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The Battle Against Heart Disease and Stroke Mortality is Being Won

But risk factors continue to rise.

   Mortality rates from heart disease and stroke have fallen dramatically in this country but the risk factors and prevalence of these diseases remain high, making prevention more important than ever.
   The latest heart disease and stroke statistics from the Journal of the American Heart Association show that the death rate from cardiovascular diseases went down 27.8 percent in 1997 to 2007 and the death rate from stroke fell 44.8 percent during that time. However, the cost of impatient heart operations and procedures went up by 27 percent making it the most expensive disease to treat in the U.S. at $286 billion, surpassing cancer and benign tumors at $228 billion.

The American Heart Association cites some troubling statistics of heart disease and stroke risk factors:

•    33.5 percent of adults 20 years and older have high blood pressure.

•    23.1 percent of men and 18.1 percent of women are
cigarette smokers.

•   15 percent of adults 20 and older have cholesterol levels of 240mg/dL or higher.

•    36.8 percent of adults have prediabetes; 8 percent have diabetes mellitus.

•    More than 67 percent of adults are overweight.

   Researchers around the world continue to make new discoveries and advances in the battle against heart disease and stroke. We compiled some fascinating new breakthroughs:

Solo Living
     Living alone could be hazardous to your heart, especially for men. The Journal of Epidemiology and Community Health reported a study of over 138,000 adults, ages 30 to 69 living in Denmark. Lone women accounted for a third of all deaths and men accounted for two-thirds of the deaths from acute coronary syndrome. Low educa-tion levels and living on a pension increased risk.

The Depression Link
   People who suffer from both heart disease and depression triple their risk of dying from all causes, but quadruple the risk of dying from a heart attack or stroke according to a report from Heart. The report emphasized the need to pay more attention to depression in cardiac patients. Another study by the AHA said that heart patients are particularly vulnerable to depression and should be screened and treated, as depression is linked with increased morbidity and mortality and lower rates of cardiac rehabilitation. Depression was shown to be approximately three times more common in people with heart disease then in the population as a whole.

Rheumatoid Arthritis and Heart Attack Risk
   Rheumatoid arthritis increases the risk of heart attack by 60 percent just a year after diagnosis according to Swedish researchers and published in the Journal of Internal Medicine. However, an international team of researchers led by Antonio Naranjo of the University of Las Palmas de Gran Canaria, Spain, and colleagues in Argentina, Europe and the U.S. found that taking methotrexate, the most popular disease-modifying anti-rheumatoid arthritis drug, could reduce the risk of heart attack by 18 percent and reduce the risk of stroke by 11 percent.

Stem Cell Sutures
   The Journal of Biomedical Materials Research reported that a research team at Worcester Polytechnic Institute is working on a new technology where surgeons could deliver stems cells to targeted areas of the body, including damaged cardiac muscle by bundling biopolymer microthreads into biological sutures and then seeding the sutures with stem cells. Adult bone marrow-derived stem cells will multiply while attached to the threads and grow into other cell types.

Heparin Helps
    A Cochrane Systematic Review showed that giving heparin to people with certain heart conditions reduces the risk of having another heart attack compared to those on placebos.

Ending Tobacco Dependence
   According to PLoS Medicine–a study from the Massachusetts Tobacco Cessation and Prevention Program, Massachusetts General Hospital, and Harvard Medical School—showed that the use of tobacco cessation medication led to lower hospital admissions of 46 percent for heart attacks and 49 percent annually for people with coronary atherosclerosis.

Anti-Smoking Legislation
    Canadian researchers found that anti-smoking legislation resulted in a decrease in hospital admissions of 39 percent for cardiovascular conditions and by 33 percent for respiratory conditions. The largest decline in hospitals admissions came after the 2001 ban of smoking in restaurants. According to the study published in the Canadian Medical Association Journal, second-hand smoke is the third leading cause of preventable poor health and premature death in the developed
world and about one billion people are esti
mate to die in the 21st century from a tobacco-related disease.

Non-Smokers and Hospital Admissions
    In New Zealand, a workplace smoking ban reduced hospital admissions for heart attacks by 9 percent for men and women aged 55-74. For 55-74 year olds who never smoked, the reduction rose to 13 percent according to a study published in the Australian and New Zealand Journal of Public Health.

Time is Crucial
   Heart attack patients need to be treated as soon as possible to cut their risk of fatality according to a paper published on the British Medical Journal website. Balloon angioplasties should be performed even sooner than the current target, which is within 90 minutes of hospital admission, in order to further reduce deaths by heart attacks.

 A Protein Recognizes Heart Disease
    The Journal of the American Medical Association reported that a new, highly sensitive test for the protein cardiac troponin T (cTnT) could show if a healthy middle-aged person has unrecognized heart disease. People with detectable levels of the protein were nearly seven times more likely to die within six years from heart disease.

Recognizing the Severity of Heart Attacks
    Doctors may be misjudging the risk of a further heart attacks in patients after being discharged from the hospital according to an international study led by the University of Edinburgh and published in Nature Clinical Practice. The study showed that two-thirds of adverse events such as a further heart attack or major bleed happen after a patient is discharged from the hospital. Patients who have had heart attacks not considered as severe may not be receiving stents to open up the artery, drug treatments or lifestyle changes.

Education and Heart Failure
    The European Heart Journal published
a study of education on the incidence of cardiovascular heart failure in Copenhagen on 18,616 patients in four different groups and followed up on the patients 21 years later. While there was no association found for mild cardiac dysfunction, there were significant associations after adjustment for potential mediating factors. This large study suggested that the poorly educated were more likely to be admitted to the hospital with chronic heart failure than those who had more education. Stress must be taken into account. The researchers wrote that there have to be more strategies to reduce the inequality in risk.

Published: February 11, 2011
Issue: February 2011 Heart Health Issue