Category Archives: Heart Health
Employer Mandate to Provide Health Insurance for Workers Delayed One Year
The U.S. Department of the Treasury announced yesterday that implementation of the rule under the Affordable Care Act requiring employers with more than fifty workers to provide health insurance or pay penalties beginning January 1, 2014, will be delayed by one year. Read more on access to health care.
Pharmacist-guided Home Hypertension Monitoring Shows Significant Results
Home blood pressure monitoring augmented by partnering with a pharmacist can lead to greater improvements in hypertension than the traditional treatments, according to a new study in the Journal of the American Medical Association. People in the study intervention group received a home blood pressure monitor, training and lifestyle advice. The monitor automatically sent updates to the pharmacists, who could adjust treatment accordingly. About 72 percent of the study participants who underwent the new care combination had their hypertension under control after six months, compared to 45 percent for the participants who underwent the usual care. This control also persisted months after the interventions. “The reason that only about half of people with [high] blood pressure have it under control is that usual care isn't working. We combined two interventions that we thought would be very powerful together—home monitoring and pharmacist managements—and this is one system that we've shown works very well for blood pressure control," said senior investigator Karen Margolis, MD, from the HealthPartners Institute for Education and Research in Minneapolis. About 30 percent of U.S. adults suffer from high blood pressure. Read more on heart health.
HHS Issues Final Plan on Improving Patient Care Utilizing Health IT
The Department of Health and Human Services (HHS) has issued its final “Health IT Patient Safety Action and Surveillance Plan” to utilize health information technology (IT) to better protect patients and improve the quality of care. “When implemented and used properly, health IT is an important tool in finding and avoiding medical errors and protecting patients,” said National Coordinator for Health IT Farzad Mostashari, MD. “This Plan will help us make sure that these new technologies are used to make health care safer.” The Office of National Coordinator for Health IT plan outlines the responsibilities of both HHS and the private sector. It includes making it easier to report health IT-related incidents and hazards using certified electronic health record technology; encouraging reports to Patient Safety Organizations and updating standardized reporting forms; encouraging the use of standardized reporting forms in hospital incident reporting systems; and training on how to use the forms to identify safe and unsafe health IT practices. Read more on technology.
Hospital Inpatient Discharge Data Can Help Prepare for Future Patient ‘Safety Events’
Hospital administration data—specifically inpatient discharge data—can be used to track the incidence of patient “safety events” now so that physicians and other health care providers are better able to treat them in the future, according to a new study in the Journal of Healthcare Risk Management. The study found that an average of 9 percent of inpatient discharges in the sample experienced a safety event, which increased the cost of a hospital stay by about $35,000. “While this figure may be a bit startling, it is not a cause for alarm, in that many of the events that we found are adverse events for which there are no known prevention strategies,” said Jennifer Taylor, MD, an assistant professor in the Department of Environmental and Occupational Health in Drexel University’s School of Public Health. “While such events may not be deemed to be preventable now, we need to start tracking them so our research and development colleagues know what’s next in the prevention pipeline.” Read more on research.
Over-Testing of Cholesterol Levels Wastes Time, Money
One-third of people with heart disease have their cholesterol levels checked too often, which can waste time, cost unneeded money and not actually improve their health, according to a new study in JAMA Internal Medicine. Possible reasons for the over-testing include the desired to reach or exceed American Heart Association performance measures, as well as the additional payment that comes with running a cholesterol panel. "I think a lot of it is because of the habit of (ordering) labs on patients…without really thinking about, ‘What am I going to do with this information with someone who is at target for cholesterol?'" said Salim Virani, MD, of the Michael E. DeBakey Veterans Affairs Medical Center in Houston. Michael Johansen, MD, of The Ohio State University in Columbus, said physicians might be better off placing patients with heart disease on a statin, while ensuring they eat properly and get the right amount of exercise. Read more on heart health.
‘Active’ Video Gaming Boosts Kids’ Physical Activity
While playing most video games is not more physically stimulating than watching television, newer-generation “active” games may in fact boost a kid’s physical activity in the home, according to a new study in the journal BMJ Open. The study first removed all games from the home for eight weeks, then had eight weeks of passive gaming followed by eight weeks of active gaming. While the positive findings were only minor, the researchers said they could prove significant because of kids’ increased exposure to technology. "Therefore small changes across a variety of these platforms could result in a more substantial clinical impact. While our study focused on the home setting, school offers another opportunity for more active technologies such as sit-stand desks or active-input electronic media as part of lessons.” Read more on technology.
CPR Quality Varies Among EMS Personnel
The quality of CPR (cardiopulmonary resuscitation) given to victims may vary depending on the EMS department or hospital administering it, according to the American Heart Association. “There have been huge advances in CPR and there’s no question that high-quality CPR saves lives,” said Peter Meaney, MD, MPH, an assistant professor of anesthesia and critical care at Children’s Hospital of Philadelphia and author of a new statement on quality CPR for the AHA. “Right now,” said Meaney, “there is wide variability in the quality of CPR—and we can do better.” Each year in the United States, more than a half-million children and adults suffer cardiac arrest, but survival rates vary significantly: 3 percent to 16 percent for arrests outside of hospitals and 12 percent to 22 percent in hospitals, according to the study authors.
In its statement the AHA offered some recommendations to improve CPR quality:
- Minimize interruptions to chest compressions.
- Provide the right rate of compressions—100 to 120 per minute are optimal for survival.
- Give deep enough compressions—at least 2 inches for adults and at least 1/3 the depth of the chest in infants and children.
- Give no more than 12 rescue breaths a minute, with the chest just visibly rising, so pressure from the breath doesn’t slow blood flow.
The AHA recommends that to ensure quality improvement, providers, managers, institutions and systems of care should do debriefings, follow CPR delivery checklists, measure patient response measurements, provide frequent refresher courses and participate in CPR data registries. Read more on heart health.
Minority Children Less Likely to Receive ADHD Diagnosis
Minority children are less likely than their white counterparts to be diagnosed with attention deficit hyperactivity disorder (ADHD), according to a new study in the journal Pediatrics. Compared to white children, Hispanic children were 50 percent less likely, black children were 69 percent less likely and minority children overall were 46 less likely. The health care disparities start as early as kindergarten and last at least through the eighth grade, and the lack of access to medications and specialized learning programs puts them at a disadvantage in terms of learning and behavior. Researchers say the findings demonstrate the need for improved ADHD awareness and questioning by health care providers, school psychologists and teachers. Read more on health disparities.
NCI Issues Guidelines to Speed Up Clinical Trials
Opening a clinical trial can sometimes take years, which can slow down introduction of new or improved therapies. The National Cancer Institute (NCI) has issued new recommendations to help get trials underway. Under the new guidelines, the target time to open a trial should be should be 210 days from the start date for the first two phases of clinical trials which assess safety and effectiveness in a small number of patients, and 300 days for phase III trials which include a much larger number of participants. According to NCI incorporating the new guidelines in some recent trials has sped up the start date for those trials. Read more on cancer.
HHS Launches HealthCare.gov to Help Americans Prepare for New Coverage Opportunities
The U.S. Department of Health and Human Services (HHS) has launched the new HealthCare.gov to help Americans prepare for new coverage opportunities through the Affordable Care Act. Open enrollment in the Health Insurance Marketplace begins in just a few months, on October 1. The website (also available in Spanish) includes social media integration, sharable content and engagement destinations, and will later incorporate web chat functionality. “The new website and toll-free number have a simple mission: to make sure every American who needs health coverage has the information they need to make choices that are right for themselves and their families—or their businesses,” said HHS Secretary Kathleen Sebelius. Read more on access to health care.
USPSTF Recommends Hep C Screenings for All ‘Baby Boomers’
All “Baby Boomers”—Americans born between 1945 and 1965—should be screened for hepatitis C, according to new final recommendations from the U.S. Preventive Services Task Force (USPSTF). Earlier recommendations in November had only suggested that doctors consider screening. The new recommendations appear in the Annals of Internal Medicine. Researchers concluded that even the “moderate” net benefit made screening worthwhile; they also recommended screening for people at higher risk, such as injection drug users. "New evidence came out since the draft recommendation, which gave us greater confidence in the linkage between a sustained viral response and important outcomes," said Albert Siu, MD, co-vice chair of the task force, to Reuters. The majority of the 3 million Americans who have hepatitis C are Baby Boomers, according to the U.S. Centers for Disease Control and Prevention. Read more on aging.
Study: Diet, Exercise Don’t Decrease Heart Health Risk for People with Diabetes
While the weight loss associated with diet and exercise does not necessarily improve heart health for people with type 2 diabetes, the positive lifestyle changes can decrease the chances of kidney failure and eye damage, according to a new study in the New England Journal of Medicine. "Intensive lifestyle intervention reduced the risk of chronic kidney disease by 31 percent," said study author Rena Wing. "So we had a very, very marked effect on the development of high-risk chronic kidney disease. We also showed a benefit in terms of self-reported eye disease." Researchers said one possibility for the lack of heart health improvement was the relatively small weight losses of both of the study groups—the one that incorporated exercise, and the one that did not. Frank Sacks, MD a professor of cardiovascular disease prevention at the Harvard School of Public Health who saw the study but did not participate, said he believed it was “stopped too soon,” which affected the results. Read more on diabetes and heart health.
APHA, National Center for Healthy Housing Release Housing Standards to Improve Health
The National Center for Healthy Housing (NCHH) and the American Public Health Association (APHA) have released a National Healthy Housing Standard aimed at improving the health of Americans by addressing serious health and safety hazards in U.S. homes. About 30 million families live in unsafe and unhealthy housing with broken heating and plumbing; holes in walls and windows; roach and rodent infestation; falling plaster; crumbling foundations; and leaking roofs. Millions more live in housing with serious health and safety hazards that can cause allergies, asthma, injuries, cancer and lead poisoning, which add billions of dollars to health care costs and harm children’s health, development and wellbeing, according to the APHA. The new standard would not apply to new construction or housing renovation, but will be used by government agencies to ensure that the existing housing stock—with more than 100 million units across the country—is maintained to protect the health and safety of Americans. The housing standard would be implemented through adoption by federal state and local agencies. NCHH is requesting comments from health and housing practitioners, advocates and other stakeholders in healthy housing on the standard through July 31, 2013 at NCHH.org. Read more on housing.
Black, Hispanic Kids With Autism Less Likely to See Specialists
Black and Hispanic children with autism are less likely than their white counterparts to access specialists such as gastroenterologists, neurologists and psychiatrists, according to a new study in the journal Pediatrics. Study author Sarabeth Broder-Fingert, MD, a fellow in the department of pediatrics at MassGeneral and Harvard Medical School, said that while she expected to see differences, she was surprised by the extent of the disparity. Diagnosing and treating the disorders that often accompany is critical so that they do not lead to further health complications. "I do worry because autism is such a complicated disorder," she said. "The children have some sort of communication difficulty, so if they have stomach problems or sleep problems they may have difficulty expressing that. I always worry these kids are not getting all the care they need in general, and minority kids are more at [risk] of not getting the care they need." The study indicated that doctors need to be more aware of when to refer patients to specialists. About one in 50 school-age children have autism in the United States, according to the U.S. Centers for Disease Control and Prevention. Read more on health disparities.
Volunteer Time Reduces High Blood Pressure Risk in Older Adults
Time spent volunteering can help reduce the risk of high blood pressure in older U.S. adults, according to a new study in the journal Psychology and Aging. Researchers analyzed data on more than 1,100 adults, finding that those who volunteered at least 200 hours per year saw a 40 percent saw a 40 percent cut in high blood pressure risk four years down the line. Approximately 65 million American suffer from high blood pressure, or hypertension. "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 interactions,” said lead author Rodlescia Sneed, a PhD candidate in psychology at Carnegie Mellon University. "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." Read more on heart health.
May is Stroke Awareness Month, a good time to bump up the percentage of Americans who recognize the most common symptoms of a stroke from only 38 percent, according to a Centers for Disease Control and Prevention (CDC) survey. Speedily identifying stroke symptoms and calling for an ambulance is essential because people who get to an emergency room for treatment within three hours are healthier three months later than people for whom stroke care was delayed, according to the CDC.
New this year to help increase symptom awareness is a free smartphone app from the American Heart Association/American Stroke Association called F.A.S.T. The acronym stands for common stroke symptoms and a critical call to action: Face drooping; Arm weakness; Speech difficulty; and Time to call 9-1-1. The app also includes a link to additional symptoms that bystanders and caregivers can access and a 9-1-1 button to call an ambulance. Using the 9-1-1 button saves time by not having to back out of the app to dial the number manually. And using the button also generates an automatic time stamp, which gives emergency room staff a good indication of when symptoms began. Some treatments can only be given within a specific time window.
IOM: Low Sodium Intake May Also Cause Adverse Health Effects
While multiple studies have shown that the average daily sodium intake for U.S. adults is far too high, lowering the intake too much could also lead to health problems, according to a new report from the Institute of Medicine. The average daily intake is 3,400 mg, or about 1.5 teaspoons. The Dietary Guidelines for Americans call for a maximum of 2,300 mg, and even 1,500 mg for certain demographics. However, there is also some evidence suggesting low sodium levels could be harmful to people such as those with mid- to late-stage heart failure. “These studies make clear that looking at sodium’s effects on blood pressure is not enough to determine dietary sodium’s ultimate impact on health,” said committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine. “Changes in diet are more complex than simply changing a single mineral. More research is needed to understand these pathways.” Read more on heart health.
CDC Guidelines Help Cut Bloodstream Infections from Dialysis
Following the U.S. Centers for Disease Control and Prevention’s (CDC) prevention guidelines helped reduce overall bloodstream infection due to dialysis by 32 percent and vascular access-related bloodstream infections by 54 percent, according to a new study in the American Journal of Kidney Disease. There are approximately 37,000 bloodstream infections each year related to dialysis with central lines; in 2010 about 380,000 U.S. patients used hemodialysis for treatment of end-stage kidney disease, with 8 in 10 of utilizing central lines. "Dialysis patients often have multiple health concerns, and the last thing they need is a bloodstream infection from dialysis,” said CDC Director Tom Frieden, MD, MPH. “These infections are preventable. CDC has simple tools that dialysis facilities can use to help ensure patients have access to the safe healthcare they deserve.” Read more on prevention.
Study: Teen’s Use of Smokeless Tobacco Steady Over Past Decade
Despite a myriad of efforts to combat tobacco use by U.S. teens, their usage rate of “smokeless” tobacco products such as chew or snuff has remained steady since 2000, according to a new study in the Journal of the American Medical Association. The rate was 5.3 percent in 2000 and just barely lower in 2011, at 5.2 percent. While younger teens in the 9-14 age range have decreased their use, those in the 15-17 range have increased. The study suggests that the relatively low prices of smokeless tobacco products may be a contributor. About 9 million Americans used smokeless tobacco in 2012. Read more on tobacco.
Business Coalitions to Receive Funds to Improve Community Health
The Robert Wood Johnson Foundation and United Health Foundation will award $700,000 in grants to nine National Business Coalition on Health member coalitions. The community health grants will fund resources to help the communities assess their health problems and come up with solutions. The issues include obesity rates, tobacco use, healthy living efforts and pre-term births. “Supporting and nurturing businesses to engage with their communities to identify and address priority local health issues is the first step in solving them,” said Reed Tuckson, MD, senior advisor of the United Health Foundation. Read more on community health.
AHA: Dog Owners at Reduced Risk of Heart Disease
Owning a pet—especially a dog—may help cut a person’s chance of heart disease, according to a new scientific statement from the American Heart Association (AHA). A study of more than 5,200 U.S. adults found a link between owning a dog and being more physically fit, because of the need to talk dogs on frequent walks. There are also calming effects to consider when looking at the lower levels of obesity, blood pressure and cholesterol. Glenn N. Levine, a professor at Baylor College of Medicine in Houston, said more research is needed to determine whether adopting a pet can help improve pre-existing cardiovascular conditions. Read more on heart health.
HHS: $150M to Help Uninsured Enroll in New Health Insurance Options
Approximately $150 million in funding from the U.S. Department of Health and Human Services (HHS) will go toward community health centers to help uninsured Americans understand and enroll in new health insurance coverage options. The improvements will include hiring new staff, staff training and community outreach. There are about 1,200 health centers serving 21 million people annually. “Health centers have extensive experience providing eligibility assistance to patients, are providing care in communities across the nation, and are well-positioned to support enrollment efforts,” said HHS Secretary Kathleen Sebelius. Read more on access to health care.
Drug Patent Expirations Helped Lower Patient Spending for First Time in 55 Years
Per patient spending on medicine dropped 3.5 percent from 2012 to 2011, the first such drop since 1957, according to the IMS Institute of Healthcare Informatics. Spending was $325.8 billion overall and $898 per person in 2012. The main contributor to the decline was the expiration of patents on major drugs such as Lipitor and Plavix, allowing people to instead opt for cheaper generic versions. Michael Kleinrock, director of research development at IMS, said this is likely the first of several years in which spending on prescriptions won’t grow as quickly as overall health care spending. Read more on prescription drugs.
CDC Releases New Resources on Lyme Disease Prevention, Treatment
As across the country the weather is gradually getting warmer and kids are spending more time outdoors, the U.S. Centers for Disease Control and Prevention (CDC) has released new resources to help kids prevent tick bites that can lead to Lyme disease and a reference guide for health care providers. The kid-targeted comic strip includes tips for both kids and their parents. Tickborne Diseases of the United States includes information on types of ticks and the various diseases they can transmit. There were more than 24,000 confirmed cases of Lyme disease in 2011, according to the CDC. Read more on infectious diseases.
Study: Everyday Noises Can Effect Heart Health
Even basic, everyday background noises can affect heart function, according to a new study in the journal Environmental Health Perspectives. That includes increased heart rate as noises become louder than normal conversation levels and a decrease in natural, healthy heart beat variability. A decrease in heart bear variability, such as when someone is stressed, has been linked to a greater risk for heart attack. While these noise effects to individuals is minimal, they could provide greater insight into the health effects of community noise on the broader population level, according to Charlotta Eriksson, a researcher at the Karolinska Institute, in Stockholm, Sweden, who was not involved in the study. Read more on heart health.
NIH Grants $40M to Combat Racial, Ethnic Disparities in Stroke Risk
The National Institutes of Health (NIH) has awarded $40 million in grants over five years to help four research centers investigate and develop strategies to reduce the risk of stroke in racial and ethnic minorities. The funds come from NIH’s National Institute of Neurological Disorders and Stroke (NINDS). Racial and ethnic minorities are at higher risk than non-whites due to higher prevalence of cardiovascular risk factors, according to said Walter J. Koroshetz, MD, deputy director, NINDS. "A few of the grantees are working closely with at-risk populations to develop interventions that give people tools to achieve blood pressure control," he said. "These research efforts will give us the traction we need to control the greatest modifiable stroke risk factor. Together, the Stroke Prevention /Intervention Research Programs represent a much needed effort to address stroke disparities in the United States." Read more on stroke.
People With Congenital Heart Disease Need Physical Activity
A new scientific statement from the American Heart Association serves to remind health professionals and patients that regular physical activity is important for people with congenital heart disease and should be promoted. Congenital heart disease (heart structural problems existing since birth) impacts close to 1 million children and 1 million adults in the United States. Specifics of the new statement include:
- While some irregular heart beat conditions may require a restriction in physical activity, “for most, physical activity can be unlimited and should be strongly promoted.”
- Most patients with congenital heart disease are relatively sedentary. But the physical, psychological and social health benefits of physical activity are important for this population which is at risk for exercise intolerance, obesity and other diseases. .
- These are general recommendations and physicians may have to tailor some specific guidelines for individual patients.
Read more on heart health.
DOT Announces Funds to Help Improve Road Safety on Tribal Lands
The U.S. Department of Transportation (DOT) has announced the availability of more than $8.6 million in Tribal Transportation Program Safety Funds from the Federal Highway Administration (FHWA). According to Transportation Secretary Ray LaHood, the funds will help improve roads on tribal lands, which have consistently ranked among the nation’s highest road fatality rates. DOT will hold a webinar on May 8 from 4-5 p.m. EDT to provide information on the grants to potential applicants. Find a link to the webinar here. Read more on transportation.