Category Archives: Heart and Vascular Health

Jun 13 2014
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Public Health News Roundup: June 13

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Older Hispanics Taking their Medicines Because of Medicare Prescription Drug Plans
Hispanics have reduced the gap with whites in taking prescribed heart medicines since the 2006 launch of Medicare’s prescription drug benefit—Medicare Part D. The findings were reported in a study presented at the American Heart Association’s Quality of Care and Outcomes Research 2014 Scientific Sessions earlier this month. Researchers reviewed prescription drug data from Medicare’s national Medical Expenditure Panel Survey for white, African-American and Hispanic Medicare seniors for the years 2007-10. After Part D, adherence rates increased among all racial groups, with the highest increase in whites and Hispanics, but increased only slightly among African-Americans.

  • Hispanics’ total group adherence rate improved about 60 percent.
  • Whites’ adherence rate improved 47 percent.
  • African-Americans’ adherence rate improved about 9 percent.

Read more on heart health.

USDA Announces Grants to Help Repair Houses in Rural Areas
The U.S. Department of Agriculture (USDA) has announced it is seeking applications for grants of about $4 million to preserve and repair housing for very-low- and low-income families living in rural areas. The funds are being made available by the USDA Rural Development's Housing Preservation Grant program. Eligible applicants include town or county governments; public agencies; federally recognized Indian Tribes; and non-profit and faith-based organizations. Applications are due July 28. Examples of previous grants include a 2012 award to Habitat for Humanity Lake County (Calif.), which received a $55,000 Housing Preservation Grant to help 12 low-income homeowners repair their homes. One person helped was a Vietnam veteran who used a wheelchair and could not leave his home without assistance. Habitat for Humanity widened his doorway and installed a wheelchair lift. Read more on housing.

Many U.S. Cancer Survivors Face Serious Financial Burdens
Many U.S. cancer survivors face significant economic burdens due to growing medical costs, missed work and reduced productivity, according to a study by the U.S. Centers for Disease Control and Prevention (CDC). “Cancer survivors face physical, emotional, psychosocial, employment and financial challenges as a result of their cancer diagnosis and treatment,” said Donatus U. Ekwueme, PhD, a senior health economist at CDC’s Division of Cancer Prevention and Control. The number of cancer survivors is expected to increase by more than 30 percent in the next decade—to 18 million Americans. Researchers analyzed data from the Agency for Healthcare Research and Quality’s 2008-2011 Medical Expenditure Panel Survey to estimate annual medical costs and productivity losses among cancer survivors  aged 18 years and older, and among persons without a cancer diagnosis. Among those employed, more than 42 percent had to make changes to their work hours and duties. The report also found that about 10 percent of survivors aged 65 years and younger were uninsured and likely to have a larger financial burden compared to survivors with some source of payment for medical services. Read more on cancer

May 30 2014
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Public Health News Roundup: May 30

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FDA: Sunlamps to Require Health Warnings
The U.S. Food and Drug Administration (FDA) has issued a final order that requires sunlamp products and ultraviolent (UV) lamps for use in sunlamp products to carry warnings stating that they should not be used by people under the age of 18. The order reclassifies the products from low-risk (class I) to moderate-risk (II). “The FDA has taken an important step today to address the risk to public health from sunlamp products,” said Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health, in a release. “Repeated UV exposure from sunlamp products poses a risk of skin cancer for all users—but the highest risk for skin cancer is in young persons under the age of 18 and people with a family history of skin cancer.” People who are exposed to UV radiation as a result of indoor tanning increase their risk of melanoma by 59 percent, according to the American Academy of Dermatology. Read more on cancer.

CDC: U.S. Measles Cases at a 20-year High
Cases of measles in the United States are at a 20-year high, with international travel by unvaccinated people a major contributor, according to the U.S. Centers for Disease Control and Prevention (CDC). The CDC reports that there were 288 U.S. cases between January 1 and May 23 this year—and 97 percent were associated with importation by travelers from at least 18 countries. Approximately 90 percent of the cases were in people who were not vaccinated or whose vaccination status was unknown. “The current increase in measles cases is being driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the United States and spread to others in communities where many people are not vaccinated,” said Anne Schuchat, MD, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases, in a release. “Many of the clusters in the U.S. began following travel to the Philippines where a large outbreak has been occurring since October 2013.” Read more on vaccines.

Type of Increased Heart Risk Depends on Which Blood Pressure Number is High
The type of increased heart risk a person with high blood pressure faces depends on which number in their blood pressure—the top, which is systolic, or the bottom, which is diastolic—is high, according to a new study in The Lancet. Researchers analyzed health care date on more than 1 million people ages 30 and older in England, finding that people with higher systolic blood pressure had a greater risk of bleeding strokes and stable angina, while people with higher diastolic blood pressure were more likely to be diagnosed with an abdominal aortic aneurysm. In addition, they found that a 30-year-old with high blood pressure has a 63 percent lifetime risk of developing heart disease, compared with 46 percent for a person with normal blood pressure. "With lifetime risks this high, the need for new blood pressure-lowering strategies is paramount," said lead investigator Eleni Rapsomaniki, MD, from The Farr Institute for Health Informatics Research in London, England, in release. Read more on heart health.

May 23 2014
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Public Health News Roundup: May 23

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HUD Awards $40 Million in Housing Counseling Grants
The U.S. Department of Housing and Urban Development (HUD) has awarded more than $40 million in grants to hundreds of national, regional and local organizations to help families and individuals with their housing needs and to prevent future foreclosures.

“HUD-approved counseling agencies use this funding to support a wide range of services from assisting lower income persons to locate an affordable apartment to helping first-time homebuyers avoid unsustainable mortgages,” said Secretary of Housing Shaun Donovan.

More than $38 million will directly support the housing counseling services provided by 29 national and regional organizations, seven multi-state organizations, 22 state housing finance agencies and 232 local housing counseling agencies. In addition, HUD is awarding $2 million to three national organizations to train housing counselors with the instruction and certification necessary to effectively assist families with their housing needs.

In 2012, HUD released two reports on the impact of HUD-approved housing counseling for families who purchase their first homes and those struggling to prevent foreclosure. In both studies, HUD found housing counseling significantly improved the likelihood homeowners remained in their homes.

Read more on housing

Chest Pain Incidence Drops for Whites, But not for Blacks
The percentage of people reporting angina (chest pain) dropped in the last two decades among Americans 65 and older and white people 40 and older — but not among black Americans, according to a study in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Angina is chest pain or discomfort that occurs when the heart isn’t getting enough oxygen-rich blood.

Researchers analyzed national health survey data starting in 1988 to find how many patients reported that a health care professional had told them they have the condition and how many people report angina symptoms.

They found:

  • The rates for whites 40 and older reporting a history of angina dropped by about one-third, from the 2001-04 survey to the 2009-12 survey.
  • The rates for whites 40 and older reporting angina symptoms declined by half from the 1988-94 survey to 2009-12 survey.
  • For blacks, the rates were essentially unchanged.
  • The rates for American women 65 and older reporting a history of angina dropped nearly in half from the 2001-04 survey to the 2009-12 survey.
  • The rates for women 65 and older reporting angina symptoms declined by almost 60 percent from the 1988-94 survey to 2009-12 survey; the rates for men in this age group declined by more than 40 percent during this same time period

Read more on heart health

United States, Canada and Mexico Set Guidelines to Strengthen Information Sharing in Health Emergencies
The United States, Canada and Mexico have adopted a set of principles and guidelines on how the three countries’ governments will share advance public information and communications during health emergencies impacting the countries.

The Declaration of Intent calls on the three countries to:

  • Share public communications plans, statements and other communications products related to health emergencies with each other prior to their public release;
  • Apprise other appropriate authorities, depending on the type of health emergency, within their respective governments when the declaration is invoked;
  • Conduct an annual short communications exercise to improve joint coordination; and
  • Hold recurrent meetings to review and propose amendments to the Declaration of Intent.

Read more on preparedness

May 20 2014
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Hypertension ‘Kills More People Around the World than Anything Else’

“Hypertension affects nearly one in three adults and kills more people around the world than anything else. It is both too common and too often poorly controlled.”

So said Tom Frieden, MD, MPH, director of the U.S. Centers for Disease Control and Prevention (CDC), during a panel discussion at the annual meeting of the American Society of Hypertension (ASH) this past weekend. The panel was convened by ASH, the American Heart Association and the CDC to launch a project supporting improved control of hypertension worldwide. According to the panel an estimated 970 million people have hypertension worldwide, and the disease is responsible for more than nine million deaths, as hypertension can lead to heart disease and stroke.

Data from the groups finds that rates of hypertension have increased in both developed and developing nations, due in part to an aging population and lifestyles that include high salt diets and low physical activity.

For the developing world, the CDC; the Pan American Health Organization; and other regional and global stakeholders are identifying both cost effective medicines and inexpensive delivery strategies for the drugs to help patients afford and receive them.

In the United States, the Affordable Care Act is expected to increase the number of people on hypertension medications, but despite the availability of coverage for hypertension diagnosis and treatment there remains concern over disparities. A study of more than 16,000 members of the Hispanic community published in the American Journal of Hypertension earlier this year found that while the prevalence of hypertension among Hispanics is nearly equal to that of non-Hispanic whites, diagnosis of the disease is much lower, as is general awareness of its symptoms and treatment options.

"Given the relative ease of identifying hypertension and the availability of low-cost medications, enabling better access to diagnostic and treatment services should be prioritized to reduce the burden of cardiovascular disease on Hispanic populations,” said Paul Sorlie, MD, the lead author of the study and an epidemiologist with the National Heart, Lung and Blood Institute. “This study gives us the information needed to support the development of policies that can improve this access and, subsequently, the overall health of countless US citizens.”

>>Bonus Links:

  • A new infographic from the Measure Up/Pressure Down initiative of the American Medical Group Association provides some key patient information about hypertension, including normal and dangerous ranges of blood pressure—numbers patients should be familiar with.
  • A map from the Institute for Health Metrics and Evaluation at the University of Washington shows hypertension levels for 2001 to 2009 by race and gender.
May 13 2014
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Public Health Campaign of the Month: ‘Save a Minute’ Stroke PSA

May is stroke awareness month and a new infographic from the American Stroke Association wants everyone to know minutes count when a stroke hits. The campaign uses research published by the Association this year in the campaign infographic to let people know that for each minute shaved off stroke response in a hospital, patients get back days of healthy living.

The infographic includes the  FAST warning signs and symptoms for stroke:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911

>>Bonus Content: The American Stroke Association has a site full of patient education resources on stroke awareness and prevention, including a very effective PSA on body language to help teach the FAST warning signs of stroke. The association also previously created another infographic on the FAST warning signs.

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May 13 2014
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Public Health News Roundup: May 13

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Living Near Foreclosed Property is Linked to Higher Blood Pressure
Living near foreclosed property may increase the risk of higher blood pressure, according to new research published in the American Heart Association journal Circulation. Researchers reviewed data from 1,740 participants (mostly white, 53 percent women) in 1987-2008 in the Framingham (Massachusetts) Offspring Cohort, which is part of the Framingham Heart Study. The researchers distinguished between real-estate-owned foreclosures, which are owned by lenders and typically sit vacant, and foreclosures purchased by third-party buyers, which are generally put into housing use. The researchers found each additional foreclosed property within 100 meters (328 feet) of participants’ homes was associated with an average increase of 1.71 mm Hg in systolic blood pressure. The association only applied to properties that were real-estate owned and there was no effect from foreclosed properties more than 100 meters from participants’ homes.

“The increases in blood pressure observed could be due in part to unhealthy stress from residents’ perception that their own properties are less valuable, their streets less attractive or safe and their neighborhoods less stable,” said Mariana Arcaya, Sc.D., M.C.P., study lead author and a research fellow at the Harvard Center for Population and Development Studies in Cambridge, Mass. “Safety could also be a concern that affects their ability to exercise in these neighborhoods.”

Research on different populations in urban and rural settings is needed, says Arcaya. The study was funded by the Robert Wood Johnson Foundation, the Harvard School of Public Health and the National Institutes of Health and the Robert Wood Johnson Foundation funded the study. Read more on prevention.

Underage College Men Downplay Danger of Driving after Using Marijuana
Underage male college students who report using marijuana in the month before they were surveyed had a high prevalence of driving under the influence of marijuana and of riding with a marijuana-using driver, at a rate more than double that of driving or riding after alcohol use, according to a recent study by researchers from the University of Massachusetts Amherst School of Public Health and Health Sciences and University of Washington pediatrics department. The researchers also found that among marijuana-using students, 44 percent of males and 9 percent of females drove after using the drug, and 51 percent of males and 35 percent of females rode as a passenger with a marijuana-using driver. The researchers say the study results reflect the widespread belief that driving after using marijuana is safe and that strategies to dispute that belief are needed to help change social norms and encourage using a designated driver not only after alcohol use, but after a driver has used any risky substance. The study was published in JAMA Pediatrics. Read more on substance abuse.

Moderate Exercise Reduces Premature Death Risk in Older Men
Older men with hypertension can lower their risk of premature death with even moderate levels of exercise, according to a new study in Hypertension. The researchers say the needed level of fitness can be achieved by a brisk twenty to forty minute walk on most days. The researchers reviewed the fitness levels of 2,153 men, aged 70 years and older with high blood pressure by a standard treadmill exercise test, using a standard measure of fitness called metabolic equivalents (METs.) An MET is equal to the amount of oxygen the body uses per kilogram of body weight per minute. The peak MET level of a sedentary 50-year-old is about five to six METs; for a moderately fit individual it’s about seven to nine METS; and for a highly fit person it’s 10 to 12 METs. (Marathon runners, cyclists and other long distance athletes often have MET levels of 20 or higher.)

After an average follow-up of nine years, researchers found that the risk of death was 11 percent lower for every one-MET increase in exercise capacity:

  • Those in the low-fit category (4.1 to 6 peak METs) had an 18 percent lower risk of death.
  • Moderately-fit men (6.1 to 8 peak METs) had a 36 percent lower risk of death.
  • High-fit men with peak METs of more than 8 reduced the risk of death by 48 percent.

Read more on heart health.

May 9 2014
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Public Health News Roundup: May 9

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Starting at Age 30, Inactivity Accounts for Greatest Risk of Heart Disease for Women
A new study in the British Journal of Sports Medicine finds that from the age of 30 onward, physical inactivity exerts a greater impact on a woman's lifetime risk of developing heart disease than other risk factors, including being overweight, smoking and having high blood pressure. The research was based on a longitudinal study of more than 30,000 Australian women ages 22-64 over almost twenty years. Read more on heart health.

Domestic Violence Victims More Likely to Take Up Smoking
A new study in 29 low and middle-income countries by researchers at the Mailman School of Public Health at Columbia University links intimate partner violence (IPV) with smoking. The researchers examined the association between IPV and smoking among 231,892 women ages 15-29 data collected from health surveys. Reports of IPV ranged from 9 to 63 percent, and using a meta-analysis that accounted for other factors including age, education, and household wealth, the researchers found a 58 percent increased risk for smoking among the women who experienced IPV. The study points to a specific need for investments to help IPV victims avoid tobacco, according to the researchers, who suggest that information about the consequences of smoking, motivation to quit smoking and smoking-cessation treatments could be incorporated into IPV treatment by health care providers who routinely interact with IPV victims. Read more on violence.

Many Veterans Face Food Insecurity
A new study by researchers at the University of Minnesota School of Public Health has found that 27 percent of veterans of the wars in Iraq and Afghanistan are facing food insecurity—nearly double the rate of the general population. The findings came from a university-supported sturdy of veterans’ behavioral health begun in 2001. Researchers found that people who report being food insecure tend to get less sleep, report using cigarettes, tend to be unemployed, ten not be married or partnered and have lower incomes. Veterans would be helped by increasing awareness of the issue so that they are connected to assistance both for food and for employment opportunities. Read more on poverty.

May 8 2014
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Public Health News Roundup: May 8

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CDC: Parasitic Diseases a Significant U.S. Public Health Issue
Although the perception is that parasitic diseases only occur in poor and developing countries, people in the United States are also at risk for the diseases, which can cause serious illnesses, including seizures, blindness, pregnancy complications, heart failure and even death, according to the U.S. Centers for Disease Control and Prevention (CDC). The CDC has designated five neglected parasitic infections (NPIs) as U.S. public health priorities: Chagas disease, cysticercosis, toxocariasis, toxoplasmosis and trichomoniasis. While they can be treated when identified, there remains difficulty in correctly diagnosing the diseases, according to the CDC.

The estimates of the burden of NPIs include:

  • More than 300,000 people living in the United States are infected with Trypanosoma cruzi, the parasite that causes Chagas disease, and more than 300 infected babies are born every year.
  • There are at least 1,000 hospitalizations for symptomatic cysticercosis per year in the United States.
  • At least 14 percent of the U.S. population has been exposed to Toxocara, the parasite that causes toxocariasis, and each year at least 70 people—most of them children—are blinded by resulting eye disease.
  • More than 60 million people in the United States are chronically infected with Toxoplasma gondii, the parasite that causes toxoplasmosis; new infections in pregnant women can lead to birth defects and infections in those with compromised immune systems can be fatal.
  • Trichomoniasis can cause pregnancy problems and increase the risk of other sexually transmitted infections including HIV.  The Trichomonas parasite is extremely common, affecting 3.7 million people in the United States, although it is easily treatable.

Read more on global health.

Study: Many People Who Believe They Are Sensitive to Gluten Do Not Get Tested for Celiac Disease
Despite the increasing number of gluten-free products on grocery store shelves, many people who believe they are sensitive to gluten do not undergo tests to rule out celiac disease, according to a new study in the journal Nutrition in Clinical Practice. The autoimmune disorder damages the lining of the intestines, resulting in digestive symptoms and potential complications, and left untreated can lead to significant health problems. “There is a great deal of hype and misinformation surrounding gluten and wheat allergies and sensitivities. The group of so-called ‘non-celiac gluten sensitivity’ remains undefined and largely ambiguous because of the minimal scientific evidence,” said study author Jessica R. Biesiekierski, according to Reuters. “This non-celiac gluten sensitivity entity has become a quandary, as patients are powerfully influenced by alternative practitioners, Internet websites and mass media who all proclaim the benefits of avoiding gluten- and wheat-containing foods.” Read more on nutrition.

Study: ECGs Should Be Added to Health Screenings for High School Athletes
Electrocardiograms should be added to the health screening programs for high school athletes, according to a new study presented at the Heart Rhythm Society's annual meeting in San Francisco. The test would increase the odds of detecting medical conditions that could lead to sudden cardiac arrest and death. Researcher used data on approximately 5,000 athletes, ages 13-19, who underwent standard American Heart Association screening and also received an electrocardiogram, finding that while 23 were found to have significant heart abnormalities that required further evaluation, seven would not have been detected without an electrocardiogram. Read more on heart health.

May 2 2014
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Place Matters: Eliminating Health Disparities in Cuyahoga County, Ohio

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The Cuyahoga County, Ohio Place Matters team's focus is on ensuring health implications and equity considerations are at the forefront as policy makers and others make decisions that substantially impact the county’s residents and the neighborhoods in which they live.

Key Team Objectives:

  • A broader definition of health. Health is not simply the absence of disease—health begins where people live, work, learn, age and play. Health includes the social conditions one lives in, such as the jobs we do, the money we're paid, the schools we attend and the neighborhoods we live in, as well as our genes, our behaviors and our medical care.
  • Inform, influence and engage policy makers and community members to develop policies—using an overarching health equity lens—that have long-term impacts, create conditions for optimal health and reduce inequities.
  • Utilize "place-based" interventions to engage and empower residents in under-resourced communities to revitalize their communities.

East Cleveland is one of the most densely settled communities in Cuyahoga County. The city has a poverty rate of 32 percent, while its heart disease mortality rates (355/100,000) are higher than in the county (10 percent higher) and the nation (32 percent higher).

Team objectives include building effective partnerships; striving for equal opportunity for all; equity; recognition that neighborhood condition is the context in which health and wellbeing begins; health in all policies; mobilizing the community for action; and measuring indicators of social determinants of health.

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Apr 11 2014
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Public Health News Roundup: April 11

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Sebelius to Step Down as Head of HHS
Kathleen Sebelius is resigning as secretary of the U.S. Department of Health and Human Services (HHS). The formal announcement is expected to come at 11 a.m. this morning, with President Obama to name Office of Management and Budget Director Sylvia Mathews Burwell as the replacement for the former Kansas governor. Sebelius assumed the HHS position in April 2009. Read more on the HHS.

FDA Expands Approved Use of Certain Pacemakers, Defibrillators
The U.S. Food and Drug Administration (FDA) has expanded the approved application of certain pacemakers and defibrillators, allowing them to also be used for patients with atrioventricular (AV) block and less severe heart failure. Previously the devices—which provide electrical impulses to the heart through implanted leads in the ventricles—were approved only for people with more severe heart failure as evaluated by their physician using specific criteria. The expansion covers two cardiac resynchronization pacemakers (CRT-P) and eight cardiac resynchronization defibrillators produced by Medtronic. Approximately 5.1 million people in the United States have heart failure. Read more on heart health.

Study: Doctor’s ‘Bedside Manner’ Has Real Effect on Patient Health
The doctor-patient relationship can have a real and significant impact on patient health, with doctors with better “beside manner” also having patients who fare better in efforts to lose weight, lower their blood pressure or manage pain, according to a new study in the journal PLOS One. Researchers reviewed 13 clinical trials, finding that improved patient outcomes were linked directly to doctors who had undergone training to hone their people skills. "I think that intuitively, people think that if you have an open, caring relationship with your provider, that's beneficial," said Helen Riess, the senior researcher on the new study, according to HealthDay. Read more on access to health care.