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Friday, May 28, 2010

Pfizer halts eplerenone HF trial early due to drug benefit

While I await the official results of this trial, it may be an important finding. Congestive Heart Failure continues to be a huge problem in the US. If this trial is correct, eplerenone may become an important additional medication for treatment of CHF even in patients with "mild" CHF (in addition to B-blockers/ACE inhibitors/Angiotension Receptor Blockers/diuretics/nitrates/digoxin)

"Pfizer is to halt recruitment of patients to the EMPHASIS-HF trial testing its selective aldosterone inhibitor eplerenone in mild heart-failure patients because of a significant benefit of the drug."


Tuesday, May 25, 2010

Elevated exercise BP nonsignificant for CVD–related death after accounting for rest BP

Here's the most important part of this study -- "Specifically, among nonhypertensives with either normal BP or prehypertension at rest, elevated exercise BP at Bruce stage 2 >180 mm Hg/90 mm Hg identified individuals with up to 2.4-fold higher risk for future CVD death and added predictive value to rest BP and risk factors, possibly warranting more aggressive treatment than is currently recommended"


Beta-Blockers May Help COPD Patients

This is very interesting.

Those who took a beta-blocker were 32% less likely to die during the study follow-up and 39% less likely to have worsening of COPD than those who didn't use the drugs.

I wonder how often a COPD exacerbation is actually started by an element of heart failure (which B-Blockers clearly help).

I look forward to a B-blocker vs placebo randomized trial


Mayo Clinic First In U.S. To Send Patient Home With Artificial Heart

AMAZING!!! --- Mayo Clinic Hospital in northeast Phoenix made history on May 3, 2010, when it became the first hospital in the U.S. to discharge a patient with an artificial heart - after he had been hospitalized for more than two years. But to call him a "man without a heart" would have been met with serious challenge by his family, friends and caregivers...


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High Blood Pressure Prevalent, but Better Controlled

We are making progress in treatment but still failing miserably in prevention.

Study: Half of Americans with high blood pressure now have the condition under control -- but more and more Americans are coming down with the dangerous condition.


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Best Sunscreens: A Consumer Reports Ranking

While sunscreens do block our bodies natural ability to make Vitamin D, they can dramatically reduce sun induced skin damage. I recommend using sunscreen (Melanoma can KILL) and taking supplemental Vitamin D.

A major consumers' group has rated the sunscreens it says work best in shielding people from harmful ultraviolet A and ultraviolet B radiation.


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6 Insect Repellents Get High Marks

Living in Southwestern CT -- Lyme Dz is very prevalent, as are mosquitoes. While this is not specifically a heart related topic, it is one I take to "heart." (Pun intended)

Consumer Reports Health has issued a new ranking of the six repellents it says are best to ward off mosquitoes and deer ticks.


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Saturday, May 22, 2010


Everybody In The Pool! Uh, Not So Fast

I found the following story on the NPR iPhone App:


Everybody In The Pool! Uh, Not So Fast
by scott hensley

- May 21, 2010

Finally, the weather is heating up, and we're daydreaming about some serious time by the pool.

But those killjoys at the Centers for Disease Control and Prevention blew up our fantasies with an analysis of more than 121,000 pool inspection reports from around the country.

The CDC found 12 percent of inspections uncovered problems serious enough to warrant an immediate pool closure.

Health departments regularly check up on swimming pools. Job No. 1 is making sure the water is treated so you don't catch an infection. Bugs that cause gastroenteritis (think diarrhea, stomach cramping and similar symptoms) are the most common, unwelcome swimmers.

Common violations of health codes include problems with water filters and circulation and insufficent disinfectant, the CDC finds.

About half the reports included information on the type of pool inspected, so there are some hints about where the problems are biggest.

Pools at child-care facilities got shutdown because of an inspection most often -- 17 percent of the time. Hotel and motel pools failed 15 percent of the time. Then came the pools at apartment complexes -- 12 percent. Copyright 2010 National Public Radio

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

Friday, May 21, 2010

Clinical Study Confirms The Potential Of A Medication To Reduce Inflammation In Patients With Atherosclerosis

This is interesting -- "The results of a major clinical study carried out at the Montreal Heart Institute (MHI) by Dr. Jean-Claude Tardif are now available in the journal Circulation Cardiovascular Imaging. Dr. Tardif is a cardiologist and director of the MHI Research Centre, as well as a professor in the faculty of medicine and holder of the atherosclerosis research chair at the Universite de Montreal..."


Grown-Up Cyclists Need Helmets, Too

PLEASE -- wear a helmet when you ride a bike. Studies now show that cyclists > 30 benefit even greater

I always wear one and I make my kids wear their's too.

I've seen way too much head trauma in my career and even a fall at low speed can be devastating.

"Helmets need not be expensive or unstylish, and they're worth the trouble of wearing: the changes of aging make people over 30 more vulnerable to head injuries."


Wednesday, May 19, 2010

CPAP Reduces Heart Risk in Nonsleepy Patients (CME/CE)

NEW ORLEANS (MedPage Today) -- Continuous positive airway pressure (CPAP) showed potential to reduce the risk of cardiovascular events and hypertension in nonsleepy patients with obstructive sleep apnea, data from a multicenter randomized trial showed.


Monday, May 17, 2010

Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus

Consumption of red and processed meat were not associated with stroke

Consumption of processed meats, but not red meats, is associated with higher incidence of CHD and diabetes mellitus.


Sunday, May 16, 2010

Testosterone Improves Metabolic Syndrome

Depot testosterone injections in men with metabolic syndrome and hypogonadism led to improvements in several important components of their disease, including significant weight loss and reduced glucose dysregulation, a researcher said here.


Friday, May 14, 2010

Cholesterol Levels Are A Telling Indicator Of Diet And Exercise

Diet and lifestyle choices aren't only evident on the bathroom scale. The effect of these choices is also reflected with relative accuracy in cholesterol numbers. The May issue of Mayo Clinic Health Letter looks at how an individual's lifestyle choices can affect "good" and "bad" cholesterol levels as well as levels of triglycerides, another blood fat. Cholesterol isn't inherently bad...


Thursday, May 13, 2010

Friends of Stroke Victims Reluctant to Call 911

Please call 911 if you think you or someone else may be having a heart attack or a stroke. Both the brain and the heart have little reserve. The quicker the issue is treated, the less the permanent damage. We try and get a stoke treated with clot busting agents within 3 hours of symptom onset and we try and get a heart artery opened in less than 90 minutes of arrival to the hospital.

A new study shows that most people who realize stroke warning signs are occurring in a friend or family member may not call 911, thereby delaying potentially lifesaving treatment.


Wednesday, May 12, 2010

Stenting vs. CABG

Left Main coronary artery stent is here!!!

Five-year risk for death, Q-wave MI and stroke were similar among patients with left main coronary artery disease who underwent stenting and those who received CABG.

However, target vessel revascularization occurred more often with stenting


Topol vs Gurbel: experts split on routine genotyping for DAPT

Routine genotyping to guide dual-antiplatelet therapy (DAPT) seems like a great idea. After all, argue Damani and Topol in a Viewpoint in JACC, the arguments are overwhelming, and the consequences of not rushing to adopt the new technique are dire. They write that loss-of-function and gain-of-function variants of CYP2c19 are extremely common, and are "the root [...]


Federal School Nutrition Programs Linked To Obesity

With obesity becoming an epidemic among school-aged children in this country, a Georgia State University professor has found a link between overweight children and federal school nutrition programs...


Tuesday, May 11, 2010

Dizziness is heart-related more often than not

Contrary to previous studies in a referred population, cardiovascular disease was the most common major cause of dizziness in the elderly in a study of primary-care patients.


Are too many people taking heartburn drugs?

Too many people in the U.S. may be taking stomach-acid-suppressing drugs such as Nexium and Prevacid, new research suggests.


Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women

Context Improving vitamin D status may be an important modifiable risk factor to reduce falls and fractures; however, adherence to daily supplementation is typically poor.

Objective To determine whether a single annual dose of 500 000 IU of cholecalciferol administered orally to older women in autumn or winter would improve adherence and reduce the risk of falls and fracture.

Design, Setting, and Participants A double-blind, placebo-controlled trial of 2256 community-dwelling women, aged 70 years or older, considered to be at high risk of fracture were recruited from June 2003 to June 2005 and were randomly assigned to receive cholecalciferol or placebo each autumn to winter for 3 to 5 years. The study concluded in 2008.

Intervention 500 000 IU of cholecalciferol or placebo.

Main Outcome Measures Falls and fractures were ascertained using monthly calendars; details were confirmed by telephone interview. Fractures were radiologically confirmed. In a substudy, 137 randomly selected participants underwent serial blood sampling for 25-hydroxycholecalciferol and parathyroid hormone levels.

Results Women in the cholecalciferol (vitamin D) group had 171 fractures vs 135 in the placebo group; 837 women in the vitamin D group fell 2892 times (rate, 83.4 per 100 person-years) while 769 women in the placebo group fell 2512 times (rate, 72.7 per 100 person-years; incidence rate ratio [RR], 1.15; 95% confidence interval [CI], 1.02-1.30; P = .03). The incidence RR for fracture in the vitamin D group was 1.26 (95% CI, 1.00-1.59; P = .047) vs the placebo group (rates per 100 person-years, 4.9 vitamin D vs 3.9 placebo). A temporal pattern was observed in a post hoc analysis of falls. The incidence RR of falling in the vitamin D group vs the placebo group was 1.31 in the first 3 months after dosing and 1.13 during the following 9 months (test for homogeneity; P = .02). In the substudy, the median baseline serum 25-hydroxycholecalciferol was 49 nmol/L. Less than 3% of the substudy participants had 25-hydroxycholecalciferol levels lower than 25 nmol/L. In the vitamin D group, 25-hydroxycholecalciferol levels increased at 1 month after dosing to approximately 120 nmol/L, were approximately 90 nmol/L at 3 months, and remained higher than the placebo group 12 months after dosing.

Conclusion Among older community-dwelling women, annual oral administration of high-dose cholecalciferol resulted in an increased risk of falls and fractures.

Trial Registration anzctr.org.au Identifier: ACTRN12605000658617; isrctn.org Identifier: ISRCTN83409867


Behavior Change Is Key to Lower Heart Risk

Behaviors such as lowering cholesterol levels and blood pressure account for nearly half of the decline in heart disease deaths, according to a new study.


Drug-Eluting Stents for In-Stent Restenosis

A new study has just shown that both Taxus stents and Cypher stents are efficacious and safe for the treatment of restenosis of a drug-eluting stents (DES).

The rate of recurrent intervention (a third procedure) was ~ 15%.

The rate of MI, death or need for a recurrent procedure was ~ 20%.

This information continues to add to the ever growing body of evidence for the benefit and indication for drug eluting stenting.


New Position Statement On Vitamin D For Older Adults

The International Osteoporosis Foundation (IOF) has released a new position statement on Vitamin D for older adults which makes important recommendations for vitamin D nutrition from an evidence-based perspective. Vitamin D is important for bone and muscle development, function and preservation...


Working Overtime May Hurt the Heart

British civil servants working three to four hours longer than usual per day appear to have an increased risk of having a coronary heart disease event, a prospective cohort study showed.


Overeating Results In Faster Weight Gain For Those With A Family History Of Diabetes Type 2

Individuals with a family history of diabetes type 2 who overeat for a specific period put on more weight than other people of the same age and lifestyle who overeat to the same extent. In other words, short-term overeating results in more weight gain for people with a genetic predisposition to diabetes type 2...


Bran Reduces Heart Disease Deaths

Eating bran-rich whole grains is associated with a lower risk of death and death from cardiovascular causes in women with diabetes, a new study finds.


Monday, May 10, 2010

Sleep Deprivation Linked to Obesity

@HeartAware: Sleep Deprivation linked to Obesity http://bit.ly/dwohLE

Twitter Link: http://twitter.com/HeartAware/statuses/13747722429

Eating Nuts Daily Lowers Cholesterol

Eating nuts on a daily basis improves blood cholesterol levels and reduces the risk of coronary heart disease, a new study says.


Raised Triglycerides (Fats) In The Blood Could Raise Risk Of Coronary Heart Disease

New genetic research suggests that raised levels of triglycerides, a type of blood fat, may be an important cause of heart disease. The results, published in an Article in this week's Lancet, are from a major international consortium led by Dr Nadeem Sarwar and Professor John Danesh of the University of Cambridge...


Sunday, May 9, 2010

Announcing: The Ultimate Vitamin D Resource Blog

As you all know, I am continually intrigued by the possible health benefits of vitamin D.

Therefore, I have started a new blog dedicated solely to providing the latest news and information of the potential health benefits of vitamin D.

Saturday, May 8, 2010

@drportnay is ranked #14

Glad to hear that people out there are appreciating my work. This feels real good. I enjoy sharing the news and my opinions with you all.

@HeartDisease_OW: @drportnay is ranked #14 on @organizedwisdom Heart Disease Expert Leaderboard for April. Leaders: http://bit.ly/bBkpU6 Congrats Dr. Portnay!

Twitter Link: http://twitter.com/HeartDisease_OW/statuses/13625567770

Friday, May 7, 2010

Thursday, May 6, 2010

How Dark Chocolate May Guard Against Brain Injury From Stroke

Researchers at Johns Hopkins have discovered that a compound in dark chocolate may protect the brain after a stroke by increasing cellular signals already known to shield nerve cells from damage...


Inflammatory Bowel Disease Linked to Increased Coronary Artery Disease Risk

Patients with inflammatory bowel disease (IBD) have a two- to threefold increased risk of coronary artery disease (CAD) despite a lower prevalence of conventional CAD risk factors.


Tweet forwarded by tportnay

@drportnay: Risk factors for statin intolerance: hypothyroid, old age, family member w statin intolerance and Vitamin D deficiency

Twitter Link: http://twitter.com/drportnay/statuses/13481307202

Tweet forwarded by tportnay

@drportnay: JUPITER trial: patients taking Crestor had a lower cancer mortality

Twitter Link: http://twitter.com/drportnay/statuses/13481176062

Wednesday, May 5, 2010

Nano-Bio-Chip For Diagnosing Heart Attacks Begins Human Trials

Once again, a news story surfaces that reads like science fiction.

This is really amazing. Researchers in Houston are using a Nano-Bio-Chip to detect cardiac enzymes in the saliva of heart attack victims. Instead of waiting for a blood test, this new test can yield bedside results. It will be trialled over the next 2 years and its diagnostic accuracy will be compared with standard blood testing.


CDC's Atrial Fibrillation Fact Sheet

Facts on Atrial Fibrillation:
 Atrial fibrillation is the most common type of arrhythmia (abnormal heart rhythm).
 When atrial fibrillation and other arrhythmias occur, the electrical activity of the heart is disorganized, causing an
irregular heartbeat. The irregular heartbeat disrupts the flow of blood through the heart.
 Treatment of atrial fibrillation represents a significant health care burden. The estimated cost of the treatment of atrial fibrillation in 2005 was $6.65 billion per year, including the costs of hospitalization, in- and outpatient physician care, and medications.
 An estimated 2.66 million people will have atrial fibrillation in 2010. As many as 12 million people will have the condition by 2050.3
 The incidence of atrial fibrillation increases with age.1 The median age for patients with atrial fibrillation is 66.8 years for men and 74.6 years for women.
 The mortality rate from atrial fibrillation as either the primary or an underlying cause of death has been increasing for more than two decades.
 African Americans experience atrial fibrillation at much lower rates than whites. Risk factors for atrial fibrillation include high blood pressure, heart failure, diabetes, advanced age, hyperthyroidism,
and heart disease.
 Symptoms of atrial fibrillation include:
o Irregular or rapid heartbeat 
o Palpitations 
o Lightheadedness, extreme fatigue 
o Shortness of breath chest pain
However, not all people with atrial fibrillation experience symptoms.
 Atrial fibrillation can be detected with an electrocardiogram (also called an EKG)—a simple, painless test that records the heart's electrical activity.
 Atrial fibrillation treatments include:
Medications to control the rhythm and rate of the heart
o Surgery
Medication that thins the blood to prevent blood clot formation and reduces the risk of having a stroke
Medication and lifestyle changes to reduce the risk factors for atrial fibrillation, which include high blood pressure, obesity, and diabetes

 Stroke and heart failure are the two most common complications of atrial fibrillation.

 Atrial fibrillation is responsible for 15 to 20 percent of ischemic strokes. During an ischemic stroke, blood flow to the brain is blocked by blood clots or fatty deposits called plaque in blood vessel linings. Atrial fibrillation increases one's risk of suffering an ischemic stroke by five times.

Monday, May 3, 2010

High Blood Pressure During Exercise

A new study just released reveals that patients with normal blood pressure at baseline and whom become hypertensive during exercise have a higher risk of cardiovascular death.

ASH: Novel Combo Antihypertensive Pill Better than Its Parts

Essential hypertension is a complex and multifactorial disease. Its no surprise that a pill containing three different medications works better that a combination of any two of the three medications.

NEW YORK (MedPage Today) -- An investigational triple combination antihypertensive pill was significantly better at lowering blood pressure and getting patients to goal than dual therapies using its components, a phase III randomized trial showed.


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