nearly twice as likely to develop erectile dysfunction.

High blood pressure. Over time, high blood pressure damages the lining of your arteries and accelerates the process of atherosclerosis — which can lead to cardiovascular disease and erectile dysfunction. [CLICK HER FOR ENTIRE ARTICLE]

ACC: Dark Chocolate Improves Vascular Function - CME Teaching Brief® - MedPage Today [CLICK HERE TO READ ARTICLE]

ACC: Depression Shortens Survival in Heart Failure - CME Teaching Brief® - MedPage Today [CLICK HERE FOR ARTICLE]

Newswise: Who Gets Heart Failure? Race Takes Back Seat to Diabetes and High Blood Pressure

Newswise — Diabetes and high blood pressure, two conditions rooted in genetics and environmental surroundings, play a much greater role than race alone in determining who is mostly likely to develop heart failure, according to the latest study from cardiologists at Johns Hopkins. Each year, nearly 300,000 Americans die from heart failure.

Experts say that racial disparities have long been known to exist in who actually develops risk factors for the condition, with African Americans nearly twice as likely to be diagnosed with diabetes and more than a third as likely to have high blood pressure than Caucasian Americans. But researchers have only now determined the precise role played by race in comparison to other risk factors, including socio-economic factors, age, gender, smoking, family history, and other health problems, as well as diabetes and hypertension.

The Hopkins team will present its findings March 27 in New Orleans at the American College of Cardiology’s annual Scientific Sessions in New Orleans.

In the study, researchers monitored nearly 7,000 men and women, age 45 to 84, of different ethnic backgrounds and with no existing symptoms of heart disease. African Americans developed heart failure at significantly higher rates (4.6 cases per 1,000 per year) than all other races, including Hispanics and Caucasians. Their rate was almost five times that of Chinese Americans (1 case per 1,000 per year) and almost twice that of Caucasians (2.4 cases per 1,000 per year).

However, these apparent risk differences among races almost disappeared (dropping from twice as likely, a significant difference, to no more than one-and-a-half times as likely, an insignificant difference) when researchers used statistical techniques to exclude the two traditional risk factors for heart disease.

“When all major factors are taken into account, the differences between races for heart failure largely evaporate in the absence of diabetes and hypertension among African Americans,” says senior study investigator João Lima, M.D.

According to Lima, an associate professor of medicine and radiology at The Johns Hopkins University School of Medicine and its Heart Institute, these early results add to other interesting findings from the so-called Multiethnic Study of Atherosclerosis (MESA).
The study, started in 2001, is monitoring its ethnically diverse participants for six to eight years to see who develops heart failure and who does not. It is the first large-scale analysis of racial or ethnic differences in heart function. So far, 79 study participants have developed congestive heart failure.

Other results presented at the meeting showed differences among races in heart strain, or contraction, which may contribute to disparities in heart failure, albeit to a lesser extent. Indeed, African American hearts were found to contract less strongly than those of Hispanic, Caucasian or Chinese American backgrounds.

Lima cautions, however, that much remains to be understood about the root causes of racial disparities and how to fix them.

He points out that while African Americans are at much higher risk of heart failure, there is no similarly higher number for risk of suffering heart attack, which, like diabetes and hypertension, often leads to heart failure.

In MESA, researchers found a reverse relationship, with African Americans having the lowest rates of heart failure due to myocardial infarct (at 25 percent), while other races had a much higher proportion: Caucasians (40 percent), Hispanics (42 percent), and Chinese Americans (100 percent.)

Lima says the difference could be due to successful disease prevention efforts among all racial groups, except for African Americans, at controlling hypertension.

“A lot of public health attention has already been paid to getting high blood pressure under control, so it may be just that this risk factor is under tighter control in some ethnic groups than in others,” he says. “African Americans are clearly getting heart failure from causes other than heart attack.”

According to lead researcher Hossein Bahrami, M.D., M.P.H., the message to physicians is clear, “warding off heart failure in African Americans requires aggressive treatment of diabetes and hypertension. Whether through increased screening or greater emphasis on drug therapies, these are two risk factors that must be brought under control.”

Bahrami, a senior cardiology research fellow at Hopkins, says removing barriers for African Americans to controlling their diabetes and hypertension could be critical to reducing new cases of heart failure. Across all ethnic groups, an estimated 550,000 Americans are diagnosed each year.

Bahrami says the team’s next steps are to determine why different rates exist for these risk factors and the role played by biological and environmental factors. Funding for this study, which is taking place in six centers in the United States, comes from the National Heart, Lung and Blood Institute, a member of the National Institutes of Health.

Besides Lima and Bahrami, another Hopkins investigator involved in this study was David Bluemke, M.D., Ph.D. Study co-authors were Richard Kronmal, Ph.D., from the University of Washington in Seattle; Kiang Liu, Ph.D., from Northwestern University in Chicago, and Gregory L. Burke, M.D., M.S., from Wake Forest University in Winston-Salem, N.C.

Fend off heart disease with fish.

Good-for-You Fish
The Greenland Inuit eat an incredibly high-fat diet with few vegetables, yet their rate of heart disease is stunningly low. Chalk it up to all the fatty fish they eat: The staple food in their diet is fish rich in omega-3 fatty acids. You've probably heard by now that omega-3s fend off heart disease -- something that could be right around the corner if your blood sugar is stuck in overdrive. It's no wonder fish makes our list of Magic foods.

A study at the Harvard School of Public Health found that women with diabetes who ate fish just once a week had a 40 percent lower risk of dying from heart disease than did women with diabetes who ate fish less than once a month.

But omega-3s do more than protect your heart. They also quell inflammation in the body, a major contributor to numerous chronic diseases of aging, including insulin resistance and diabetes. It may even play a role in brain diseases such as Alzheimer's as well as certain cancers.

Of course, fish is also a protein food, and protein foods have virtually no impact on blood sugar. We suggest that you aim to eat fish for dinner once or twice a week when you might otherwise have chicken or beef. Make it baked, broiled, pan-fried, stewed, or grilled. Just don't make it fast food or deep fried, like fish and chips or a fish sandwich. Loaded with bad-for-you fats, this fare just isn't the same kettle of fish. One study found eating fried fish and fish sandwiches offered no heart benefits at all.

All fish contain some omega-3s, but fatty types such as albacore tuna, salmon, mackerel, lake trout, herring, and sardines are richest in them.

Health Bonus
While the strongest proof of the health benefits of fish points to the heart, there's also plenty of research showing that food with fins can cut the risk of prostate cancer and help maintain brain power as you age. There's also evidence that fatty fish may help defend against depression.

Study: Aspirin May Lower Risk Of Death In Women

(CBS News) CHICAGO Aspirin in low-to-moderate doses may lower the risk of death in women, particularly those who are older and prone to heart disease, a 24-year study of nearly 80,000 women suggests.

However, experts cautioned that the results are not definitive and that women shouldn't take aspirin as a health preventive without talking to their doctor.

In this long-running study of nurses who were middle-aged and older, women who took aspirin had a 25 percent lower risk of death compared to those who never took it. Aspirin-takers had a 38 percent lower risk of death from cardiovascular disease and a 12 percent lower risk of death from cancer.

Many doctors advise people who've had heart attacks and strokes to take a daily 81-milligram baby aspirin, costing less than 50 cents a week. The new study suggests aspirin may help healthy women, too.

No benefit was found for high doses, which the study defined as two or more standard 325-milligram aspirin tablets a day.

"This confirms what we already know: Aspirin is good for you, whether you're a man, whether you're a woman," said Dr. Jeffrey Berger of Duke University Medical Center who studies aspirin's effects. He was not involved in the new research and receives no money from aspirin makers.

However, since aspirin can cause ulcers and bleeding, Berger said, women should talk to their doctors before taking it to prevent disease.

"It's not a little vitamin; it's not a sugar pill," he said....[MORE]

HEART FELT -- Kastan Fills Emotional Gaps for Women With Heart Disease
By Mary Powers / powers@commercialappealcom

She never smoked.

She wasn't overweight.

Her blood pressure was normal.

She exercised regularly.

But at age 41, Kathy Kastan of Cordova started having symptoms of heart disease.

It would take two years, visits to two Memphis heart specialists and a trip to the Mayo Clinic in Rochester, Minn., to get the correct diagnosis and relief from crippling chest pain. Before it was over, she'd undergo five heart procedures plus emergency heart bypass surgery.

During her search for information, she found plenty of books about how to prevent or reverse heart disease. Most were written by physicians. None addressed the emotional roller coaster she was riding.

So she wrote that book.

"From the Heart: A Woman's Guide to Living Well with Heart Disease" is what she was looking for when she was diagnosed. Its official publication date is Sunday, but the book ($25, Da Capo Press) is in book stores now.

"I would have realized I'm not alone," Kastan said, explaining how the information would have helped her. "I would have felt more hopeful. I would have had something to direct me in a positive way and help me understand why I was floundering."

Instead of the physiology of atherosclerosis, in "From the Heart," Kastan writes about body image and sex. Instead of low-fat meal ideas, she details her own struggle to digest the diagnosis.

Along with strategies for navigating the health system, Kastan outlines the healing power of activism.

Kastan, whose father and husband are both physicians, is a licensed clinical social worker who had worked as a psychotherapist before her diagnosis. She now devotes herself full time to advocacy.

She is in her second term as president of WomenHeart, a national coalition for women with heart disease. She's also chairwoman of the American Heart Association's northwest region. In 2005, Kastan and the the foot-long bypass scar bisecting her chest were featured in a national public-awareness campaign about women and heart disease.

It's work that has her traveling, sometimes several times a month, lobbying elected and government officials or speaking to medical, consumer and other groups. She talks about the still under- appreciated risk heart disease poses to women as well as the need for more research about women and heart disease.

Her message to doctors: Take seriously female patients and their heart disease risk. Although she said more research and education are needed, she is hopeful. "We are getting there. We are moving in the right direction," she said.

She got serious about writing the book three years ago after surveying WomenHeart members. What they told her about their experiences with heart disease reinforced her belief that her story wasn't unique.

Kastan had a family history of heart disease and elevated cholesterol, but she wasn't considered an obvious candidate for the problem.

So when her left arm would tingle during a swim or a bike ride left her short of breath and nauseated, she blamed her age and asthma.

The first doctor blamed a leaky heart valve. The next one found a blockage in one of the main arteries supplying blood to her heart and vasospasm, a cramping of the blood vessel that temporarily reduced or halted its blood supply. But it took a trip to the Mayo Clinic's women's heart clinic before more aggressive treatment of the vasospasm brought symptom relief....[MORE]

Bloomberg.com: AtheroGenics Drug That Failed in Study Cuts Diabetes (Update2)

March 27 (Bloomberg) -- AtheroGenics Inc.'s experimental heart drug, which failed to meet a primary study goal last week, reduces diabetes and deaths from heart disease and should be developed, doctors said. Shares soared as much as 26 percent.

The medication, an anti-inflammatory known as AGI-1067, lowered deaths from heart attacks, cardiac arrest and strokes by 19 percent in the study, details of which were presented at the American College of Cardiology meeting in New Orleans. It cut by 64 percent the number of patients diagnosed with diabetes.

The study was initially designed to measure effectiveness against a range of complications, including chest pain. AtheroGenics reported last week that the medicine failed to meet the wider goal, though details weren't available. Doctors now say the drug should be developed because of how it works individually against deaths, heart attacks and diabetes.

The results ``are very encouraging and suggest that the drug is having a beneficial effect,'' said Steven Nissen, president of the cardiology group and chairman of cardiology at the Cleveland Clinic, in an interview. ``Someone should pursue further development of this drug.''

AtheroGenics' stock rose 17 cents, or 4.8 percent, to $3.75 at 11:14 a.m. New York time in Nasdaq Stock Market composite trading, after touching $4.54 earlier. The stock plunged 61 percent last week after the company first announced the trial failed to meet its primary goal, trading low as $2.83.

Marketing Agreement
London-based AstraZeneca Plc has a marketing agreement with AtheroGenics to develop AGI-1067 that could be worth as much as $1 billion if the drug completes development and hits sales goals. AstraZeneca hasn't yet told AtheroGenics if it plans to continue working with them on the product, said Russell Medford, Chief Executive Officer of AtheroGenics, in an interview today.

AGI-1067 is designed to counter the buildup of plaque in the arteries that occurs in 16 million Americans. More than 6,000 patients in the U.S., U.K., Canada and South Africa took part in the phase III study, the last stage generally required for regulatory approval.

Patients in the study were already getting drug therapy for the year following a heart attack or sudden on-set of chest pain, suggesting that the new medication may provide additional benefit beyond the current standard of care, researchers said.

Heart disease is the leading cause of death worldwide and kills 700,000 people in the U.S. each year, according to government statistics. The drug is the first in a new class that aims to treat heart disease by fighting inflammation.

Additional studies are needed to confirm the benefits and ensure the drug is safe. Patients getting AGI-1067 were more likely to be hospitalized for heart failure and develop diarrhea in the study.

There were also signs that the drug might affect liver function. One patient developed liver failure and recovered after the drug was halted.

Associated Press: Jurors side with Merck in Illinois Vioxx trial
Drug maker cleared over 2003 heart-attack death

EDWARDSVILLE, Illinois - Jurors in the Midwest's first trial over the once-blockbuster painkiller Vioxx on Tuesday cleared the drug's maker in the 2003 deadly heart attack of an obese 52-year-old woman.

The jury deliberated over two days before siding with Merck & Co., which had argued that Patty Schwaller's obesity and other health issues might have posed risks that better explain her collapse and sudden death.

Schwaller had taken Vioxx for about 20 months. Her husband claimed that Vioxx contributed to his wife's death and that Merck failed to sufficiently warn consumers that the drug increased the risk of cardiovascular problems.

The victory was Merck's 10th in 15 cases that have been tried in the mushrooming litigation over the drug Merck pulled off the market in 2004 after its research showed it increased the risk of heart attacks and strokes.

During the monthlong trial, Merck lawyers insisted that Patty Schwaller had several risk factors for heart disease, including obesity, diabetes, high blood pressure and a sedentary lifestyle.

The 5-foot-2 woman's weight fluctuated between 250 pounds and 300 pounds for roughly two decades before her death, attorneys have acknowledged.

But attorneys for Schwaller's widower, Frank Schwaller, pressed that the woman had no heart attacks, strokes or symptoms of congestive heart disease before her fatal collapse, fueling their belief that Vioxx contributed to her demise....[MORE]

Telephone-Based Psychotherapy Shows Durability in Depression - CME Teaching Brief® - MedPage Today

SEATTLE, March 22 -- For depressed patients on medication but too sad to seek psychotherapy as well, lasting help may be available by phone researchers found in a follow-up study.

For more than 75% of nearly 400 patients, the positive effects of six months of brief telephone psychotherapy at the start of antidepressant medication endured for 18 months after the first session, including six months beyond the end of all phone therapy, said Evette Ludman, Ph.D., of the Group Health Cooperative Center for Health Studies here, and colleagues.

This study, reported by Dr. Ludman and colleagues in the April issue of the Journal of Consulting and Clinical Psychology, was a follow-up to a 2004 report on the same sample of 393 patients, published in the Journal of the American Medical Association.

The follow-up found that at 18 months, 77% of those given phone-based therapy reported that depression was "much" or "very much" improved, compared with only 63% of those receiving usual care.

In the 18-month analysis, the benefits of telephone psychotherapy in the first six months were sustained during the second six months when only brief booster sessions were provided. Significantly a "robust clinical benefit" endured for six months after all treatment contact was discontinued, the researchers found.

"As with weight control," Dr. Ludman said, "maintaining improvement is the hardest part of treating depression."

Traditional in-person psychotherapy has limited reach among the large number of patients beginning antidepressant treatment in primary care, the researchers wrote. Expanding access to therapy calls for considering new therapy approaches, such as phone-based sessions, that place greater emphasis on accessibility, outreach, and patient convenience, the investigators concluded.

Of the participants, 195 were randomly assigned to antidepressant medication and usual care while 198 got medication and phone therapy. Of these, 348 (89%) completed the six-month blinded assessment, and 334 (85%) completed the 18-month follow-up.

On average, all patients reported a moderate level of depressive symptoms at baseline, two to four weeks after starting antidepressants prescribed by a primary-care provider.

Phone psychotherapy sessions, delivered by masters-level therapists, included eight core sessions (about 30 minutes) during the first six months, with 15- to 20-minute booster sessions every two months up to a year. After that, phone therapy ended.

According to a structured cognitive behavioral-based psychotherapy program, patients were encouraged to identify and counter their negative thoughts (cognitive behavioral therapy), pursue activities they had enjoyed in the past, and develop a plan to care for themselves....[MORE]

Doctor’s Orders: Take HeartAware Assessment Today

Tuesday, 20 March 2007
By David Schneider, MD
Director of Cardiology, University Cardiology at Fletcher Allen Health Care

Now available free to the community through Fletcher Allen Health Care is a quick and confidential online questionnaire that will help determine your risk for heart disease. Taking this test could save your life.

According to the National Heart, Lung., and Blood Institute, 50 percent of men and 64 percent of woman who die suddenly from coronary heart disease have no previous symptoms of the disease.

Those are pretty sobering statistics. What is more sobering is that many of these deaths can be prevented by identifying people at increased risk. This assessment will help identify people with unrecognized heart disease and will allow them to take action to reduce their risk.

The questionnaire called HeartAware, is available at www.FletcherAllen.org. It evaluates several risk factors including overall health and family history. When completed, you will receive a personalized, confidential report assessing your heart health and providing recommendations for lifestyle modifications. You also have the option of receiving free heart health information by e-mail.

Those who are found to be at-risk will be eligible for a free, 20-minute consultation with a nurse at Fletcher Allen’s outpatient cardiology office in South Burlington. This consultation which includes a blood pressure and cholesterol check, will help identify if you are at-risk and help your physician to prevent heart disease.

Also now available at our Web site is a comprehensive heart health information center that includes a wealth of prevention tips and information about conditions and procedures, complete with interactive animations.

If you have questions, please e-mail heartaware@vtmednet.org or call Fletcher Allen Cardiology at 847-4600. Don’t delay. Take HeartAware today.

Knowing Cholesterol, Blood Pressure Numbers Can Save Lives

If one of your New Year's resolutions was to get healthier, then 'knowing your numbers' is a good way to start.

Andre Stanley decided to visit his doctor to get his health back on track for the new year. One of the first things she told him was to get to know his numbers.

"When she told me about the numbers, that they were very important based on my size," says Stanley. When I came here to her, I didn't know anything about numbers at all, O was just lost."

Stanley's physician, cardiologist Dr. Patricia Davidson says it's no longer acceptable to just know your total cholesterol level. Now you also need to know your HDL, LDL and triglycerides numbers.

"I know practically no one that will walk in my office and tell me they know what their numbers are," says Dr. Davidson, "It's a difference between life and death."

Doctors have long believed that people with a low total cholesterol level, under 150, are less likely to have heart attacks. But recent studies show that the HDL, or the good cholesterol, levels might be the key to good heart health.

A low HDL level can predict heart problems, especially if there's a family history of heart disease.

"It's very sensitive in the female population," says Dr. Davidson. "If women tend to have low good cholesterol levels they have a much higher risk of heart disease than that of the male population."

Health experts say knowing your blood pressure number can be important, too. Untreated high blood pressure can lead to health problems such as stroke, heart attack, damage to the eyes, kidney failure, and hardening of the arteries.

"So optimal blood pressure is under 120 and under 80 and if you can achieve that, there is a very small likelihood that you will have a heart attack or a stroke as a result of high blood pressure," says Dr. Davidson.

Dr. Davidson says it's important to know your numbers, and have them checked regularly, because they're measurements that can help you live a longer, healthier life.

"You need to participate in your care," says Dr. Davidson. "You know 911, that's the one number that will save your life, and so will your cholesterol numbers, your HDL or triglycerides, your LDL, your blood pressure, those are numbers that will save your life."

For more information on 'knowing your numbers,' visit the websites below:
American Heart Association
National Cholesterol Education Program
National Institute of Health

CME Teaching Brief® - MedPage Today - Strokes Stop Essential Brain Crosstalk

ST. LOUIS, March 14 -- Spatial neglect -- a common attention-deficit sequel to stroke -- appears to be caused by a lack of communication between two regions of the brain, according to researchers here.

The finding contradicts the traditional explanation that spatial neglect is caused by damage to a specific brain region, said Maurizio Corbetta, M.D., of Washington University.

Instead, magnetic resonance imaging showed that patients with neglect -- in which patients have difficulty paying attention to one side of their bodies or the visual field -- have disrupted connections between dorsal and ventral frontoparietal attention networks, reported Dr. Corbetta and colleagues in the March 15 issue of Neuron.

"For more than a century, we have linked neurological deficits and their recovery to the damage done to neurons directly affected by a stroke or other injury," Dr. Corbetta said in a statement. ...[MORE]

CME Teaching Brief® - MedPage Today - FDA Warns of Sedative-Aided Sleep Driving and Anaphylaxis

ROCKVILLE, Md., March 14 -- The FDA has taken steps to ensure that clinicians and patients are aware of rare bizarre effects associated with sedative hypnotics, including driving or eating while sleeping.

The agency has ordered makers of all sedative-hypnotic drugs to strengthen label warnings about the risk of "complex sleep-related behaviors" and also severe allergic reactions. The FDA defined sleep driving as "driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event."

Last December, the FDA sent letters to manufacturers of products approved for the treatment of sleep disorders requesting that the whole class of drugs revise product labeling to include warnings about the following potential adverse events:

Anaphylaxis and severe facial angioedema, which can occur the first time the product is taken. Complex sleep-related behaviors which may include sleep-driving, making phone calls, and preparing and eating food while asleep.

"There are a number of prescription sleep aids available that are well-tolerated and effective for many people," said Steven Galson, M.D., MPH, director of FDA's Center for Drug Evaluation and Research. "However, after reviewing the available post-marketing adverse event information for these products, the FDA concluded that labeling changes are necessary to inform health care providers and consumers about risks."

Russell Katz, M.D., director of the FDA's division of neurology products at the center, said the new label will warn that a number of complex-sleep related behaviors "including cooking and eating, using the telephone, having sex, and driving" have been reported by persons using the drugs. Typically, the patient has no memory of these actions.

At a press briefing today, Dr. Katz repeatedly emphasized that the allergic reactions, including anaphylaxis and angioedema, and the complex sleep-related behaviors,"are rare by any definition" and he said the FDA has not received any reports of death associated with either side effect....[MORE]

USA Today: Stay calm, or you may calcify your arteries: CLICK HERE FOR MORE

Older adults with explosive tempers are more likely than mellow people the same age to have calcium deposits in their coronary arteries, a key sign of high risk for heart attack, a study reported Wednesday.

The more likely someone over 50 expresses anger by lashing out, the more calcification shows up in his coronary arteries, researchers from Washington State University say. They reported their findings at the American Psychosomatic Society meeting in Budapest.

At the start, 185 participants filled out questionnaires on how they dealt with anger. Researchers used electron beam computerized tomography (EBCT) to measure the calcium deposits in arteries. Nine years later, everyone's arteries were scanned again....

Radiation for breast cancer ups heart disease risk: CLICK HERE FOR MORE
POSTED: 9:27 p.m. EST, March 7, 2007


NEW YORK (Reuters) -- As a treatment for breast cancer, radiation, even modern regimens, appears to increase the risk of cardiovascular disease, according to a report in the Journal of the National Cancer Institute.

Earlier reports have indicated that radiotherapy regimens used in the 1970s elevate heart disease risk, but it has been less clear whether more recent regimens also increase the risk.
Apart from the "clear benefits" of radiotherapy, doctors should still be aware of the potentially increased risk of cardiovascular disease following specific radiotherapy regimens in long-term breast cancer survivors, Dr. Flora E. van Leeuwen, from the Netherlands Cancer Institute in Amsterdam, and colleagues note in the report....

Should Everyone Be on a Statin? CLICK HERE FOR MORE
Posted 03/06/2007
Charles P. Vega, MD, FAAFP

Summary and Viewpoint
Statins have become some of the most popular medications prescribed in primary care offices, and for good reason. In a meta-analysis involving 25 studies enrolling 69,511 individuals with a history of coronary heart disease, statin therapy reduced the rate of coronary heart disease mortality or nonfatal myocardial infarction by 25% and reduced all-cause mortality by 16%.[1] The beneficial effects of statins in this meta-analysis were evident in both sexes and among older adults, and statins improved outcomes regardless of baseline levels of low-density lipoprotein (LDL) cholesterol.

The record of cholesterol-lowering therapy in improving outcomes among patients without a prior history of cardiovascular disease is less strong. A previous meta-analysis examining all cholesterol-lowering medications in the primary prevention of cardiovascular events and death found a reduction in the rate of coronary heart disease events of 30%.[2] However, the mortality rate was unaffected by the use of cholesterol-lowering medications, and when the authors examined trials of statins alone, these medications failed to reduce rates of coronary heart disease or mortality....

Pfizer's Lipitor OKd for expanded uses: CLICK HERE FOR MORE
From Reuters March 8, 2007

The Food and Drug Administration has approved expanded use of Pfizer Inc.'s blockbuster cholesterol-lowering medicine Lipitor by five new categories, including one to reduce the risk of non-fatal heart attacks and strokes, the company said Wednesday.

The expanded label for the world's top-selling prescription drug will also include its approval for use in reducing the risks of certain types of heart surgery, hospitalization for heart failure and chest pain in patients with heart disease.

Pfizer said Lipitor was the first cholesterol-lowering drug to win approval for reducing risk of hospitalization for heart failure.

The expanded label may provide Pfizer sales representatives with new ammunition in the battle to stem market erosion as health plans turn up the pressure to switch patients to much less expensive generic versions of Merck & Co.'s Zocor....

t2cure Founders Honored for Medical Top Science: CLICK HERE FOR MORE

FRANKFURT, Germany, March 8 /PRNewswire/ -- The founding team of t2cure GmbH, the two clinicians and scientists from the university clinics,
Frankfurt, Professor Dr. med. Andreas Zeiher, Director of the department of
internal medicine/cardiology, and Prof. Dr. rer. nat. Stefanie Dimmeler,
Head of the department of Molecular Cardiology, have been awarded the Ernst
Jung Prize for Medicine 2007 together with Professor Dr. med Josef M.
Penninger, Vienna. The prize is being awarded by the Jung-Foundation for
Science and Research. With an allocated 250,000 Euro it is among the
highest European prizes for research.

Professor Zeiher und Professor Dimmeler have jointly translated
research on the regenerative potential of bone marrow-derived precursor
cells from bench to bedside. In a recently published double blind, placebo
controlled clinical phase II study they could show that the administration
of such progenitor cells has a significant benefit on top of standard of
care in patients that have suffered from a severe acute myocardial
infarction. Pump function of the affected heart recovered significantly
better and even longer-term the therapy seems to have a beneficial effect
on morbidity and mortality of patients that have suffered from a severe
acute myocardial infarction.

Prof. Penninger contributed to the better understanding of the role of
certain genes in the organism or in disease by changing or suppressing the
expression of those genes. With his research he elucidated basic mechanisms
and elaborated on the development of certain diseases....

Basketball Legend Walt Frazier Teams with Association to Fight Diabetes, Heart Disease: CLICK HERE FOR MORE
The Heart Of Diabetes Encourages People to Control Type 2 Diabetes

HOUSTON, March 8 /PRNewswire/ -- Walt "Clyde" Frazier knows the
importance of good health goes beyond the basketball court. At the peak of
his professional basketball career in the 1970s, he kept a work-out
routine, had regular check-ups and paid close attention to his overall
health. Now, almost 40 years later, Frazier continues to maintain a healthy
lifestyle because a healthy future means more to him than ever.

It is also important to Frazier that others learn how to have a healthy
future, which is why he is teaming up with the American Heart Association's
The Heart Of Diabetes(SM): Understanding Insulin Resistance national
campaign. The goal of the program is to educate people who live with type 2
diabetes about their increased risk of cardiovascular disease (CVD) because
adults with diabetes have heart disease death rates that are approximately
two to four times higher than adults without diabetes. In fact, at least 65
percent of people with diabetes die from some form of heart disease and
stroke.

Frazier has a family history of type 2 diabetes, obesity and CVD. The
Heart Of Diabetes program offers participants a family history tool that
helps them track blood relatives who have or had diabetes or associated
cardiovascular diseases....

Kidney Disease Opens Door to Heart Disease, Other Leading Killers, Says National Survey: CLICK HERE FOR MORE
National Kidney Foundation program demonstrates value of simple tests to
diagnose kidney disease in people who are most at risk

NEW YORK, March 8 /PRNewswire/ -- People with chronic kidney disease are significantly more likely to have other, life-threatening conditions
such as heart disease, according to new findings from a nationwide
screening program by the National Kidney Foundation (NKF) published in the
March issue of the American Journal of Kidney Diseases. The report is
released today in conjunction with the 2nd annual "World Kidney Day"
observance in recognition of the worldwide significance of kidney disease
as a public health problem.

In the survey of people at risk of developing kidney problems, those
who were already diagnosed with Chronic Kidney Disease, or CKD, were also
at increased risk of having poorly controlled blood sugar, a hallmark of
diabetes. Compared to the general population, people at risk of CKD were
more likely to be overweight, and have high blood pressure. The survey was
conducted through NKF's Kidney Early Evaluation Program (KEEP), a free
kidney health detection program designed to help people at risk for chronic
kidney disease (CKD) receive early diagnosis and treatment.

"People at risk of CKD are more than twice as likely as people who are
not at risk to have high blood pressure," says Allan Collins, MD, president
of the NKF. "Among people at risk, 27% of those already diagnosed with CKD
have heart disease, the nation's top killer, relative to only 15% of people
at risk of, but not yet diagnosed with, kidney problems," he adds. "These
findings suggest that CKD can multiply the risk of other devastating
illnesses, demonstrating the importance of diagnosing and managing the
disease in those who are most vulnerable."...

How to tell if you're having a heart attack, and what to do next
Is it a heart attack? A guide
Date published: 1/28/2007

Heart disease is the leading cause of death in the United States, and heart attack, the sudden blockage of blood flow to the heart, is one way that heart disease reveals itself.

Each year about 1.2 million Americans suffer a heart attack. If you become one of them, here's some information that could save your life.

Is it a heart attack?
The first thing that a person having a heart attack must do is acknowledge that it's happening, said Lisa Lucas, director of cardiac services for Mary Washington Hospital.

"They delay a lot," Lucas said. "It's hard for them to imagine that they're having a heart attack. When they realize that they need to go to the emergency room, it's hours and hours after they've had this pain."

This admission is even more critical for those at increased risk of heart attack, such as those who smoke or have diabetes, hypertension or a family history of heart disease.

So how do you recognize a heart attack? There are a couple of important indicators, Lucas said.

Pressure in the chest: With most heart attacks, there is an uncomfortable pressure, squeezing, fullness or pain in the center of the chest.

"It could be a heaviness, a pressure, radiating down one of their arms," Lucas said.

Discomfort in other areas: Symptoms also can include pain that moves to the back, neck, jaw or stomach. Shortness of breath that lasts for more than a few seconds is common, as are sweating, nausea and lightheadedness.

Women's symptoms: Women can have some of the same symptoms as men, such as shortness of breath, nausea and back or jaw pain. But their symptoms are likely to be different.

"A common symptom that differs from men is 'lingering tiredness'," said Diana R. Louder, coordinator for cardiovascular research and community programs at Mary Washington. Women usually don't get the crushing "elephant sitting on your chest" symptom, Louder said.

"Women's symptoms are usually a little more vague," Lucas said. "Sometimes they can't describe it."

What to do: Call 911. Patients who call an ambulance can get treatment up to an hour sooner, compared with those who go to the hospital by car.

"They think the rescue squad is just a ride to the hospital, and it's not," Lucas said. "The rescue squad is central to the care you receive on the way."

Up to one-fourth of heart-attack patients die before reaching the hospital.

"Sudden death is a high probability for those patients when they wait at home," Lucas said. "If they're driving themselves, there's no way to provide emergency care on the way."

While waiting for the ambulance, the patient should chew one regular aspirin tablet

Los Angeles Times Brief: Depression drug aids heart patients
From Times wire reports
January 29, 2007

A drug can combat depression common among patients with severe heart disease, but psychological counseling doesn't seem to work, a study has found.

The report from the University of Montreal Hospital Center said there have been few studies looking at how much antidepressants help heart disease patients with depression, even though as many as 27% may suffer from it. Doctors believe that treating the depression may also slow the deterioration of patients' health.

The Canadian study, published in the Jan. 25 issue of the Journal of the American Medical Assn., involved 284 patients variously given the drug citalopram — sold as Celexa — a placebo or short-term psychotherapy. The patients had previously suffered a heart attack or major blockage of arteries.

Citalopram is one of a class of antidepressants called SSRIs.

The study found that the drug worked to combat depression by easing its most common symptoms, with the effect apparent within six weeks. But, it concluded, counseling did not have an effect.

To read the study, go to jama.ama-assn.org/cgi/content/full/297/4/367

Victims of heart attacks, strokes need quick treatment
By: BRADLEY J. FIKES - Staff Writer

Someone's been hit by a car and is bleeding profusely. A child falls down a flight of stairs and is knocked unconscious.

Of course, you dial 911 immediately to get an ambulance.

But what if you feel prolonged pain and pressure in your chest? What if someone suddenly has trouble speaking, or becomes partially paralyzed? These, too, are life-threatening emergencies. And you need to dial those three numbers right away.

However, people aren't taking these warning signs of a heart attack or stroke seriously enough, says the American Heart Association and the local medical community.

Half of people who need emergency treatment are driving themselves or being driven to the hospital, said Shelley Berthiaume, quality improvement initiative director for the American Heart Association.

As a result, people die or become permanently injured who could make a full recovery ---- if they had been treated quickly.

If only they had made that call.

When to call
Medical emergencies that demand a 911 call include unconsciousness, heavy bleeding or very intense pain, said Dr. Mark Olcott, an urgent care physician with ScrippsHealth. But heart attack and stroke are the biggest concerns, Olcott said, because they are so common and the damage from delaying treatment can be so severe.

"We're assuring people not to be worried in the emergency room for using the system in the face of any of these conditions," Olcott said. Lesser matters, such as a sprain or a persistent cold or cough not accompanied by significant chest pain, are best treated at urgent care centers, he said.

Berthiaume said people may not want to think about being in a life-threatening situation.

"They may not want to admit that their lives could change forever," she said. But by delaying, they make matters worse.

Dennis Leahy, an interventional cardiologist at Palomar Medical Center in Escondido, said people can gauge the significance of their symptoms by taking into account their medical history.

For a 60-year-old male who is overweight and has a family history of heart disease, severe chest pains and shortness of breath should be considered a heart attack until proven otherwise, Olcott said. But in a 20-year-old man who has just completed a strenuous task, with no personal or family history of heart disease, those symptoms are probably harmless.

"You make it easier for us all if you came to us early," said Berthiaume, a registered nurse who was formerly a hospital coordinator at Palomar Medical Center.

Berthiaume helped Palomar comply with the heart association's Get With the Guidelines program to teach the most up-to-date medical-care methods for heart attack and stroke patients. Palomar Medical Center is the only hospital in San Diego or Riverside counties recognized for meeting the guidelines for two or more years. (MORE)

Expertise Essential for Coronary Intervention Without Surgical Backup - CME Teaching Brief® - MedPage Today

TEMPLE, Tex., Feb. 5 -- Only high-volume cardiac interventionalists with meticulous track records should consider performing percutaneous coronary procedures without onsite surgical backup, according to a consensus statement.

Without endorsing the use of such procedures without onsite surgical backup, the Society for Coronary Angiography and Interventions said that only cardiologists who perform a minimum of 100 interventions annually -- including at least 18 of them primary -- should be eligible to intervene without a surgical safety net.

Moreover, no cardiologists should begin working at such a facility until "they have a lifetime experience of more than 500 percutaneous coronary interventions as primary operator after completing fellowship."

Gregory J. Dehmer, M.D., of the Texas A & M School of Medicine, and SCAI president, said that by spelling out those requirements the society "has defined 'expert' interventionalist." Only experts, he said, should be working without a safety net.

The consensus statement was published in the February issue of Catheterization and Cardiovascular Interventions and a shorter version was published on the journal's website.
Although the SCAI statement sets forth minimum volume requirements, Dr. Dehmer said the statement gives equal emphasis to quality, noting that it recommends that free-standing percutaneous coronary intervention centers and interventionalists at those centers should also meet quality benchmarks. [MORE]

Hypertension During Pregnancy Linked to Later Heart Disease - CME Teaching Brief® - MedPage Today

Although hypertension during pregnancy usually subsides after delivery, a postmenopausal second act may await, found researchers here.

The postmenopausal course of women with a history of hypertension during pregnancy may be marked by coronary calcification and an increased risk of coronary artery disease, said Michiel Bots, M.D., Ph.D., of the Julius Center for Health Sciences and Primary Care here, and colleagues.

They found women with mild elevations of blood pressure from preeclampsia had a 57% increased risk of coronary calcification several decades later compared with women who were normotensive during pregnancy, they reported in the February issue of Hypertension.

"To the best of our knowledge, the present study is the first to show that a history of high blood pressure during pregnancy is related to coronary calcification later in life," they said.

Many women who have had preeclampsia exhibit the phenotype of the metabolic syndrome and impaired endothelial function three to 12 months postpartum, the researchers said. In addition, preeclampsia is associated with an increased risk of cardiovascular events and death later in life.

The findings of this study are in line with these observations, they said, and expand the evidence to an increased risk of atherosclerosis, a significant predictor of subsequent cardiovascular disease and total mortality.

The study population included 491 healthy postmenopausal women selected from participants enrolled in the PROSPECT study from 1993 to 1997. PROSPECT was one of two Dutch cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Information on high blood pressure during pregnancy was obtained by questionnaire. Of the women, 151 (30.7%) reported having had high blood pressure in pregnancy.

The high prevalence of hypertension was most likely the result of a definition of "hypertension during pregnancy" that included not only brief and modest elevations during pregnancy but also women with preeclampsia, the researchers said. Unfortunately, they added, blood pressure levels for women with nonproteinuric hypertension or mild elevations were not available. [MORE]

"PRESS RELEASE FROM JOHNS HOPKINS UNIVERSITY: CALL MADE FOR CHANGES IN WOMEN'S HEART DISEASE RISK-FACTOR LIST"
-- Family history and blood C-reactive protein should be added to traditional risk factors for all older women

Johns Hopkins cardiologists are calling for an expansion of the criteria widely used by physicians to detect and assess a postmenopausal woman's chances of developing cardiovascular disease, the leading cause of death among women in the United States.

In an editorial appearing in the Journal of the American Medical Association (JAMA) online Feb. 14, Roger Blumenthal, M.D., and colleagues say that a family history of heart disease and blood levels of a protein tied to vessel inflammation, C-reactive protein, should quickly be added to traditional assessments of women's risk of suffering a heart attack, stroke or severe chest pain (angina).

"Physicians should incorporate these factors into their testing and decision-making about which women are most likely to develop cardiovascular disease," says Blumenthal, an associate professor and director of the Ciccarone Preventive Cardiology Center at The Johns Hopkins University School of Medicine and its Heart Institute. "And physicians should intervene with lifestyle changes and drug treatment before symptoms start to appear," he adds. "Our best means of prevention is through early identification of those most at risk."

Blumenthal says these changes could help ameliorate the discrepancy between the death rate for men and women from cardiovascular disease, which has steadily declined for men over the last 20 years, but has remained relatively the same for women.

The new risk-factor list would strengthen existing assessment tools, including the Framingham Risk Estimate, which gauges how likely a person is to suffer a fatal or nonfatal heart attack within 10 years and calculates risk based on a summary score of such factors as age, blood pressure, cholesterol levels and smoking.

The Johns Hopkins experts base their editorial call on research conducted elsewhere and published in the same issue of JAMA, which looked at the predictive value of more than 35 risk factors not included in the Framingham score but reported to play a role in heart disease and stroke.

They found clear evidence that only family history and C-reactive protein, or hsCRP for short, had significant, additional predictive value in determining women really at moderate or high risk of future cardiovascular disease. The new method changed risk scores for at least 20 percent of the women studied.

"These are the best data yet to show how we should be assessing our female patients," says Blumenthal, whose own research showed in 2005 that the gold standard Framingham tool failed to identify approximately one-third of women over age 60 who had advanced hardening and narrowing of the arteries for their age and sex.

The latest findings are not surprising, the Johns Hopkins team says. Family history - where either a parent or a sibling suffered a coronary event - doubles a woman's own chances of arterial disease. High blood levels of C-reactive protein, in excess of 3 milligrams per liter, also double the risk. And the effects are multiplied if both factors are present, with a woman's risk rising almost fourfold.

Also in 2005, Blumenthal and his team suggested additional screening, using CT scans of the arteries and calcium scoring to better find women who would likely benefit from aspirin and statin therapy. Such additional tests, he says, should still be considered for those women with no symptoms and at least two traditional risk factors who are also undergoing lifelong drug therapy with aspirin and lipid-lowering drugs.

But, he notes, the latest analysis, which was funded by the Donald W. Reynolds Foundation, provides a thorough review of many potential risk factors and should be applied for all postmenopausal women. Results are available online at http://www.reynoldsriskscore.org/

Evaluation of the women in the current study included analysis of race, age, body mass index, menopause status, frequency of exercise, alcohol use, postmenopausal hormone use and dietary supplements of vitamin E, other multivitamins and aspirin. Blood factors studied were equally varied and included levels of homocysteine, creatinine, fibrinogen and hemogloblin A1C levels.

The information came from the U.S. Women's Health Study, which tracked for a decade more than 24,000 healthy women to see who developed coronary heart disease and who didn't. All women were over age 45.

"Our goal is to make heart attacks less likely to occur, and to do so by strongly considering therapies such as aspirin, cholesterol-lowering medications and, possibly, blood pressure medications for individuals at higher risk," says editorial co-author and cardiologist Erin Michos, M.D., a clinical fellow at Johns Hopkins.

In addition to researchers' call for change, Michos says that existing treatment guidelines, the 2001 National Cholesterol Education Program Adult Treatment Panel, which currently emphasize the Framingham score, should be revised to incorporate family history and hsCRP.

Assistance with the Johns Hopkins editorial was provided by Khurram Nasir, M.D., M.P.H.

Air Pollution Linked to Increased Cardiovascular Events and Death in Postmenopausal Women - CME Teaching Brief® - MedPage Today

Fine-particulate air pollution over time significantly increased the risk of first heart attack or stroke, as well as cardiac mortality, in postmenopausal women, researchers here reported.

Moreover, the risk increased as pollution worsened so that for every 10 µg per cubic meter increase in fine-particulate matter the risk of a cardiovascular event rose by 24% and the risk of death jumped by 76%, found Kristin A. Miller, M.S., of the University of Washington, and colleagues, in an observational study. (MORE...)

BREAKING NEWS: 18 MILLION U.S. MEN AFFECTED BY ER*CT*LE DYSFUNCTION - Lifestyle Changes Could Improve Male Sexu*l Function
(PRESS RELEASE FROM: Johns Hopkins University)

From: Johns Hopkins University
Date: February 1, 2007 3:00:00 AM MST
Johns Hopkins University Bloomberg School of Public Health
Office of Communications and Public Affairs

NOTE: Due to its subject matter, some words in this release have been edited to avoid its being captured by spam filters

FOR IMMEDIATE RELEASE
18 MILLION U.S. MEN AFFECTED BY ER*CT*LE DYSFUNCTION
- Lifestyle Changes Could Improve Male Sexu*l Function
More than 18 million men in the United States over age 20 are affected by er*ct*le dysfunction, according to a study by researchers from the Johns Hopkins Bloomberg School of Public Health.
The prevalence of er*ct*le dysfunction was strongly linked with age, cardiovascular disease, diabetes and a lack of physical activity. The findings also indicate that lifestyle changes, such as increased physical activity and measures to prevent cardiovascular disease and diabetes, may also prevent decreased er*ct*le function. The study is published in the Feb. 1, 2007, issue of the American Journal of Medicine.

"Physicians should be aggressive in screening and managing middle-aged and older patients for er*ct*le dysfunction, especially among patients with diabetes or hypertension," said Elizabeth Selvin, PhD, MPH, lead author of the study and a faculty member in the Bloomberg School of Public Health's Department of Epidemiology. "The associations of er*ct*le dysfunction with diabetes and cardiovascular risk factors may serve as powerful motivators for men who need to make changes in their diet and lifestyle."

For the study, the research team analyzed data from 2,126 men who participated in the National Health and Nutrition Examination Survey (NHANES). Men who reported being "sometimes able" or "never able" to get and keep an er*ct*on were categorized as having er*ct*le dysfunction, while men who reported being "always or almost always able" or "usually able" were not.

The overall prevalence of er*ct*le dysfunction among men in the United States was 18 percent. Men aged 70 and older were much more likely to report having er*ct*le dysfunction compared to only 5 percent in men between the ages of 20 and 40. Nearly half of all men in the study with diabetes also had er*ct*le dysfunction. And, almost 90 percent of all men with er*ct*le dysfunction had at least one risk factor for cardiovascular disease, including diabetes, hypertension, having poor cholesterol levels or being a current smoker. Men with er*ct*le dysfunction were also less likely to have engaged in vigorous physical activity within the month prior to participation in the study.

###
"Prevalence and Risk Factors for Er*ct*le Dysfunction in the U.S." was written by Elizabeth Selvin, PhD, MPH, Arthur L. Burnett, MD, and Elizabeth A. Platz, ScD, MPH. Selvin and Platz are with the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. Platz and Burnett are with the James Buchanan Brady Urological Institute at Johns Hopkins Hospital.

Unhappy Meals

Eat food. Not too much. Mostly plants.

That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy. I hate to give away the game right here at the beginning of a long essay, and I confess that I’m tempted to complicate matters in the interest of keeping things going for a few thousand more words. I’ll try to resist but will go ahead and add a couple more details to flesh out the advice. Like: A little meat won’t kill you, though it’s better approached as a side dish than as a main. And you’re much better off eating whole fresh foods than processed food products. That’s what I mean by the recommendation to eat “food.” Once, food was all you could eat, but today there are lots of other edible foodlike substances in the supermarket. These novel products of food science often come in packages festooned with health claims, which brings me to a related rule of thumb: if you’re concerned about your health, you should probably avoid food products that make health claims. Why? Because a health claim on a food product is a good indication that it’s not really food, and food is what you want to eat.

Uh-oh. Things are suddenly sounding a little more complicated, aren’t they? Sorry. But that’s how it goes as soon as you try to get to the bottom of the whole vexing question of food and health. Before long, a dense cloud bank of confusion moves in. Sooner or later, everything solid you thought you knew about the links between diet and health gets blown away in the gust of the latest study.

Last winter came the news that a low-fat diet, long believed to protect against breast cancer, may do no such thing — this from the monumental, federally financed Women’s Health Initiative, which has also found no link between a low-fat diet and rates of coronary disease. The year before we learned that dietary fiber might not, as we had been confidently told, help prevent colon cancer. Just last fall two prestigious studies on omega-3 fats published at the same time presented us with strikingly different conclusions. While the Institute of Medicine stated that “it is uncertain how much these omega-3s contribute to improving health” (and they might do the opposite if you get them from mercury-contaminated fish), a Harvard study declared that simply by eating a couple of servings of fish each week (or by downing enough fish oil), you could cut your risk of dying from a heart attack by more than a third — a stunningly hopeful piece of news. It’s no wonder that omega-3 fatty acids are poised to become the oat bran of 2007, as food scientists micro-encapsulate fish oil and algae oil and blast them into such formerly all-terrestrial foods as bread and tortillas, milk and yogurt and cheese, all of which will soon, you can be sure, sprout fishy new health claims. (Remember the rule?)

By now you’re probably registering the cognitive dissonance of the supermarket shopper or science-section reader, as well as some nostalgia for the simplicity and solidity of the first few sentences of this essay. Which I’m still prepared to defend against the shifting winds of nutritional science and food-industry marketing. But before I do that, it might be useful to figure out how we arrived at our present state of nutritional confusion and anxiety.

The story of how the most basic questions about what to eat ever got so complicated reveals a great deal about the institutional imperatives of the food industry, nutritional science and — ahem — journalism, three parties that stand to gain much from widespread confusion surrounding what is, after all, the most elemental question an omnivore confronts. Humans deciding what to eat without expert help — something they have been doing with notable success since coming down out of the trees — is seriously unprofitable if you’re a food company, distinctly risky if you’re a nutritionist and just plain boring if you’re a newspaper editor or journalist. (Or, for that matter, an eater. Who wants to hear, yet again, “Eat more fruits and vegetables”?) And so, like a large gray fog, a great Conspiracy of Confusion has gathered around the simplest questions of nutrition — much to the advantage of everybody involved. Except perhaps the ostensible beneficiary of all this nutritional expertise and advice: us, and our health and happiness as eaters.

FROM FOODS TO NUTRIENTS

It was in the 1980s that food began disappearing from the American supermarket, gradually to be replaced by “nutrients,” which are not the same thing. Where once the familiar names of recognizable comestibles — things like eggs or breakfast cereal or cookies — claimed pride of place on the brightly colored packages crowding the aisles, now new terms like “fiber” and “cholesterol” and “saturated fat” rose to large-type prominence. More important than mere foods, the presence or absence of these invisible substances was now generally believed to confer health benefits on their eaters. Foods by comparison were coarse, old-fashioned and decidedly unscientific things — who could say what was in them, really? But nutrients — those chemical compounds and minerals in foods that nutritionists have deemed important to health — gleamed with the promise of scientific certainty; eat more of the right ones, fewer of the wrong, and you would live longer and avoid chronic diseases. (CONTINUED): Unhappy Meals

100 percent juices found as beneficial to health as fruits and vegetables

When it comes to some of today’s health issues, 100 percent fruit and vegetable juices do help reduce risk factors related to certain diseases.

This conclusion is the result of a European study designed to question traditional thinking that 100 percent juices play a less significant role in reducing risk for both cancer and cardiovascular disease than whole fruits and vegetables.

Juices are comparable in their ability to reduce risk compared to their whole fruit/vegetable counterparts say several researchers in the United Kingdom who conducted the literature review. The researchers analyzed a variety of studies that looked at risk reduction attributed to the effects of both fiber and antioxidants. As a result, they determined that the positive impact fruits and vegetables offer come not from just the fiber but also from antioxidants which are present in both juice and the whole fruit and vegetables.

This 2006 review of the literature states, “When considering cancer and coronary heart disease prevention, there is no evidence that pure fruit and vegetable juices are less beneficial than whole fruit and vegetables.” The researchers add that the positioning of juices as being nutritionally inferior to whole fruits and vegetables in relationship to chronic disease development is “unjustified” and that policies which suggest otherwise about fruit and vegetable juices should be re-examined.

The researchers who authored the paper “Can pure fruit and vegetable juices protect against cancer and cardiovascular disease, too? A review of the evidence” suggest that more studies in certain area are needed to bolster their findings. The study was published in the International Journal of Food Science and Nutrition (2006).

“Although this independent review of the literature is not designed to focus on any particular 100 percent juice, it does go a long way in demonstrating that fruit and vegetable juices do play an important role in reducing the risk of various diseases, especially cancer and cardiovascular heart disease,” says Sue Taylor, RD, with the Juice Products Association, a non-profit organization not associated with this research. She adds that appropriate amounts of juices should be included in the diet of both children and adults, following guidelines established by leading health authorities.

Taylor also points to a large epidemiological study, published in the September 2006 issue of the Journal of Medicine, which found that consumption of a variety of 100 percent fruit and vegetable juices was associated with a reduced risk for Alzheimer’s disease. In fact, that study found that individuals who drank three or more servings of fruit and vegetable juices per week had a 76 percent lower risk of developing Alzheimer’s disease than those who drank juice less than once per week.

News - New Therapy to Treat Patients With Severely Elevated Cholesterol Levels
PHILADELPHIA, PA -- January 11, 2007 -- Researchers at the University of Pennsylvania School of Medicine have demonstrated the potential of a new type of therapy for patients who suffer from high cholesterol levels.

The findings are in the January 11 issue of the New England Journal of Medicine (NEJM). In this study, patients with homozygous familial hypercholesterolemia (FH), a high-risk condition refractory to conventional therapy, had a remarkable 51% reduction in low-density lipoprotein (LDL) or "bad cholesterol" levels.

"Our study shows that targeted inhibition of the microsomal triglyceride transfer protein (MTP) is highly effective in reducing cholesterol levels in these very high risk patients," stated Daniel J. Rader, MD, Director of Preventive Cardiology and the Clinical and Translational Research Center at Penn, and principal investigator of this study. "Furthermore, there are many other patients who have cholesterol levels that are difficult to treat or who are not tolerant to treatment with statins. New therapies are required for these patients as well, and it is possible that after further research MTP inhibition could eventually be used for such patients."

Genetic defects in MTP lead to profoundly low levels of LDL. Using this information, Bristol-Myers Squibb began to search for inhibitors of this protein and discovered the study drug, originally known as BMS-201038. Bristol-Myers Squibb then donated it to Penn for use in clinical trials in patients with severe cholesterol problems. Rader and his team at Penn designed and carried out the current study in homozygous FH patients with support from the Doris Duke Charitable Foundation. Due to the success in this study, Penn has licensed the drug to Aegerion Pharmaceuticals Inc for further development as AEGR-733.

Patients who suffer from homozygous FH typically respond poorly to standard drug therapy and have a very high risk of premature cardiovascular disease.

Homozygous FH is caused by loss-of-function mutations in both alleles of the LDL receptor gene. It is a rare form of hypercholesterolemia affecting approximately one in every million people. Patients with this disorder typically have plasma cholesterol levels of more than 500 mg per deciliter. If untreated, patients develop cardiovascular disease before they are 20-years-old and generally do not live past the age of 30. Because existing cholesterol lowering drugs are relatively ineffective in this patient population, new therapies to reduce LDL levels are needed.

In this study, researchers conducted a dose-escalation study to examine the safety, tolerability and effects on lipid levels of an inhibitor of MTP in six patients with homozygous FH. Patients received the MTP inhibitor at four different doses, each for four weeks, and returned for a final visit after an additional four-week drug washout period. Analysis of lipid levels, safety laboratory analyses, and magnetic resonance imaging of the liver for hepatic fat content were performed throughout the study.

All patients tolerated titration to the highest dose studied. In addition to the 51% reduction in LDL cholesterol, treatment at this dose also decreased total cholesterol levels by 58%, triglyceride levels by 65% and apolipoprotein B levels by 56% from baseline. In contrast to statin drugs, which have relatively little effect on cholesterol levels in homozygous FH patients, the MTP inhibitor was shown to reduce the liver's ability to produce LDL. The most notable adverse events in the study were loose stools and elevation of liver transaminase levels and accumulation of hepatic fat in some but not all of the patients studied.

Rader concluded, "Although our study establishes proof of concept, a longer-term study in more patients will be required to determine the benefits and risks of this approach as a potential new therapy for homozygous familial hypercholesterolemia." Marina Cuchel, MD, PhD, a co-investigator in this study at Penn, is now the principal investigator of a Phase III study for this compound in homozygous FH patients that is funded by the U.S. Food and Drug Administration Orphan Drug program and planned for later this year.

Rader points out that this study is a superb example of "translational research" in which discoveries in basic science are "translated" into use in humans for the development of novel therapies. Rader is an internationally recognized leader in translational research in the areas of cholesterol metabolism and heart disease prevention. Penn recently created a new Cardiovascular Institute that is charged with promoting translational research in the diagnosis, treatment, and prevention of cardiovascular disease. Additionally, Penn was recently awarded a large NIH grant to foster the further development of translational research under the auspices of the newly created Institute for Translational Medicine and Therapeutics.

The results of this study are in The New England Journal of Medicine (http://content.nejm.org). The article is titled "Inhibition of Microsomal Triglyceride Transfer Protein in Homozygous Familial Hypercholesterolemia."

Healthy Fats For Life Will Help You To Understand The Difference Between 'Good' Fats And 'Bad' Fats: "Research and Markets (http://www.researchandmarkets.com/reports/c47485) has announced the addition of 'Healthy Fats for Life: Preventing and Treating Common Health Problems with Essential Fatty Acids, 2nd Edition: Revised and Updated' to their offering.

You CAN eat fat and be healthy!

For years we have been told that 'fat' is bad for us. But the low- fat and no- fat- diets designed to improve our health have instead created an overweight society with skyrocketing rates of heart disease and diabetes. Recent scientific research has shown that certain types of essential fatty acids (EFAs) -- healthy fats -- improve immune and hormone functions, and play a vital role in treating all forms of degenerative disease, including cancer.

Healthy Fats for Life will help you to understand the difference between 'good' fats and 'bad' fats, while providing a simple plan for obtaining essential fats to reach optimum health. Learn how to:

-- reduce your weight

-- lower your cholesterol

-- control your diabetes

-- prevent heart disease

-- reduce the risk of cancer

-- improve brain function

-- develop stronger bones

-- increase your longevity

-- eliminate arthritis symptoms

-- protect the prostate

-- improve fertility

-- give birth to a healthier baby

You will discover the important role of essential fatty acids for health and learn how to easily incorporate them into your diet to reduce the risks of disease.

About the author

Lorna Vanderhaeghe is a medical journalist who has been researching and writing on the subject of nutritional medicine for over 20 years. Her list of accomplishments include: working at the Journal of Orthomolecular Medicine at the Canadian Schizophrenia Foundation; past editor- in- chief of Healthy Living Guide; senior editor of the Encyclopaedia of Natural Healing (winner of the prestigious Benjamin Franklin Award in 1998). She is currently an associate editor for Total Health magazine in the United States and alive magazine in Canada. Lorna is co- author of the award winning and bestselling book The Immune System Cure, now published in six countries, and translated into French, Dutch and German, and author of the Canadian bestseller Healthy Immunity: Scientifically Proven Natural Treatments for Conditions from A- Z, released in September 2001. Her most recent co- authored book, No More HRT: Menopause Treat the Cause, was released in September 2002. An internationally- known lecturer, she believes in empowering people with health knowledge so they can achieve optimal wellness.

"

APP.COM - Shape-up Santa! CLICK FOR MORE: "Sure, Santa Claus has some attributes in his health's favor. His jolly, ho-ho-ho attitude indicates good mental health, despite living at the North Pole, which is plunged into darkness this time of year.

His longtime marriage to Mrs. Claus is a plus, because married men tend to live longer than single men.

He doesn't seem to be a high-strung, Type A personality. He must delegate well to his elves.

Keeping track of who's been naughty, who's been nice and what's on everyone's wish lists is a good intellectual challenge to ward off dementia.

Traveling by reindeer-pulled sleigh keeps him off the roads and away from car exhaust, which is a health benefit.

But that plump belly?

Very risky.

Asked about Santa's health, physicians, exercise and diet specialists all said that if Santa was their patient, they'd be concerned.

A man whose waistline is 40 inches or larger is more likely to develop heart disease, stroke and diabetes.

The experts encourage Santa to get out and play with the reindeer in the snow. Take walks through the toy workshop. Put on some music and get dancing with Mrs. Claus..."

Power of Hallucinogenic Mushrooms Revealed: "Power of Hallucinogenic Mushrooms Revealed

Call it a 'shroom with a view: Researchers at Johns Hopkins University found that people who took psilocybin, the active ingredient in hallucinogenic mushrooms, ranked the experience as one of the most meaningful experiences in their life. This is the first detailed examination of the psychological impact of psilocybin since the late 1960s, when hallucinogens came under regulatory scrutiny.

Roland Griffiths and his colleagues worked with 36 subjects who had never taken hallucinogens before, but all reported at least intermittent participation in religious or spiritual activities such as church services, prayer, or meditation. In two or three 8-hour sessions, with two months in between each session, the volunteers were given either psilocybin or Ritalin. Seven hours later, and again months afterward, they completed questionnaires about their experience. More than 60 percent of the subjects who received psilocybin had what they described as a 'complete mystical experience.' Only 11 percent of the placebo group did. Two months later, 71 percent recalled it as one of the five most spiritually significant events in their lives..."

The Top 13 Medicine Stories of 2006 CLICK FOR MORE: "Every year, like clockwork, DISCOVER digs through reams of newspapers and gigabytes of Web sites to find the 100 most important and interesting science stories of the year. We're unveiling the top stories from 2006 over the next couple of weeks, one subject at a time. Here's the whole list (only subscribers get access to the whole special package immediately).

Tissue Engineering Triumph: Lab-Grown Bladders
Artificial bladders can be grown from a patient's own cells and successfully implanted...

Fast-Food Fats Prove Health Hazard
Small daily amounts of trans fats cause weight gain, atherosclerosis, and insulin resistance...

Drugs Aim to Silence Bad Genes
RNA interference helped launch an entirely new class of drugs into trials...

World Trade Center Fallout Fails Health Test
A report revealed widespread, persistent respiratory illness among rescue and recovery workers...

Mouse Breast Grown in Lab
To make a breast, all you need is a single cell...

Bird Flu Risk Explained
The deep infection makes it difficult to spread the avian flu virus...

First Face Transplant
Attaching the nose, chin, cheeks, and lips of a 46-year-old brain-dead woman...

New HIV Drugs
Three new categories of anti-HIV drugs are in the pipeline...

British Clinical Drug Trial Goes Spectacularly Awry
Six of the test subjects wound up with massive organ failure...

Stem Cells Reverse Parkinson's in Rats
Embryonic stem cells helped rats suffering from Parkinson's-like symptoms...

Power of Hallucinogenic Mushrooms Revealed
People who tripped ranked the experience as one of the most meaningful in their life...

Low-Fat Diet A Bust?
Cutting fat from the diet doesn't significantly reduce the incidence of breast or colorectal cancer, heart disease, or stroke...

Fat Vaccine Works in Rats
In August, immunologist Kim Janda grabbed headlines with reports of a vaccine against obesity...
Tissue Engineering Triumph: Lab-Grown Bladders

On April 15, the British medical journal The Lancet carried a landmark article showing that it is now possible to engineer a complex organ to replace one ravaged by disease. Anthony Atala, a surgeon and director of the Institute for Regenerative Medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina, reported that artificial bladders can be grown in the lab from a patient's own cells and successfully implanted. Over the past six years, seven children have received the organs, which are functioning well..."

Yoga for Everyone CLICK FOR MORE: "
Yoga for Everyone
Tone your body, improve your flexibility and de-stress your mind with these simple moves

Why is yoga so popular these days? It's much more than just a trend. People of all shapes, sizes, ages and fitness levels are catching on to the many benefits of this ancient practice. Yoga can tone and strengthen your body and improve your flexibility and posture. It can get you energized for a busy day or help you decompress and clear your mind after a long, stressful one.

Yoga isn't about competing with yourself or anyone else—it's about tuning in to your body and modifying the moves to fit your needs. Whether you take five minutes to try just one of these moves or do a full series, you'll be doing your body and brain a favor. So start stretching and have fun!

• Getting started: To do these moves you'll need comfortable clothes (elastic or drawstring waistbands are best) and bare feet. If you don't have an exercise mat, you can do the standing poses on the floor and the seated and reclining poses on a rug or blanket. You may also want to keep a sturdy blanket, a phone book or dictionary, plus a belt or one of your husband's old ties, handy. These props can be helpful if you find that you are unable to stretch fully into a pose."

Study says new blood tests are no better than the old methods for predicting heart attacks CLICK FOR MORE: "New blood tests that doctors hoped would more accurately predict which patients are headed for a heart attack or stroke are no better than cholesterol levels, blood pressure and other conventional measurements, a study found.

Doctors in recent years had become excited over substances in the blood that appeared to be powerful new predictors of a heart attack. These substances included C-reactive protein, or CRP; homocysteine; and BNP, or B-type natriuretic peptide.

An increasing number of family doctors have been ordering expensive tests for these substances, and some patients have started requesting them, in hopes of identifying people who do not have the standard risk factors but are still likely to suffer a heart attack or stroke.

But the new research, by scientists at the highly regarded Framingham Heart Study, found that tests of CRP, BNP, homocysteine and seven other substances are only a couple of percentage points better at predicting outcomes than the standard, commonsense risk factors that doctors have known for decades."

New heart disease markers no better than old: study� CLICK FOR MORE: "Sophisticated screening tests are no better at predicting life-threatening heart problems than simple old-fashioned risk factors such as diabetes, high blood pressure and cholesterol, a study showed on Wednesday.

Thomas Wang of the Massachusetts General Hospital and his colleagues looked at 10 'biomarkers' that try to evaluate risk for heart disease, including C-reactive protein and homocysteine.

Their conclusion to be published in Thursday's New England Journal of Medicine: don't bother.

'The traditional risk factors that have stood the test of time turn out to be the best evaluation of risk,' Wang told Reuters.

He said some of the tests have other functions in medicine and might help doctors better understand heart disease.

But when it comes to using them to routinely test patients to assess their risk, 'there doesn't seem to be a role for keeping these biomarkers,' he said.

The conclusion is based on the longtime Framingham Heart Study in Massachusetts in which 3,209 participants were followed for up to 10 years to see if any of the markers could foretell who would have a heart attack, stroke, or heart failure..."

New heart disease markers no better than old: study� CLICK FOR MORE: "Sophisticated screening tests are no better at predicting life-threatening heart problems than simple old-fashioned risk factors such as diabetes, high blood pressure and cholesterol, a study showed on Wednesday.

Thomas Wang of the Massachusetts General Hospital and his colleagues looked at 10 'biomarkers' that try to evaluate risk for heart disease, including C-reactive protein and homocysteine.

Their conclusion to be published in Thursday's New England Journal of Medicine: don't bother.

'The traditional risk factors that have stood the test of time turn out to be the best evaluation of risk,' Wang told Reuters.

He said some of the tests have other functions in medicine and might help doctors better understand heart disease.

But when it comes to using them to routinely test patients to assess their risk, 'there doesn't seem to be a role for keeping these biomarkers,' he said.

The conclusion is based on the longtime Framingham Heart Study in Massachusetts in which 3,209 participants were followed for up to 10 years to see if any of the markers could foretell who would have a heart attack, stroke, or heart failure..."

Shock Waves Can Save Hearts: "Extracorporeal cardiac shock wave therapy sounds like something Capt. Picard might need after a run-in with the Borg. But it's actually a new, real-life way to treat end-stage heart disease.
A team of Japanese researchers found that blasting the heart with shock waves helps patients grow new blood vessels and increase blood flow.
Coronary artery disease -- a leading cause of death in men and women in the United States -- happens when plaque builds up in blood vessels, blocking the flow of oxygenated blood to the heart muscle. Medication, angioplasty or bypass surgery can sometimes treat the disease. But when these approaches aren't enough, the only hope is to grow new blood vessels. Gene and cell therapies can also engender new blood vessels, but those procedures require surgery, which is risky for elderly or severely sick patients..."

Over 40, female and fat around the middle? Beware your risk for diabetes or heart disease CLICK FOR MORE: "Getting fatter around the middle? Have a family history of heart disease or diabetes? You could be headed for the same trouble, especially if you're over 40 and female.
There are no obvious symptoms from high blood sugar or the condition called insulin resistance, so few people realize it is creeping up and putting them on the path to diabetes, heart disease or both.
But insulin resistance, a type of pre-diabetes, is a growing national problem: Some experts believe half of all overweight or obese American adults are insulin-resistant.
Yet, even many women with a family history of heart disease or diabetes don't know they need to eat a healthier diet and get more exercise to avoid those problems -- two of the nation's top killers.
'We think this is a very important new issue for women,' said Audrey Sheppard, chief executive of the National Women's Health Resource Center. 'There's very little awareness..."

Jumping for American Heart Association CLICK FOR MORE: "Heart disease is the number one killer in America today. But there's good news. Research shows that the habits and choices developed in childhood influence whether or not a person develops heart disease later in life. Reducing the risk of many forms of heart disease can be easy.

Students at the Fort Stockton Intermediate School participated in 'Jump Rope for Heart.' They experience the fun of jumping rope and the joy of physical activity. That's a positive message that can bring a lifetime of benefits. 'Jump Rope for Heart' supports the American Heart Association's fight against heart disease and stroke.
The funds the students raised will be used for cardiovascular research, as well as educational programs and materials that teach our children how to help prevent these diseases. For the 2006/2007 school year, Intermediate students collected a total of $1747.15. Total money collected for the past 17 years has been $40,986.48..."