Costlier Heart Device May Not Be Worth It, Study Suggests

Dual-chamber implanted defibrillators had more complications than single-chamber models

By Brenda Goodman

HealthDay Reporter

TUESDAY, May 14 (HealthDay News) -- Patients prone to dangerously fast heart rhythms may get just as much help and have fewer complications with less-expensive implanted defibrillators that run one wire to the heart instead of two, a new study shows.

Implantable cardioverter defibrillators, or ICDs, are like having an emergency "crash cart" in the chest. The devices can sense runaway heart rhythms and deliver powerful shocks to jolt the heart back to a normal, steady pace.

Studies have shown that the devices cut deaths in patients at risk for sudden cardiac arrest because their heart muscles are too weak to effectively pump blood throughout the body, a condition called cardiomyopathy.

But little evidence exists to help doctors decide when it's better to choose a single-chambered ICD for patients or the more complex dual-chambered model.

The study, published in the May 15 issue of the Journal of the American Medical Association, compared the fates of more than 32,000 Medicare patients who received ICDs, from 2006 through 2009. None of the patients also needed a pacemaker, a device that speeds up a slow heartbeat.

"There is evidence for greater risk of complications. Not clear evidence of benefit. That risk-benefit ratio really doesn't support the routine use of dual-chamber devices for primary prevention," said study co-author Dr. Pamela Peterson, an associate professor of medicine at the University of Colorado at Denver.

About one-third of patients received a single-chamber ICD, in which an electrical lead is attached to the heart's lower right pumping chamber. The other two-thirds got dual-chamber devices, in which wires are attached to the upper and lower chambers of the heart's right side.

After a year, patients who got single-chamber ICDs were no more likely to die or be hospitalized than patients who got the more expensive dual-chamber models. They were, however, slightly less likely to face serious complications, including fluid build-up around the heart or lungs and mechanical problems with the device that required a second surgery to fix.

That was true even after researchers adjusted their results to control for any differences between patients who got single- and dual-chamber devices.

Overall, close to 4 percent of patients with single-chamber ICDs had complications with their devices compared to about 5 percent of patients with dual-chamber models, the investigators found.

The study was observational, which means researchers couldn't prove that the type of ICD was the only reason patients fared the way they did. Though they tried to carefully control their data for important differences between the two groups, other factors they couldn't measure, such as medications people were taking, may have influenced the results.

The study was funded by a grant from the U.S. Agency for Healthcare Research and Quality.

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Hysterectomy May Not Raise Heart Risks After All: Study

Finding might reassure women considering the procedure, researcher says

By Steven Reinberg

HealthDay Reporter

TUESDAY, May 14 (HealthDay News) -- Women who have a hysterectomy are not in danger of increasing their risk of cardiovascular disease later in life, a new study says.

Although earlier research had found higher chances of cardiovascular disease in the years following a hysterectomy, different criteria were used in this latest study, the researchers noted.

"If women are contemplating hysterectomy, they don't need to be worried about increased cardiovascular risk," said study author Karen Matthews, a professor of epidemiology and psychology at the University of Pittsburgh.

A hysterectomy is a surgical procedure that removes the uterus; sometimes the ovaries are also removed, to lower the risk of cancer.

Previous studies found an increased risk for conditions such as coronary heart disease, stroke and heart failure in women who underwent a hysterectomy.

Unlike other studies, however, the new research included only women who had a hysterectomy in midlife and who didn't have their ovaries removed due to cancer, Matthews explained.

"It is possible that women who have a hysterectomy when they are young have an increase in cardiovascular risk," she noted.

The report was published May 14 in the online edition of the Journal of the American College of Cardiology.

To see if a hysterectomy actually increased a women's risk for cardiovascular disease, Matthews' team collected data on more than 3,300 premenopausal women who took part in a national study on women's health.

They compared cardiovascular risk factors before and after the women had elective hysterectomy with or without ovary removal with women who had a natural menopause.

These risk factors included cholesterol, blood pressure, inflammation, blood sugar and insulin resistance, Matthews said.

Matthews' group found there were changes in cardiovascular risk factors after a hysterectomy, compared to risk factor changes after natural menopause.

These changes, however, were not associated with an increase in the risk of cardiovascular disease. Women who had a hysterectomy with removal of ovaries did tend to gain weight, the researchers found.

These effects were similar in all ethnic groups.

It's not known why these findings differ from other studies. The researchers speculated that differences in their study -- such as excluding women who had a hysterectomy because of cancer and the older age of the women -- may have played a role.

The women in this study were middle-aged and it is possible that women who have a hysterectomy earlier may have more cardiovascular risk, they explained.

One expert agreed that the evidence on a possible association between a hysterectomy and an increased chance of heart trouble has been mixed.

"Prior studies have suggested that there may be increases in cardiovascular risk after women undergo hysterectomy, particularly if accompanied by removal of the ovaries," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles.

However, other studies have not found elevated risk for cardiovascular events with hysterectomy with or without the removal of the ovaries, he added.

"These findings suggest that hysterectomy with or without removing the ovaries does not appear to play a major role in worsening cardiovascular risk factors in women compared to natural menopause," said Fonarow.

"Nevertheless, as cardiovascular disease remains the leading cause of death in women, women should closely assess, monitor and improve their cardiovascular health," he said.

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Swimming Pools May Pose Hazard for People With Heart Devices

By Alan Mozes
HealthDay Reporter

THURSDAY, May 9 (HealthDay News) -- With summer approaching, researchers caution that swimming pools may pose a risk to patients with irregular heartbeats who've received implantable defibrillators.

The issue: a danger that electrical currents linked to standard pool utilities such as lighting may "leak," causing a defibrillator to misread the status of a patient's heart.

Implanted cardioverter defibrillators continuously monitor and control a patient's heart rhythm.

"How common this is, we don't know," said Dr. John Day, second vice president of the Heart Rhythm Society, a group representing arrhythmia specialists. "It's quite possible that there's underreporting going on, because when we see patients and we see noise recorded on their device we can't account for where it's coming from."

The concern stems from a few recent incidents that have been documented. In two cases, people with defibrillators experienced device misreadings while in a private family or hotel pool, and in another two cases, people experienced unwarranted shocks from their defibrillators while in public pools.

The cases all involved younger arrhythmia patients between the ages of 8 and 23. However, the investigators said there's no reason to believe that patients of all ages would not face a similar risk if they had such devices.

"I don't want to be an alarmist, because I do think we would have heard about this sort of thing happening much more often than we have if it were a really widespread problem," said study lead author Dr. Daniel Shmorhun, a pediatric cardiologist-electrophysiologist with Children's Cardiology Associates, an affiliate of the Dell Children's Medical Center of Central Texas in Austin.

"The nice thing about defibrillators is that they put a time-stamp on all activity," he noted. "So we were able to ask questions and delve into this after two patients came in with interference noise on their devices. And we found that both had been in pools at the time their defibrillators read the interference."

Shmorhun and co-author Dr. Arnold Fenrich are slated to present their findings at the Heart Rhythm Society meeting taking place this week in Denver. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Arrhythmia is a chronic condition in which the heart's electrical system has the potential to go awry -- on occasion beating too fast, too slow, or irregularly. While many instances of arrhythmia pose little harm, severe cases can be life-threatening.

For such patients, implanted defibrillators can be life-savers, continuously surveying a patient's heartbeat for signs of trouble and instantaneously correcting for problems as they arise by sending out a corrective electrical pulse.

In the new study, Shmorhun and Fenrich reviewed the cases of two female patients (one aged 8 years and one aged 23 years), in which their defibrillators registered so-called "noise reversions" directly linked to time spent in swimming pools.

In each case their devices picked up the reversion, classified it as an outside interference, reverted to a mode that actively ignored noise, and thereby prevented any accidental shock.

After the lighting system was repaired in the family pool in which the 8-year-old had swam, the girl did not experience any further defibrillator trouble, the researchers said. The older patient, however, simply decided to no longer use public pools, and has experienced no further problems.

Others were not so lucky. For example, in the past year a 21-year-old male -- a competitive college swimmer and lifeguard -- experienced not one but two shocks while swimming in a public pool. "He remembers that he had his back against the pool wall, quite close to lights in water," said Shmorhun. "And as he was moving away from the light he got shocked."

Shmorhun and Fenrich believe that low-level electrical current leaking from swimming pool wiring might be an "underappreciated cause" of unwarranted defibrillator shocks.

"Water is an attractive source for electrical activity," Shmorhun explained. "We don't think there would be an issue at all in, say, the ocean or bay. But in a pool, where you have wires coming into the water from the outside, from the house, from an aging utility system, or an improperly grounded system, there is a potential for this kind of problem. Or if a pool is not properly bonded -- meaning the pool circumference is not intact -- there could be a problem," he noted.

"I'm not sure anybody can really predict up front what pools are an issue, and there's no practical means by which to easily test pools for this," Shmorhun added. "At the same time, we don't know the overall incidence, although three cases in the Austin area in one year seems like a lot to me. But at minimum, [defibrillator] patients need to be counseled about the risk."

For his part, Heart Rhythm Society vice president Day said the finding should not deter patients from swimming.

"We want our cardiac patients to be physically active. We don't want to restrain them and we don't want to create alarm," Day said.

"But in each of these cases we had these underwater pool lights that had an alternating current pool leak that could trigger a shock," noted Day, who is also director of Heart Rhythm Services at Intermountain Medical Center in Murray, Utah. "So, I think we certainly need pool safety. And clinically this is just one more thing that should be considered as a potential source of a problem for any patient with an implantable defibrillator."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: John Day, M.D., second vice president, Heart Rhythm Society, and director, Heart Rhythm Services at Intermountain Medical Center, Murray, Utah; Daniel Shmorhun, M.D., pediatric cardiologist-electrophysiologist, Children's Cardiology Associates (affiliated with Dell Children's Medical Center of Central Texas), Austin, Texas; May 8, 2013, Heart Rhythm Society meeting, Denver

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Pets a Boon for the Human Heart, Cardiologists Say

THURSDAY, May 9 (HealthDay News) -- That four-legged friend of yours may be more than a companion -- he also may be boosting your heart health, experts say.

An official statement released Thursday by the American Heart Association says there is evidence that having a pet, particularly a dog, may lower your risk of heart disease.

Cardiology specialists weren't all that surprised.

"Pets really might be man's best friend," said Barbara George, director of the Center for Cardiovascular Lifestyle Medicine at Winthrop-University Hospital in Mineola, N.Y.

"Studies have shown people who own pets, particularly dogs, have lower blood pressure, increased mood-related brain chemicals, better cholesterol numbers, lower weight and improved stress response," George said.

Members of the American Heart Association (AHA) committee that wrote the statement reviewed data from an array of relevant studies. They found that pet ownership appears to be associated with a reduction in heart disease risk factors such as high blood pressure, high blood cholesterol levels and obesity -- and improved survival among people with heart disease.

Dog ownership in particular may help reduce heart risk, the statement said. People with dogs may get more exercise because they take their dogs for walks. A study of more than 5,200 adults found that dog owners did more walking and physical activity than those who didn't own dogs, and that dog owners were 54 percent more likely to get the recommended level of physical activity.

"Walking your dog is a healthy chore; it is a great way to exercise without thinking about it," said Dr. Nieca Goldberg, clinical associate professor in the department of medicine at the Tisch Center for Women's Health at NYU Langone Medical Center in New York City. "Pet owners increase their physical activity simply by walking their dogs."

Pets can also have a positive effect on the body's reactions to stress, according to the AHA. George agreed, saying pets can be "a tool for weight loss, socialization, calming our nerves and easing anxiety and depression."

The AHA stressed, however, that the studies they reviewed cannot prove that owning a pet directly reduces heart disease risk.

"It may be simply that healthier people are the ones that have pets, not that having a pet actually leads to or causes reduction in cardiovascular risk," statement committee chairman Dr. Glenn Levine, a professor at Baylor College of Medicine in Houston, said in an AHA news release.

"There probably is an association between pet ownership and decreased cardiovascular risk," he said. "What's less clear is whether the act of adopting or acquiring a pet could lead to a reduction in cardiovascular risk in those with pre-existing disease. Further research, including better quality studies, is needed to more definitively answer this question."

In the meantime, George said, humans can benefit from the mental and physical rewards of furry companions. "Pets tug at our heartstrings," she said. "But they also improve our health -- both mental and physical -- helping us to live longer and happier lives."

The AHA statement was published online May 9 in the journal Circulation.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Barbara George Ed.D., R.N., director, Center for Cardiovascular Lifestyle Medicine, Winthrop-University Hospital, Mineola, N.Y.; Nieca Goldberg, M.D., clinical associate professor, department of medicine, Leon H. Charney Division of Cardiology, Joan H. Tisch Center for Women's Health, NYU Langone Medical Center, New York City; American Heart Association, news release, May 9, 2013

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Pets a Boon for the Human Heart, Cardiologists Say

American Heart Association cites stress-busting, dog-walking benefits of companion animals

By Robert Preidt

HealthDay Reporter

THURSDAY, May 9 (HealthDay News) -- That four-legged friend of yours may be more than a companion -- he also may be boosting your heart health, experts say.

An official statement released Thursday by the American Heart Association says there is evidence that having a pet, particularly a dog, may lower your risk of heart disease.

Cardiology specialists weren't all that surprised.

"Pets really might be man's best friend," said Barbara George, director of the Center for Cardiovascular Lifestyle Medicine at Winthrop-University Hospital in Mineola, N.Y.

"Studies have shown people who own pets, particularly dogs, have lower blood pressure, increased mood-related brain chemicals, better cholesterol numbers, lower weight and improved stress response," George said.

Members of the American Heart Association (AHA) committee that wrote the statement reviewed data from an array of relevant studies. They found that pet ownership appears to be associated with a reduction in heart disease risk factors such as high blood pressure, high blood cholesterol levels and obesity -- and improved survival among people with heart disease.

Dog ownership in particular may help reduce heart risk, the statement said. People with dogs may get more exercise because they take their dogs for walks. A study of more than 5,200 adults found that dog owners did more walking and physical activity than those who didn't own dogs, and that dog owners were 54 percent more likely to get the recommended level of physical activity.

"Walking your dog is a healthy chore; it is a great way to exercise without thinking about it," said Dr. Nieca Goldberg, clinical associate professor in the department of medicine at the Tisch Center for Women's Health at NYU Langone Medical Center in New York City. "Pet owners increase their physical activity simply by walking their dogs."

Pets can also have a positive effect on the body's reactions to stress, according to the AHA. George agreed, saying pets can be "a tool for weight loss, socialization, calming our nerves and easing anxiety and depression."

The AHA stressed, however, that the studies they reviewed cannot prove that owning a pet directly reduces heart disease risk.

"It may be simply that healthier people are the ones that have pets, not that having a pet actually leads to or causes reduction in cardiovascular risk," statement committee chairman Dr. Glenn Levine, a professor at Baylor College of Medicine in Houston, said in an AHA news release.

"There probably is an association between pet ownership and decreased cardiovascular risk," he said. "What's less clear is whether the act of adopting or acquiring a pet could lead to a reduction in cardiovascular risk in those with pre-existing disease. Further research, including better quality studies, is needed to more definitively answer this question."

In the meantime, George said, humans can benefit from the mental and physical rewards of furry companions. "Pets tug at our heartstrings," she said. "But they also improve our health -- both mental and physical -- helping us to live longer and happier lives."

The AHA statement was published online May 9 in the journal Circulation.

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iPads Could Affect Implanted Heart Devices, Early Study Finds

Young researcher suggests that users avoid placing tablets too close to the chest

By Barbara Bronson Gray

HealthDay Reporter

THURSDAY, May 9 (HealthDay News) -- Sprawled out on the couch, reading the news on your iPad, you'd never think you could be putting yourself at risk. But you might be, if you happen to have an implanted heart device.

Magnetic interference could alter the settings and even deactivate the technology of implantable cardioverter defibrillators (ICDs), according to a small new study -- conducted by a 14-year-old investigator and her colleagues.

The researchers found that magnets imbedded in the iPad 2 and its Smart Cover may cause electromagnetic interference that can disrupt a cardiac rhythm device.

Specialized magnets are imbedded in the heart devices to allow physicians to routinely adjust their settings. The magnets can suspend the ability of the devices to prevent sudden rapid heart rates, such as tachycardia and fibrillation.

That risk occurs when a person falls asleep with the tablet on the chest. Thirty percent of study participants had interference with their devices when the iPad 2 was placed there, the researchers found. Yet electromagnetic interference was not found when the iPad was at a normal reading distance from the chest.

The magnetic field drops off quickly with distance, explained Gianna Chien, the lead study author. And heavier people who happen to have more fat on their chest -- not just in their abdomen -- also seem to be less sensitive to the interference, she added.

The research is scheduled to be presented Thursday at the Heart Rhythm Society's annual meeting in Denver. Chien, a high school freshman, worked with her father, Dr. Walter Chien, a cardiologist with Central Valley Arrhythmia in Stockton, Calif., to coordinate patient testing.

Other devices with imbedded magnets -- such as cellphones and magnetic resonance imaging (MRI) machines -- may also affect cardiac rhythm devices, but were not tested in this study.

Last year, research published in the Journal of Neurosurgery: Pediatrics suggested that the iPad 2 can interfere with the settings of magnetically programmable shunt devices in the brain when held within two inches of the technology.

That study reported on a 4-month-old girl with hydrocephalus -- abnormal accumulation of cerebrospinal fluid (CSF) in the brain -- who developed a shunt malfunction. This was due to a changed setting of the magnetically programmable valve that regulates the flow of CSF out of the brain cavity, or ventricle. The mother had been using an iPad 2 while holding the infant.

An expert noted how difficult it could be to detect such a malfunction.

"The real problem is that you don't even know; there is no trigger, no light goes off [to alert you]," said Dr. Salvatore Insinga, a neurosurgeon at the Cushing Neuroscience Institute at North Shore-LIJ Health System, in New York. "With all the tech devices people are using now and all the implanted things in patients, this is more of an issue now." Insinga was not associated with either study.

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Everyday Noise Levels May Affect the Heart

Even not-so-loud sounds seemed to raise people's heart rate in small study

By Amy Norton

HealthDay Reporter

THURSDAY, May 9 (HealthDay News) -- Even the minor noise that fills everyday life, from the ring of a cell phone to the conversation that follows, may have short-term effects on heart function, a small new study suggests.

In the study of 110 adults equipped with portable heart monitors, researchers found that people's heart rate tended to climb as their noise exposure increased -- even when the noise remained below 65 decibels. That's about as loud as a normal conversation or laughter.

There was also a negative impact on people's heart rate "variability" -- a measure of the heart's adaptation to what is going on around you. Greater variability in the interval between heartbeats is better. When people are relaxed, the space between heartbeats is usually a bit longer as they exhale, and shorter as they inhale.

When people are stressed, however, some of that natural variation is lost. And studies have linked lesser heart rate variability to an increased risk of heart attack.

So does all of this mean you need to wear earplugs to protect your heart? Probably not, experts say.

For any one person, the effects of everyday noise on heart function may be small, said Charlotta Eriksson, a researcher at the Karolinska Institute, in Stockholm, Sweden. Eriksson was not involved in the study.

But since we are all exposed to noise, even a minor effect on heart health could be important on the broad "population level," said Eriksson, who has studied the effects of loud traffic -- from roads or airports -- on people's blood pressure and heart function.

Research has consistently found links between loud workplaces and an increased risk of heart disease, said Dr. Wenqi Gan, a researcher at North Shore-LIJ Health System's Feinstein Institute for Medical Research, in Manhasset, N.Y.

The evidence is more mixed when it comes to "community noise," like traffic sounds, said Gan, whose own research has found a connection.

He said the mixed results may be because it's difficult to weed out the effects of community noise on individuals. You might live in a noisy section of a big city, but have good, sound-muffling windows, for example.

"And some people are more sensitive to noise than others," Gan said. If noise affects the heart by stressing people out, he said, then your personal sensitivity to it would be important.

The new findings, reported in the May issue of the journal Environmental Health Perspectives, are based on 110 adults who wore portable devices that measured their heart activity and noise exposure during their normal daily routines.

What was "interesting," Eriksson said, is that lower-level noise seemed to curb activity in the parasympathetic nervous system -- the branch of the nervous system that acts as a "brake," lowering heart rate and relaxing the blood vessels, for example.

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Mediterranean Diet Benefits Heart, Even Without Weight Loss: Study

Healthy eating helped men lower bad cholesterol

By Robert Preidt

HealthDay Reporter

WEDNESDAY, May 1 (HealthDay News) -- Men at high risk for heart disease might reduce their "bad" cholesterol by eating a heart-healthy Mediterranean diet, even if they don't lose weight, a small new study suggests.

The study included 19 men, aged 24 to 62, with metabolic syndrome, which means they had three or more major risk factors for heart disease and stroke. The risk factors among men in this study included large waist size, high blood pressure, low levels of "good" HDL cholesterol and high triglyceride and fasting glucose levels.

For the first five weeks of the study, the men ate a standard North American diet, which is high in fats, carbohydrates, refined sugar and red meat. For the second five weeks, they ate a Mediterranean diet, which is high in fruits, vegetables and whole grains; low in red meat; and includes olive oil and moderate amounts of wine.

This was followed by a five-month weight-loss program, then another five weeks of a Mediterranean diet.

Regardless of whether they lost weight, the men had a 9 percent decrease in levels of "bad" LDL cholesterol when they ate a Mediterranean diet, according to the study, scheduled for presentation Wednesday at a meeting of the American Heart Association in Lake Buena Vista, Fla.

The Mediterranean diet "may be recommended for effective management of the metabolic syndrome and its related risk of cardiovascular disease," said lead study author Caroline Richard, a registered dietitian and doctoral candidate in nutrition at Laval University in Quebec, Canada. The study, however, showed only an association between a Mediterranean diet and lowered cholesterol, not a cause-and-effect relationship.

Data and conclusions presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

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3 New Packs of Face Wipes We Heart

I'm a clean-face addict, but I'm also prone to over doing it -- which is probably while I coat my face in this stuff every night. But I've been spending way too much time out of the house and it's seriously getting to be a problem when I get home and I'm tired, stressed, grimy, sweaty, annoyed, whatever -- and have no interest in washing my face.

So, I started stocking up on another option: face wipes.

I know what you're thinking, guys: "Those towelettes will NOT clean your face!" But I totes promise these do. No false advertising here.

Gone are the days of one-size-fits-all wipes. There is an awesome mix of crazy-effective benefits in every pack you pick up. Here are three of my latest faves guaranteed to give a clean, glowy complexion.

If you're like me and you're starting to feel a little less-than-useful (I swear grad school is aging me way too quickly), reach for cleansing wipes with anti-aging ingredients. The new Ole Henriksen Truth To Go Wipes have vitamin C to brighten, lighten and tighten, algae to firm and rev skin's collagen production, coQ10 to repair and green tea to protect. Sigh. I feel younger just talking about them.Next time you are feeling especially grimy, pull out a pack of Alba Botanica Hawaiian 3-in-1 Clean Towelettes, Deep Pore Purifying, Pineapple Enzyme . These bad boys have gentle cleansers to get rid of makeup, fruit enzymes to break through oil and awapuhi (aka ginger's long lost cousin) to tone and tighten skin. Bonus: the towelettes are biodegradable so you don't feel totally wasteful using 'em to clean yourself up.Tend to be on the sensitive side? Not only did Aveeno Ultra Calming Makeup Removing Wipes win our Healthy Beauty Award for Best Makeup Remover. They're super gentle (they have aloe and cucumber) and soft, but somehow still crazy effective.

RELATED LINKS:

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What is chelation therapy, and can it reduce my risk of heart attack?

Posted June 18, 2013, 2:00 am

I have heart disease. Will chelation therapy help reduce my risk of a heart attack?

That’s a timely question, because a recent study of chelation therapy has generated a lot of interest and debate.

Chelation therapy is used to eliminate metals or other toxins from your body. During the procedure, chemicals are infused into your bloodstream. When these chemicals find unwanted substances as they travel through your blood, they attach themselves to them and carry them out of the body in your urine. For people with toxic levels of lead or mercury, chelation therapy is an FDA-approved method to help with their removal from the body.

Its use for heart disease is more controversial. Here’s the idea: Heart disease results when your blood vessels are narrowed by atherosclerotic plaques that limit blood flow. These plaques are largely made up of fat, cholesterol and calcium. Chelation with a chemical called EDTA pulls calcium out of atherosclerotic plaques — or so the thinking goes. This is supposed to shrink plaques and make artery walls healthier. Thus, the risk of heart attack, stroke and other problems related to blood vessel diseases should decrease.

For decades, chelation practitioners have claimed that the procedure works. But results of a recently published study didn’t support the positive claims.

The study included 1,708 adults age 50 and older who had a previous heart attack. Half of the patients got 40 infusions of EDTA solution along with high doses of vitamin and mineral supplements. Half got a placebo (saltwater) solution. People were chosen for the chelation therapy group and the placebo group by a random process.

The researchers followed the patients for about 4.5 years. Twenty-six percent of people in the chelation group had heart attack, stroke or hospitalization for chest pain or heart bypass surgery. That was compared with 30 percent of patients in the placebo group. Statistical testing showed that the slightly lower rate of heart problems in the chelation group could have occurred by chance.

More troubling was the fact that many people who were assigned to have chelation therapy never actually received the therapy. Nearly 20 percent dropped out of the study before completing the therapy. So drawing conclusions about the value of chelation therapy from this study is difficult.

There are more established ways to prevent heart attacks, stroke and premature death. For example:

Get activeEat betterDon’t smokeControl cholesterolManage blood pressureLose weightReduce blood sugar

If you already have atherosclerosis, you should be taking a statin drug and a daily aspirin.

If you take these steps, I think the current evidence says that you’re unlikely to get any extra benefit from chelation therapy. In contrast to that inconclusive evidence, the evidence on each of these lifestyle changes and medications is conclusive: They all definitely protect you from heart disease, strokes and premature death.

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Hard Physical Labor May Boost Risk of Heart Disease, Stroke: Studies

THURSDAY, April 18 (HealthDay News) -- Demanding physical work may boost a person's risk of heart disease, two new studies suggest.

"Physicians know that high stress can be associated with increased risk of heart disease," said one expert not connected to the study, Dr. Lawrence Phillips, a cardiologist at NYU Langone Medical Center in New York City. "These two studies suggest that, in addition to normal life stressors, the physical demands a person experiences in the workplace can independently increase their risk as well."

"The reason for this [labor-linked risk] is unclear, but might be related to higher stress levels," Phillips said.

In one study, researchers looked at 250 patients who had suffered a first stroke and 250 who had suffered a first heart attack or other type of heart event. They were compared to a control group of 500 healthy people.

Stroke and heart patients were more likely to have physically demanding jobs than those in the control group, researchers found. After adjusting for age, sex and a number of lifestyle and health factors, they concluded that having a less physically demanding job was associated with a 20 percent lower risk of a heart event or stroke.

The findings suggest that people with physically demanding jobs should be considered an important target group for prevention of cardiovascular disease, said study author Dr. Demosthenes Panagiotakos, an associate professor of biostatistics and epidemiology at Harokopio University in Athens, Greece.

The results seem to conflict with recommendations that people should exercise to reduce their risk of heart trouble. But Panagiotakos said the increased risk of stroke and heart events among people with physically demanding jobs may be due to mental stress, while exercise helps reduce stress. He also said people with physically demanding jobs tend to have lower incomes, which might limit their access to health care.

The study suggests that leisure-time exercise might be important to "balance out" the physical stress encountered in laborious jobs, said Dr. Tara Narula, associate director of the cardiac care unit at Lenox Hill Hospital in New York City. She was not connected to the study.

"This delicate interaction between work and leisure-time activity warrants further research in order to appropriately guide public health," she said.

The study was presented at a meeting of the European Society of Cardiology, taking place this week in Rome.

In a second study presented at the same meeting, researchers looked at more than 14,000 middle-aged men who did not have heart disease and were followed for about three years on average. The investigators found that physically demanding work was a risk factor for developing coronary heart disease.

They also found that men with physically demanding jobs who also did moderate to high levels of exercise during their leisure time had an even greater risk (more than four-fold higher) of developing coronary heart disease.

Phillips, who also is an assistant professor in the department of medicine at NYU Langone, said the finding was a bit surprising. "This is a new finding that was not previously seen," he said. "Further studies to support this finding will be needed. As with many areas of medicine, a one-size-fits-all approach to leisure exercise might not work."

Study author Dr. Els Clays, of the department of public health at the University of Ghent, in Belgium, weighed in on the study in a society news release.

"From a public health perspective, it is very important to know whether people with physically demanding jobs should be advised to engage in leisure-time activity," Clays said.

"The results of this study suggest that additional physical activity during leisure time in those who are already physically exhausted from their daily occupation does not induce a 'training' effect but rather an overloading effect on the cardiovascular system," Clays said.

On the other hand, the study did find that men with less physically demanding jobs were 60 percent less likely to develop heart disease if they exercised during their leisure time.

"Further studies will be needed to find out the cause of increased heart disease in those people who have high physical job demands," Phillips said.

Both studies could point only to an association between hard physical labor and increased heart risk, not a cause-and-effect. Studies presented at a medical meetings typically are viewed as preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Lawrence Phillips, M.D., assistant professor, department of medicine, Leon H. Charney Division of Cardiology, NYU Langone Medical Center, New York City; Tara Narula, associate director, cardiac care unit, Lenox Hill Hospital, New York City; European Society of Cardiology, news release, April 18, 2013

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Volunteering May Be Good for the Heart in More Ways Than One

Time spent helping others linked to lower blood pressure in older adults, study finds

By Robert Preidt

HealthDay Reporter

FRIDAY, June 14 (HealthDay News) -- Anyone who has ever been a volunteer knows that it feels good to help others, but researchers have found a less obvious benefit: volunteering can help reduce older adults' risk of high blood pressure.

The new study included more than 1,100 adults, aged 51 to 91, who were interviewed about their volunteering and had their blood pressure checked in 2006 and 2010. All of them had normal blood pressure at the time of the first interview.

The investigators found that participants who said during the first interview that they volunteered for at least 200 hours per year were 40 percent less likely to have high blood pressure four years later than those who did not volunteer.

It didn't matter what type of activity the volunteers performed. Only the amount of time spent helping others as a volunteer was associated with a reduced risk of high blood pressure, according to the study scheduled for publication in the journal Psychology and Aging.

The findings suggest that volunteering may be an effective medicine-free option to help prevent high blood pressure, which is a major contributor to cardiovascular disease -- the leading cause of death in the United States. High blood pressure, or hypertension, affects about 65 million Americans.

"Every day, we are learning more about how negative lifestyle factors like poor diet and lack of exercise increase hypertension risk," lead author Rodlescia Sneed, a Ph.D. candidate in psychology at Carnegie Mellon University, said in a university news release.

"Here, we wanted to determine if a positive lifestyle factor like volunteer work could actually reduce disease risk. And, the results give older adults an example of something that they can actively do to remain healthy and age successfully," Sneed explained.

"As people get older, social transitions like retirement, bereavement and the departure of children from the home often leave older adults with fewer natural opportunities for social interaction," Sneed noted. "Participating in volunteer activities may provide older adults with social connections that they might not have otherwise. There is strong evidence that having good social connections promotes healthy aging and reduces risk for a number of negative health outcomes."

While the study found an association between time spent volunteering and blood pressure levels, it did not prove a cause-and-effect relationship.

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Hard Physical Labor May Boost Risk of Heart Disease, Stroke: Studies

Researcher says higher mental stress, lower income could be factors

By Robert Preidt

HealthDay Reporter

THURSDAY, April 18 (HealthDay News) -- Demanding physical work may boost a person's risk of heart disease, two new studies suggest.

"Physicians know that high stress can be associated with increased risk of heart disease," said one expert not connected to the study, Dr. Lawrence Phillips, a cardiologist at NYU Langone Medical Center in New York City. "These two studies suggest that, in addition to normal life stressors, the physical demands a person experiences in the workplace can independently increase their risk as well."

"The reason for this [labor-linked risk] is unclear, but might be related to higher stress levels," Phillips said.

In one study, researchers looked at 250 patients who had suffered a first stroke and 250 who had suffered a first heart attack or other type of heart event. They were compared to a control group of 500 healthy people.

Stroke and heart patients were more likely to have physically demanding jobs than those in the control group, researchers found. After adjusting for age, sex and a number of lifestyle and health factors, they concluded that having a less physically demanding job was associated with a 20 percent lower risk of a heart event or stroke.

The findings suggest that people with physically demanding jobs should be considered an important target group for prevention of cardiovascular disease, said study author Dr. Demosthenes Panagiotakos, an associate professor of biostatistics and epidemiology at Harokopio University in Athens, Greece.

The results seem to conflict with recommendations that people should exercise to reduce their risk of heart trouble. But Panagiotakos said the increased risk of stroke and heart events among people with physically demanding jobs may be due to mental stress, while exercise helps reduce stress. He also said people with physically demanding jobs tend to have lower incomes, which might limit their access to health care.

The study suggests that leisure-time exercise might be important to "balance out" the physical stress encountered in laborious jobs, said Dr. Tara Narula, associate director of the cardiac care unit at Lenox Hill Hospital in New York City. She was not connected to the study.

"This delicate interaction between work and leisure-time activity warrants further research in order to appropriately guide public health," she said.

The study was presented at a meeting of the European Society of Cardiology, taking place this week in Rome.

In a second study presented at the same meeting, researchers looked at more than 14,000 middle-aged men who did not have heart disease and were followed for about three years on average. The investigators found that physically demanding work was a risk factor for developing coronary heart disease.

They also found that men with physically demanding jobs who also did moderate to high levels of exercise during their leisure time had an even greater risk (more than four-fold higher) of developing coronary heart disease.

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Cycle House Adds New Heart Rate Readings for Calorie-Torching Tech

We've made no secret of our love for L.A. hotspot Cycle House; we ranked the boutique cycling studio's 1,000-Calorie Ride as one of the 33 hottest fitness classes in the country, and it earned the left coast major points in our 2011 East Vs. West fitness competition, too. So it comes as no surprise that Cycle House is back on top with a brand new, first-of-its-kind technology that takes calorie burning to a whole new level.

When you take a class at Cycle House, all of the stats from your ride get saved into your user profile and can be accessed online through your private account. This is pretty cool in itself, but not really much different than what a lot of the other fancy cycling studios are also doing. But starting this month, thanks to wireless bluetooth sensors throughout the studio, each bike can pick up on its rider's individual heart rate monitor, as well.

This -- along the weight, age, and gender info you've already entered online -- makes for an extremely accurate calculation of calories burned. (Without heart rate, calories are often estimated based on RPMs, pedal resistance, and the user's weight, but that can't take into account one of the biggest factors: your actual level of exertion.) Your online Cycle House account keeps track of these stats, and you can access them anytime, anywhere.

Here's hoping this cool technology makes its way to other studios soon ... or that maybe Cycle House makes its way across the country? (Share the wealth, Cali!) Until then, I'll stick with my own local cycling studios -- and this Cycle House-inspired 1,000-calorie, at-home ride. Complete with heart rate monitor to track my burn, of course.

Do you wear a heart rate monitor for indoor cycling classes? Tweet us at @amandaemac and @SELFmagazine.

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Image Credit: Courtesy Photo

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Radiation Therapy May Raise Future Death Risk From Heart Surgery

THURSDAY, April 11 (HealthDay News) -- Cancer survivors who had chest radiation therapy have a nearly twofold increased risk of dying in the years after having major heart surgery, a new study finds.

Researchers looked at 173 people who had chest radiation treatment for cancer an average of 18 years before they required heart surgery. These patients were compared to 305 people who underwent similar heart surgeries but had no history of radiation therapy.

The death risk in the first 30 days after heart surgery was about the same for both groups. But during an average follow-up of nearly eight years, 55 percent of the patients in the radiation group died, compared with 28 percent of those in the nonradiation group, the investigators found.

The study was published April 8 in the journal Circulation.

"These findings tell us that if you had radiation, your likelihood of dying after major cardiac surgery is high," study author Dr. Milind Desai, an associate professor of medicine at the Cleveland Clinic, said in a journal news release.

"That's despite going into the surgery with a relatively low risk score. In patients who have had prior [chest] radiation, we need to develop better strategies of identifying appropriate patients that would benefit from surgical intervention. Alternatively, some patients might be better suited for [nonsurgical] procedures," Desai said.

"While radiation treatments done on children and adults in the late 1960s, '70s and '80s played an important role in cancer survival, the treatment often takes a toll on the heart," Desai explained.

"Survivors are at greater risk than people who do not have radiation to develop progressive coronary artery disease, aggressive valvular disease, as well as pericardial diseases, which affect the heart's surrounding structures," he said. "These conditions often require major cardiac surgery."

While the study found an association between chest radiation therapy for cancer and future risk of death after heart surgery, it did not establish a cause-and-effect relationship.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Circulation, news release, April 8, 2013

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Study: Low Blood Pressure May Weaken Brains of Some Heart Patients

Pressure that's too low -- or too high -- might damage brain cells, new research suggests

By Steven Reinberg

HealthDay Reporter

MONDAY, June 10 (HealthDay News) -- People suffering from cardiovascular disease who have lower-than-normal blood pressure may face a higher risk of brain atrophy -- the death of brain cells or connections between brain cells, Dutch researchers report.

Such brain atrophy can lead to Alzheimer's disease or dementia in these patients. In contrast, similar patients with high blood pressure can slow brain atrophy by lowering their blood pressure, the researchers added.

Blood pressure is measured using two readings. The top number, called systolic pressure, gauges the pressure of blood moving through arteries. The bottom number, called diastolic pressure, measures the pressure in the arteries between heartbeats. Normal blood pressure for adults is less than 120/80, according to the U.S. National Heart, Lung, and Blood Institute.

For the study, 70 to 90 was considered normal diastolic blood pressure, while under 70 was considered low.

"Our data might suggest that patients with cardiovascular disease represent a subgroup within the general population in whom low diastolic blood pressure might be harmful," said researcher Dr. Majon Muller, an epidemiologist and geriatrician at VU University Medical Center in Amsterdam.

On the other hand, lowering blood pressure in people with high blood pressure might slow brain atrophy, she said.

"Our findings could imply that blood pressure lowering is beneficial in patients with higher blood pressure levels, but one should be cautious with further blood pressure lowering in patients who already have low diastolic blood pressure," Muller added.

The report was published in the June 10 online edition of JAMA Neurology.

A U.S. expert noted the complex effects of blood pressure levels on the brain.

"High blood pressure has been shown to increase the risk of vascular brain lesions and brain atrophy. Trials of blood pressure lowering in patients with hypertension have shown reduced risk of brain lesions," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association.

However, in patients with hypertension, the relationship between the levels of systolic and diastolic blood pressure and brain atrophy has been less clear, he said.

This new study suggests that low diastolic blood pressure levels were associated with brain atrophy regardless of blood pressure levels after patients developed dementia, Fonarow said.

"These findings suggest that while treatment and control of high blood pressure is very important for brain and cardiovascular health, caution is needed in patients who have low diastolic blood pressure levels," he said.

To see what changes blood pressure would make in the progression of brain atrophy, Muller's group studied 663 patients who suffered from heart disease, cardiovascular disease, peripheral artery disease or abdominal aortic aneurysm. The average age of participants was 57 and most were men.

People whose diastolic blood pressure was below 70 had more brain atrophy over time, the study found. For people with higher-than-normal blood pressure, brain atrophy decreased when their blood pressure did. When blood pressure rose, however, atrophy increased.

Another expert, Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center in New York City, said that the finding "is an important cautionary tale."

"This implies that one must adapt the approach to the individual patient. Correction of hypertension is helpful, but reducing blood pressure in patients with normal blood pressure is risky and complicated," Gandy said.

Although the study found an association between low diastolic blood pressure and the risk of developing brain atrophy for people with artery disease, it did not establish a cause-and-effect relationship.

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Balding Men Could Face Higher Heart Risks, Study Finds

But not those with a receding hairline, say Japanese investigators who analyzed previous research

By Alan Mozes

HealthDay Reporter

WEDNESDAY, April 3 (HealthDay News) -- New research out of Japan shows a potential link between male baldness and an increased risk for coronary heart disease.

But it only affects men who are balding on top. Those with a receding hairline are not at risk, the researchers reported.

The findings stem from an analysis of six published studies on hair loss and heart health that involved approximately 37,000 men.

And although the researchers admitted the small study size was a limitation, they reported that men whose baldness affected the crown on their head faced a 32 percent to 84 percent increase in the risk of developing heart disease compared to men with a full head of hair or a receding hairline.

Study lead author Dr. Tomohide Yamada, of the department of diabetes and metabolic diseases at the University of Tokyo's Graduate School of Medicine, in Japan, reported his findings in the current issue of the journal BMJ Open and called for more research on the topic. Although the research review found an association between baldness and heart disease risk, it did not prove a cause-and-effect link.

Male pattern baldness (technically referred to as "androgenetic alopecia") affects up to 40 percent of adult men and is the most common type of hair loss, the researchers reported. By age 80, about four in five men will experience this form of baldness.

To explore the link to heart disease, the researchers analyzed databases covering the period 1950 through 2012. Out of 850 related investigations, they selected six studies, all published between 1993 and 2008 in the United States, Denmark or Croatia.

In the three studies that tracked patients for a minimum of 11 years, the research showed that, overall, balding men face a 33 percent greater risk for heart disease than other men, and those between 55 and 60 years old faced an even higher risk (44 percent).

The other three studies, comparing the cardiac health of balding men to non-balding men, showed a 70 percent bump in heart disease risk among the balding group, and an 84 percent risk for younger balding men.

What's more, a balding man's heart disease risk appeared to be dependent on the severity of his hair loss, with more severe loss translating into greater risk, the studies showed.

Yamada's team said the driving mechanism behind the connection is unknown, but they theorized that baldness could be a marker for insulin resistance, chronic inflammation or an increased sensitivity to testosterone, all of which are factors in the onset of heart disease.

Regardless, Yamada said, balding men should do what all men should do when it comes to controlling heart disease risk. "I recommend adapting a heart-healthy lifestyle that includes a low-fat diet, exercise and less stress [in order to mitigate against] classical coronary risk factors," such as age, high blood pressure, blood lipid disruption and a history of smoking, he said.

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Compound in Red Meat, Energy Drinks May Have Heart Disease Link

Gut bacteria break down carnitine into another substance that damages blood vessels, study finds

By Robert Preidt

HealthDay Reporter

SUNDAY, April 7 (HealthDay News) -- A compound found in red meat and added as a supplement to popular energy drinks promotes hardening and clogging of the arteries, otherwise known as atherosclerosis, a new study suggests.

Researchers say that bacteria in the digestive tract convert the compound, called carnitine, into trimethylamine-N-oxide (TMAO). Previous research by the same team of Cleveland Clinic investigators found that TMAO promotes atherosclerosis in people.

And there was an another twist: The study also found that a diet high in carnitine encourages the growth of the bacteria that metabolize the compound, leading to even higher TMAO production.

"The [type of] bacteria living in our digestive tracts are dictated by our long-term dietary patterns. A diet high in carnitine actually shifts our gut microbe composition to those that like carnitine, making meat eaters even more susceptible to forming TMAO and its artery-clogging effects," study leader Dr. Stanley Hazen, head of preventive cardiology and rehabilitation in Cleveland Clinic's Heart and Vascular Institute, said in a clinic news release.

Hazen's team looked at nearly 2,600 patients undergoing heart evaluations. The researchers found that consistently high carnitine levels were associated with a raised risk of heart disease, heart attack, stroke and heart-related death.

They also found that TMAO levels were much lower among vegetarians and vegans than among people with unrestricted diets (omnivores). Vegetarians do not eat meat while vegans do not eat any animal products, including eggs and dairy.

Even after consuming a large amount of carnitine, vegans and vegetarians did not produce significant levels of TMAO, while omnivores did, according to the study in the current issue of the journal Nature Medicine.

Although the new study could not prove any cause-and-effect relationship between carnitine and heart damage, the findings may provide a new understanding of the benefits of vegan and vegetarian diets, the researchers said.

"Vegans and vegetarians have a significantly reduced capacity to synthesize TMAO from carnitine, which may explain the cardiovascular health benefits of these diets," said Hazen, who is also vice chair of translational research for the clinic's Lerner Research Institute.

Two heart disease experts said the study yields up important new insights.

According to Dr. Robert Rosenson, it appears that poor eating habits could raise TMAO levels and "increase the ability of the cholesterol to get into our arteries and interfere with the ability of our body to eliminate that excess cholesterol." Rosenson, director of cardiometabolic disorders at the Icahn School of Medicine at Mount Sinai, in New York City, said the study "sheds important new information on the association between diet, atherosclerosis and cardiovascular events."

Another expert pointed the finger specifically at red meat and energy drinks.

"Most Americans have heard the famous saying 'you are what you eat,'" said Dr. Tara Narula, associate director of the Cardiac Care Unit at Lenox Hill Hospital, New York City. "This phrase may be more true and different than we might have imagined."

The new study "brings awareness that many 'supplements' like energy drinks can have the same [vessel-damaging] compounds as red meat," she said. "Energy drinks may not be harmless and can have unseen side effects that consumers should recognize."

As for beef, pork and the like, Narula said that the "real take-away message is the reinforcement of the current recommendations that a heart-healthy diet should have little to no red meat consumption."

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U.S. Spends More on Dementia Care Than Heart Disease or Cancer: Study

Annual bill now tops $200 billion, largely for long-term care, researchers say

By Amy Norton

HealthDay Reporter

WEDNESDAY, April 3 (HealthDay News) -- The cost of caring for Americans with Alzheimer's and other forms of dementia may now be as high as $215 billion a year -- more than the cost of caring for heart disease or cancer, a new study finds.

And that number is expected to escalate as the elderly population grows.

In 2010, the United States spent somewhere between $157 billion and $215 billion on dementia care, researchers reported in the April 4 issue of the New England Journal of Medicine. That includes direct medical expenses and the costs of caring for people with dementia -- both professional care and the "informal" care that families provide.

Dementia is a progressive deterioration in memory, thinking ability, judgment and other vital brain functions.

Alzheimer's disease is the most common form of dementia, and a recent study estimated that with the aging baby boom generation, the number of Americans with Alzheimer's could triple by 2050, to nearly 14 million.

The new study tried to take a "comprehensive look" at the financial impact -- including the costs to family caregivers, said lead researcher Michael Hurd, a senior principal researcher at the nonprofit research institute RAND.

"It's not a happy situation," Hurd said. "A lot of the costs fall on families, and right now, there's no solution in sight."

The researchers based their estimates on a government study of older Americans, plus Medicare records and other data sources. Of the billions spent on dementia in 2010, only a small portion went to medical treatments, the study found.

Instead, long-term care -- either nursing homes, or home care provided by professionals or family members -- was the big expense, accounting for up to 84 percent of the total.

Per person, the costs ranged from about $41,700 to $56,300, depending on how the researchers calculated the cost of family caregiving. In the first case, they considered only family members' lost wages; in the second, they gave family members' time the same value as formal paid care.

As for who paid, Medicare foot the bill for $11 billion out of the up to $215 billion in total expenses, Hurd's team said.

It's a small share because Medicare does not usually cover nursing home or other long-term care. Medicaid, the government health insurance program for the poor, will cover it -- but only after certain patient assets have been spent down.

"A large part of the burden is borne by families," said Dr. Richard Hodes, director of the U.S. National Institute on Aging, which funded the study.

Hodes noted that things could get tougher in the years to come. The younger baby boomers had fewer children compared with past generations -- so along with the rise in the number of elderly adults with dementia, there will be fewer family members to care for them.

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Brisk Walking Equals Running for Heart Health: Study

Title: Brisk Walking Equals Running for Heart Health: Study
Category: Health News
Created: 4/4/2013 4:35:00 PM
Last Editorial Review: 4/5/2013 12:00:00 AM

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