HIV Drugs May Help Protect Young Patients' Hearts: Study

Far from harming the cardiovascular health of infected children, drug cocktails may give benefit

By Robert Preidt

HealthDay Reporter

MONDAY, April 22 (HealthDay News) -- Long-term use of powerful drug cocktails known as highly active antiretroviral therapy (HAART) may help protect the hearts of children and teens infected with HIV, a new study reports.

HAART is a form of antiretroviral therapy that is widely used to treat people with HIV, the virus that causes AIDS. Prior to the introduction of antiretroviral therapies, youngsters infected with HIV were at increased risk for heart failure, noted a team led by Dr. Steven Lipshultz of the University of Miami Miller School of Medicine.

Since the advent of powerful HIV-suppressing medications, "the effects of HIV and [antiretroviral therapy] on the cardiovascular system of HIV-infected children are not completely understood," the researchers wrote in the April 22 online issue of JAMA Pediatrics. They pointed out that such children are exposed to these drugs for many years, often beginning while they are still in the womb, but the effects on their cardiovascular systems "are unknown."

The new study sought to clear that up. It included nearly 600 HIV-infected and uninfected patients from 14 pediatric HIV clinics across the United States.

According to the team, heart function was better among HIV-infected children receiving HAART than those who were infected with HIV and did not receive HAART, and children who were exposed to HIV but not infected.

"Our results indicate that the current use of combination [antiretroviral therapy], usually HAART, appears to be cardioprotective in HIV-infected children and adolescents," the study authors reported. "This finding is even more relevant in the developing world where the prevalence of HIV disease in children is much higher."

The researchers added that further study comparing different drug regimens might be beneficial "in optimizing HIV outcomes and protecting long-term cardiac health" of children with HIV.

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A dog could be your heart’s best friend

Posted May 22, 2013, 11:14 am

My twice-daily walks with my border collie, Clair DeNoon, are the highlights of my day. A new report from the American Heart Association will put an extra spring in my steps on these walks. It turns out that having a canine companion may help lower my risk of heart disease.

Studies linking pet ownership to better physical and mental health have been popping up for decades. The findings were usually encouraging to pet owners, but none of these studies offered conclusive proof. Although that’s still lacking, a panel of experts from the American Heart Association (AHA) has weighed all the available evidence. The verdict: Having a pet—a dog in particular—likely lowers the risk of heart disease. Why?

“People who have dogs live longer than people who have cats, and the assumption has been that dogs naturally cause their owners to be more active,” suggests Dr. Thomas Lee, Co-Editor in Chief of the Harvard Heart Letter. “The emotional benefits of having an affectionate creature are also one of the theories for why dog-lovers live longer.”

The evidence reviewed by the AHA indicates that dog owners are more likely to exercise, have a better cholesterol profile, have lower blood pressure, be less vulnerable to the physical effects of stress, and be more likely to survive a heart attack.

Or it could be the other way around, points out Dr. Lee, a cardiologist and a professor of medicine at Harvard Medical School. It’s possible that healthier people—or those who are making the kinds of lifestyle changes that reduce heart risk—are more likely to have a dog than are people in frail health.

The AHA panel could not rule out this possibility. It admitted it can’t tell whether owning a dog causes heart health or is merely a marker for people more likely to have healthy hearts.

Even so, the panel’s cautious recommendation favors dogs: “Pet ownership, particularly dog ownership, may be reasonable for reduction in cardiovascular disease risk.” The statement on pet ownership was published online in the journal Circulation.

Clair DeNoon

If it were just about companionship, maybe dogs wouldn’t beat cats. But while the data show that dog owners get more physical activity than people who don’t own dogs, the evidence is pretty convincing that ownership isn’t enough. A 2008 study of 2,199 people found that those who owned a dog but didn’t walk it were actually more likely to be obese than people who didn’t own a dog. Dog walkers, on the other hand, were much less likely to be obese – although they were no less likely to be overweight than their petless peers.

But it’s not all about physical activity. A 2001 study looked at 48 people with high blood pressure and high-stress jobs who agreed to adopt a dog or a cat if so asked. Half did, and six months later those who got a dog or cat had significantly lower blood pressure when stressed.

Getting a dog also seems to help even if you already have heart disease. A 1995 study followed 369 people with cardiovascular disease. A year later, those who owned a dog were four times more likely to be alive than those who didn’t have a dog. Cats, however, did not improve their owners’ odds of survival.

If dog ownership is heart healthy, should everyone who cares about heart health have a dog?

No. According to the AHA panel, “the primary purpose of adopting, rescuing, or purchasing a pet should not be to achieve a reduction in cardiovascular risk.”

The mere act of getting a dog is no substitute for a plan to get regular physical activity, to eat a heart-healthy diet, and to get regular medical care. That said, dogs do seem to be good for your heart in many ways.

“Loneliness can’t be a good thing, either from a cardiovascular or a psychological perspective,” Dr. Lee notes. “I am not going to be prescribing dogs for patients with heart disease, but I certainly won’t discourage them—even if they consider themselves fairly limited by their medical problems.

So I say “Good dog!” C’mon, Claire DeNoon—let’s go for a walk.

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Heart Failure Drug May Only Help Heart's Function, Not Symptoms

By Amy Norton

HealthDay Reporter

TUESDAY, Feb. 26 (HealthDay News) -- A drug often used to treat chronic heart failure may not ease symptoms in people with one form of the disease, a new study suggests.

The medication, called spironolactone (Aldactone), failed to improve symptoms or quality of life among 422 patients with diastolic heart failure -- a form of the disease that affects about half of all people with heart failure.

The drug did, however, benefit the structure and function of patients' hearts. And experts said it's too early to know what to make of the results, which appear in the Feb. 27 issue of the Journal of the American Medical Association.

"It would be premature to say this is not beneficial," said Dr. Sanjiv Shah, a cardiologist at Northwestern University Feinberg School of Medicine, in Chicago, who was not involved in the study.

Shah is involved in an ongoing study of spironolactone's effects in people with diastolic heart failure. And that trial is focusing on the big questions: Can the drug prevent or delay hospitalizations, or prolong people's lives?

Spironolactone is in a class of drugs called aldosterone receptor antagonists. They cause the kidneys to eliminate excess water and sodium from the body, so they can lower blood pressure and get rid of fluid build-up in some people with heart failure.

And studies have shown that spironolactone can extend the lives of some heart failure patients -- namely, those with a low "ejection fraction." That means the percentage of blood pushed out by the heart with each contraction is abnormally low.

The problem is that heart failure is "heterogeneous," according to Shah, who described it as a "syndrome" -- or a collection of signs and symptoms -- rather than a disease. So a treatment that works for some patients may not work as well for others.

In general, heart failure is a chronic condition where the heart does not pump blood efficiently enough to meet the body's needs. That causes symptoms such as fatigue, breathlessness and fluid build-up in the legs and feet.

In systolic heart failure, the heart's left ventricle (the main pumping chamber) cannot contract strongly enough, and many people with this form of heart failure have a reduced ejection fraction.

In the diastolic form, the left ventricle doesn't relax enough between contractions, which means it cannot fill up with as much blood as it should. But the heart's ejection fraction is actually normal.

Diastolic heart failure is trickier to diagnose, and doctors know less about how to best treat it, said Dr. John Cleland, a cardiologist at Hull York Medical School in Kingston-upon-Hull, England, who co-wrote an editorial published with the study.

He agreed that it's too soon to draw conclusions from the current findings, and that doctors will know more when Shah's study results are in.

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Injected 'Hydrogel' May Help Repair Failing Hearts

Title: Injected 'Hydrogel' May Help Repair Failing Hearts
Category: Health News
Created: 2/20/2013 2:35:00 PM
Last Editorial Review: 2/21/2013 12:00:00 AM

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Healthy Diet Helps Damaged Hearts

ByJennifer Warner
WebMD Health News Reviewed byLouise Chang, MD

Dec. 5, 2012 -- It’s never too late to start reaping the benefits of a heart-healthy diet.

A new study shows older people with established heart disease who ate the most heart-healthy diet rich in fruits, vegetables, fish, and nuts had a much lower risk of dying or having another heart attack or stroke than those who ate the unhealthiest diet.

The study shows people who ate the most heart-healthy diet had a:

35% lower risk of heart or stroke-related death 14% lower risk of heart attack 28% lower risk of heart failure 19% lower risk of stroke

“It doesn’t matter what type of medication you take, if you follow a healthy diet you will get benefits,” says researcher Mahshid Dehghan, PhD, research associate at McMaster University in Hamilton, Ontario, Canada. “Eating fruits and vegetables substantially reduces cardiovascular disease recurrence over and above medication alone.”

Researchers say it’s the first large, international study to show eating a heart-healthy diet can help prevent another heart attack and stroke in people already on medications to treat high blood pressure and unhealthy cholesterol levels.

24 Foods That Can Save Your Heart

Healthy Diet Better Than Drugs Alone

The study followed 31,546 adults ages 55 and older in 14 countries who were enrolled in two separate clinical trials of blood pressure-lowering medications. All of the people had a history of heart disease, stroke, peripheral arterial disease, or diabetes with organ damage. All of them were considered at high risk for heart attack, stroke, or other heart-related complication.

Researchers asked them about how often they ate foods like fruits, vegetables, grains, fish, meat, poultry, and dairy products in the past 12 months.

Diets were given an overall heart-healthy score based on how frequently people ate healthy foods like fruits and vegetables. Higher scores were also given to diets that included a higher amount of fish relative to meat, poultry, and eggs and those that included whole grains and fewer deep-fried foods.

During nearly five years of follow-up, 5,190 heart- or stroke-related problems were reported in the study.

The results showed those who ate the most heart-healthy diets had lower risk of heart disease, stroke, or death due to either condition compared to those who ate the most unhealthy diets, regardless of the type or combination of heart medications they took or their nationality, income level, age, or other heart disease risk factors.

Experts say many studies have already proven the benefits of eating a heart-healthy diet in preventing heart disease in healthy people.

But this study is noteworthy because it is the first major, international study to show heart-healthy diets also benefit those who are already on medication for existing heart disease.

Heart-Healthy Diet Changes

Dehghan says many people with heart disease may be under the mistaken impression that taking their medication is enough to reduce their risk.

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