Category Archives: Heart and Vascular Health

Mar 20 2014
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Public Health News Roundup: March 20

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Study: School Hearing Tests Cannot Detect Adolescent High-Frequency Hearing Loss
School-administered hearing tests cannot detect the sort of adolescent high-frequency hearing loss associated with exposure to loud noises, according to a new study in the Journal of Medical Screening. Researchers at Penn State College of Medicine compared the results for 282 11th graders of a special hearing screening designed to detect noise-related high-frequency hearing loss with the results of the standard Pennsylvania school hearing test. Each tests for the ability to hear a tone at a specific loudness. "More participants failed the initial screening than we predicted," said study author Deepa Sekhar, assistant professor of pediatrics, in a release, "Even with the effort and care put in by school nurses across the state, the current Pennsylvania school screen just isn't designed to detect high-frequency hearing loss in adolescents," adding "The results of this study have the potential to reach schools across the nation, as many use screens similar to those used in Pennsylvania schools." Read more on pediatrics.

HUD Gives $1.8B to Support 3,100 Public Housing Authorities
The U.S. Department of Housing and Urban Development (HUD) has awarded almost $1.8 billion to approximately 3,100 public housing authorities across all 50 states, as well as the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. The grants, which come through HUD’s Capital Fund Program, will go toward building, repairing, renovating and modernizing public housing, from large scale improvements such as replacing roofs or smaller tasks such as energy-efficient upgrades. “This funding is critically important to public housing agencies as they work to provide the best housing possible for their residents,” said HUD Secretary Shaun Donovan. There are 1.1 million public housing units in the United States. Read more on housing.

New Heart Health Guidelines Would Increase Adults Eligible for Statins to 12.8M
New guidelines from the American College of Cardiology and the American Heart Association (ACC–AHA) for the treatment of cholesterol would increase the number of adults who would be eligible for statin therapy by 12.8 million, according to a new study in the New England Journal of Medicine. Roughly half of the U.S. population between 40 and 75 years of age—or 56 million people—would be eligible. Most of the increase would be among older adults without cardiovascular disease. Read more on heart health.

Mar 14 2014
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Public Health News Roundup: March 14

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Teens who Leave Gangs Still Face Consequences as Adults
A new study in the American Journal of Public Health finds that joining a gang during teen years has significant consequences in adulthood beyond criminal behavior, even after a person leaves the gang.

The study authors followed 808 fifth-grade students from 18 elementary schools in high-crime neighborhoods in Seattle, beginning in 1985. Participants were interviewed every year until the age of 18, then every three years until the age of 33.

Researchers used 23 risk factors, including poverty and associating with kids with problem behaviors, to calculate a child’s propensity for joining a gang, and then compared 173 youth who had joined a gang with 173 who did not but showed a similar propensity for doing so. The average age of joining a gang was just under 15 years old and the majority (60 percent) were in a gang for three years or less.

The study found that subjects between ages 27 and 33 who had joined a gang in adolescence were:

  • Nearly three times more likely to report committing a crime,
  • More than three times more likely to receive income from illegal sources
  • More than twice as likely to have been jailed in the previous year
  • Nearly three times more likely to have drug-abuse problems
  • Nearly twice as likely to say they were in poor health
  • Twice as likely to be receiving public assistanÎ
  • Half as likely to graduate from high school.

The study was funded by the National Institute on Drug Abuse the Robert Wood Johnson Foundation, and the National Institute on Mental Health.

Read more on poverty

Stroke Survivors May Lose a Month of Healthy Life for Every 15-Minute Delay in Treatment
Every 15-minute delay in delivering a clot-busting drug after stroke takes away about a month of a healthy life for stroke survivors, according to a new study in the journal Stroke. Researchers at the University of Melbourne in Australia analyzed data from clot-busting trials and applied the time to efficacy to over 2,000 stroke cases in Australia and Finland to calculate what the patient outcomes would have been if they had been treated faster or slower. They found that for every minute the treatment could be delivered faster, patients gained an average 1.8 days of extra healthy life. The researchers also found that while all patients benefited from faster treatment, younger patients with longer life expectancies gained more than older patients

Read more on access to health care

One in Five Older Americans Take Medications that Work Against Each Other
More than 20 percent of older Americans take Medicines that work at odds with each other, and in some cases the medication being used for one condition can actually make the other condition worse, according to a new study in the online journal PLUS One by researchers at Oregon State University and the Yale School of Medicine. The study was conducted by researchers from OSU and Yale with 5,815 community-living adults over a two year period.  

“Many physicians are aware of these concerns but there isn’t much information available on what to do about it,” says David Lee, an assistant professor in the Oregon State University/Oregon Health & Science University College of Pharmacy. “As a result,” says Lee, “right now we’re probably treating too many conditions with too many medications. There may be times it’s best to just focus on the most serious health problem, rather than use a drug to treat a different condition that could make the more serious health problem even worse.”

The chronic conditions in which competing therapies are common include coronary artery disease, diabetes, COPD, dementia, heart failure, hypertension, high cholesterol and osteoarthritis and others.

Read more on prescription drugs

Mar 13 2014
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Public Health News Roundup: March 13

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Hypertension Often Untreated in U.S. Hispanic Community
A new study in the American Journal of Hypertension finds that there is too little recognition and control of hypertension among the Hispanic population of the United States.

The new data comes from the Hispanic Community Health Study/Study of Latino, a longitudinal study of 16,415 Hispanics/Latinos, ages 18 to 74 years from four communities in the U.S. (Bronx, Chicago, Miami, and San Diego). Measures including hypertension levels and whether patients were on hypertension medications were collected between 2008 and 2011 and then followed up last year.

The study also found that the prevalence of hypertension in the Hispanic community increased with age, and was highest among those with Cuban, Puerto Rican, and Dominican backgrounds.

Read more on heart health.

USDA Funds News Childhood Obesity Prevention Programs at Three Universities
The National Institute of Food and Agriculture of the U.S. Department of Agriculture has given grants to childhood obesity prevention projects at three U.S. universities:

  • University of Tennessee, Knoxville, Tenn. for "Get Fruved:" A peer-led, train-the-trainer social marketing intervention to increase fruit and vegetable intake and prevent childhood obesity
  • Tufts University, Boston, Mass., for a “kids-only" retail coupon study to promote healthy snack options among adolescents in convenience stores.
  • Winston-Salem State University, Winston-Salem, N.C., for a program works with 10-12 year-old children from low income families.

Read more on obesity.

Almost Half of U.S. Population Lives in Jurisdictions that Strengthened Gun Laws in 2013
Fifteen states and the District of Columbia strengthened their gun laws in the year following the Newtown school shooting, according to a new review from the Johns Hopkins University press, Updated Evidence and Policy Developments on Reducing Gun Violence in America.

Among the changes in the last year was legislation at the state level to reduce intimate partner violence offenders’ access to firearms.

Read more on injury prevention.

Mar 10 2014
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Public Health News Roundup: March 10

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Majority of Youth C. Difficile Infections Linked to Doctor Visits
Antibiotics prescribed in a doctor’s office for other conditions are associated with the majority of Clostridium difficile infections, according to a new study in the journal Pediatrics. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) determined that 71 percent of the cases for youth ages 1-17 were linked to the visits, rather than to overnight stays in health care facilities; two-thirds of adult cases are linked to hospital stays. The findings raise the profile of ongoing efforts to reduce unnecessary prescriptions. “Improved antibiotic prescribing is critical to protect the health of our nation’s children,” said CDC Director Tom Frieden, MD, MPH. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.” Read more on prescription drugs.

Study: Even Slightly Elevated Blood Pressure Can Do Cardiovascular Damage Over Time
Even slightly elevated blood pressure that does not rise to the clinical definition of hypertension can do cardiovascular damage over time, according to a new study in the Journal of the American Medical Association. Researchers at the University of Oklahoma Health Sciences Center analyzed blood pressure data on more than 4,600 participants, all of whom had their readings tracked over 25 years from young adulthood to middle age. They placed the participants in five blood pressure trajectory categories:

  • Low-stable: blood pressure that starts low and stays low
  • Moderate-stable: blood pressure that begins only slightly elevated and stays that way
  • Moderate-increasing: blood pressure begins only slightly elevated and increases over time
  • Elevated-stable: blood pressure that starts at elevated levels, but does not increase
  • Elevated-increasing: blood pressure that begins elevated and increases over time

The study determined that participants in the moderate-stable group were 44 percent more likely to have coronary artery calcification than those in the low-stable group. Read more on heart health.

Study: Men Die Earlier in More Patriarchal Societies
Gender differences when it comes to mortality rates are higher in more patriarchal societies, meaning women’s rights are good for men’s health, according to a new study in the American Psychological Association’s Evolutionary Behavioral Sciences. Utilized sociodemographic and mortality data from the World Health Organization, researchers from the University of Michigan (UM) School of Public Health found that men living in the top 25 percent most-patriarchal societies were 31 percent more likely to die than men in the least patriarchal quartile, compared to mortality rates for women. Researchers noted that the study only included societies with infrastructures capable of providing reliable data, so the difference could be even more pronounced. Possible explanations include:

  • Males in societies where they are more socially dominant tend to engage in riskier behaviors that can lead to death.
  • These societies tend to have more resources and social status concentrated in a smaller group of elite men, and men with greater control of resources and social status historically have had more reproductive success.
  • In their quest for social dominance, men will go up against other men to gain power and engage in forms of competitive, and sometimes dangerous, behavior.

"Gender inequality is inherently related to inequality in general, and this is bad for both men and women's health, though especially harmful to men in increasing the risk of death," said UM researcher Daniel Kruger. Read more on health disparities.

Feb 21 2014
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Public Health News Roundup: February 21

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HHS, Heart Disease Organizations Join Forces to Vastly Reduce Premature Death Linked to Heart Conditions by 2025
Leaders from the World Heart Federation , the American Heart Association, the U.S. Department of Health and Human Services, and the American College of Cardiology are joining together to help cut premature mortality from cardiovascular disease by at least 25 percent by 2025.
 Key strategies will include secondary prevention efforts for people who have already experienced a heart incident, or have established heart disease, as well as primary prevention strategies in the United States and around the world. “Heart disease can touch anyone, no matter where you live,” said Nancy Brown, chief executive officer of the American Heart Association.  “It will take the collective efforts of everyone from community leaders to healthcare professionals, educators and business leaders to stop this No. 1 killer at the national and global level...” Read more on heart health.

New Guidelines for Stroke Risk, Prevention in Women
The American Heart Association/American Stroke Association has published the first ever set of guidelines dedicated to stroke risk and prevention in women. The 86-page document appears in the journal Stroke and address risk factors distinct to women, including pregnancy, oral contraceptives, menopause and hormone replacement. It also covers factors that affect women more than men, including atrial fibrillation and migraine with aura. “We reviewed a large body of research to be able to summarize our current understanding of stroke risk and stroke prevention in women, information that is critically important for care providers and researchers in the field,” according to Judith Lichtman, MD, associate professor at the Yale School of Public Health and co-author of the study. “The guidelines are also important to empower women and their families to better understand their risk for stroke and be aware of ways they can minimize their likelihood of having a one.” Strokes are the third-leading cause of death among women in the United States. Read more on strokes.

Study: Indicators of Potential Heart Disease as Early as Age 18
Indicators of potential heart disease can be seen as early as age 18, according to a long-term study recently published in the Journal of the American Medical Association. Researchers found that elevated blood pressure at that age, as well as found distinct blood pressure patterns from ages 18-55, indicate people at high risk for calcification of coronary arteries by middle age. “This shows that your blood pressure in young adulthood can impact your risk for heart disease later in life,” said Norrina Allen, PhD, lead study author and assistant professor of Preventive Medicine at Northwestern University Feinberg School of Medicine, in a release. “We can’t wait until middle age to address it. If we can prevent their blood pressure from increasing earlier in life we can reduce their risk of future heart attacks and stroke.” Approximately one in three U.S. adults have hypertension. Read more on prevention.

Feb 14 2014
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Public Health News Roundup: February 14

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Public Health Wants to be Your Valentine

Looking for powerful ways to save I love you?

Read more on heart health.

American Society of Clinical Oncology Weighs in on Mammography
In response to a study published this week in the British Medical Journal which called into question the benefit of mammography, the American Society of Clinical Oncology (ASCO) issued a statement today saying that because mammography is similar to many other tests that can detect a condition that may never cause harm, the benefits of screening are likely to be greater for women who are at increased risk of developing breast cancer based on factors such as age and family history, than for women at average risk. It also stated no single study should be used to change screening policy and that all women should be encouraged to speak with their doctors about their personal risk for breast cancer, as well as the potential benefits and harms of mammography screening. ASCO and other cancer advocacy and women’s health groups have announced that they will be monitoring additional mammography studies now being conducted, and the American Cancer Society is expected to release new mammography recommendations later this year. Read more on cancer.

NHTSA Announces New Mandatory Label to Help Owners Instantly Identify Recall Mailings
The U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) today announced that starting February 18, all manufacturers must use a distinctive label on the agency’s required mailings that notify owners of recalled vehicles or equipment.

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The requirement was introduced to help owners instantly distinguish important recall notices arriving in their mailboxes from other mail and hopefully avoid mistakenly discarding the safety notices. NHTSA has also just launched the SaferCar app for Android devices that will provide information for car owners and shoppers, including recalls and safety performance. There is already a SaferCar app for iPhone, iPad and iPod Touch users. Other safety notification options from NHTSA include:

  • Register Your Cars, Tires and Car Seats: Receive NHTSA email notifications when there is a recall by the federal government. There is no way to locate or notify individual owners of car seats or tires if the product is not registered with the manufacturer or NHTSA.
    Check for Open Recalls on Used Cars: Verify with the previous owner or dealer whether a used car has been fixed by using www.safercar.gov, which provides a general search tool to help consumers identify recalls that may affect their vehicle.

Read more on transportation.

Feb 11 2014
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Public Health News Roundup: February 11

AHA Releases Stroke Prevention Guidelines for Women
For the first time, the American Heart Association (AHA) has released stroke prevention guidelines for women. The guidelines outline stroke risks unique to women and provide evidence-based recommendations on how best to treat them, including:

  • Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks.
  • Women who have preeclampsia have twice the risk of stroke and a four-fold risk of high blood pressure later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors such as smoking, high cholesterol, and obesity in these women should be treated early.
  • Pregnant women with moderately high blood pressure (150-159 mmHg/100-109 mmHg) should be considered for blood pressure medication; expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.
  • Women should be screened for high blood pressure before taking birth control pills because the combination raises stroke risks.
  • Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
  • Women over age 75 should be screened for atrial fibrillation risks; a risk factor for stroke.

Read more on prevention.

New Study Predicts Flu Severity
Researchers at St. Jude Children’s Research Hospital in Memphis say flu patients, regardless of age, who have elevated levels of three particular immune system regulators, called cytokines, early in the infection were more likely to develop severe flu symptoms and to be hospitalized than patients with lower levels of the same regulators. Study participants ranged in age from 3 weeks to 71 years.

The study, published in the American Journal of Respiratory and Critical Care Medicine, found that cytokine levels early in the infection were predictive of flu-related complications regardless of patient age, flu strain, the ability of the virus to replicate and other factors. The cytokines studied help to regulate inflammation caused by the body’s immune response to the flu until antibodies and T cells take over. Patients with the elevated cytokines seem to develop airway distress as a reaction to the immune response, a development separate from the effects of the flu virus. “We need to explore targeted therapies to address this problem separately from efforts to clear the virus, says study author Paul Thomas, PhD, an assistant member of the St. Jude Department of Immunology. Read more on flu.

Community Health Worker Model Can Reduce Hospital Readmissions
A new study in JAMA Internal Medicine reports on a community health worker (CHW) program developed at the University of Pennsylvania School of Medicine that hired people from the local community to help discharged patients navigate the health care system and address key health barriers, such as housing instability or food insecurity. The study found that the intervention improved patient experiences and health outcomes and reduced hospital readmissions.

The Penn team tested the model in a randomized trial with 446 hospitalized patients who were either uninsured or on Medicaid, and lived in low-income communities in which more than 30 percent of the population lived below the Federal Poverty Level. More than one-third of all readmissions to the hospitals participating in the study come from a five-zip code region. Patients in the trial received support from CHWs hired for traits such as empathy and active listening. The CHWs connected during a patient's hospital stay and continued after they were discharged to help with issues including scheduling doctor appointments, accessing medications, or finding child care or shelter. The control group received routine hospital care, medication reconciliation, written discharge instructions, and prescriptions from the hospital. The CHW group had a 52 percent greater chance of seeing a primary care physician within two weeks after being discharged from the hospital and scores measuring a patient's confidence in managing their own care in the future more than doubled in the CHW group. While the two groups had similar rates of at least one hospital readmission (15 percent vs 13.6 percent), the CHW group was less likely to have multiple readmissions (2 percent vs 6 percent in the control group). Read more on health disparities.

Feb 10 2014
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Public Health Campaign of the Month: Air Pollution and Heart Health

>>NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newPublichealth.org.

In honor of American Heart Month, held each February, the U.S. Environmental Protection Agency (EPA) has created a new Public Service Announcement (PSA) to educate the public and health care providers about the risks of air pollution to the heart.

"Over more than four decades of EPA history, we've made tremendous progress cleaning up the air we breathe by using science to understand the harmful effects of air pollution," said EPA Administrator Gina McCarthy. “While EPA continues to fight for clean air, Americans can take further action to protect their heart health by following the advice in our new PSA.”

One of EPA’s commitments in the U.S. Surgeon General’s National Prevention Strategy is to educate health care professionals on the health effects of air pollution, including heart risks. This PSA supports the Million Hearts Initiative, launched by the U.S. Department of Health and Human Services in September 2011, to prevent one million heart attacks and strokes by 2017. 

Research has shown that air pollution can trigger heart attacks, stroke and worsen heart conditions, especially in people with heart disease—that’s one in three Americans. According to the EPA, very small particles are the pollutants of greatest concern for triggering health effects from exposure to air pollutants. These particles are found in transportation exhaust, haze, smoke, dust and sometimes even in air that looks clean. Particle pollution can also be found in the air at any time of the year. 

The new PSA advises people with heart disease to check the daily, color-coded Air Quality Index forecast. At code orange or higher, particle pollution can be harmful to people with heart disease. On bad air quality days, it is recommended to reschedule outdoor exercise or to exercise indoors instead, and avoid exercising near busy roads.

Air Quality Index forecasts for more than 400 cities are available on the forecast map through a free AirNow app for iPhone and Android phones, and through the free EnviroFlash e-mail service. To sign up, visit here and click on the “Apps” or “EnviroFlash” icons.

>>Bonus Links
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Feb 10 2014
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Public Health News Roundup: February 10

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Minimum Alcohol Prices Could Help Low-income, High-risk Drinkers
Setting a minimum price for alcohol would have a positive impact on low-income, high-risk drinkers, but little effect on low-income, moderate drinkers, according to a new study in The Lancet. British researchers at the University of Sheffield utilized a computer model to assess the impact of a 73 cents per unit of alcohol minimum on different demographics, finding it would have the greatest positive impact—reducing the amount of alcohol consumption—on the 5 percent of the population defined as high-risk drinkers. "Our study finds no evidence to support the concerns highlighted by government and the alcohol industry that minimum unit pricing would penalize responsible drinkers on low incomes,” said study co-author Petra Meier, director of the Sheffield Alcohol Research Group. “Instead, minimum unit pricing is a policy that is targeted at those who consume large quantities of cheap alcohol. By significantly lowering rates of ill health and premature deaths in this group, it is likely to contribute to the reduction of health inequalities." Read more on alcohol.

Smoking Linked to Most Common Type of Breast Cancer
Adding yet another health risk to the use of tobacco, smoking is linked to an increased risk for the most common type of breast cancer, according to a new study in the journal Cancer. Researchers at the Fred Hutchinson Cancer Research Center in Seattle conducted a population-based study of 778 patients, ages 20-44, with estrogen receptor positive breast cancer (the most common type) and 182 patients with triple-negative breast cancer; there were 938 cancer-free controls. They found that women who were current or recent smokers and had been smoking a pack a day for at least 10 years had a 60 percent increased risk of estrogen receptor positive breast cancer. "The health hazards associated with smoking are numerous and well known. This study adds to our knowledge in suggesting that with respect to breast cancer, smoking may increase the risk of the most common molecular subtype of breast cancer but not influence risk of one of the rarer, more aggressive subtypes," said Christopher Li, MD, PhD. Read more on cancer.

Low Testosterone Drugs Can Double Heart Attack Risk in Some Men
Ads asking men about their “low T”—or low testosterone levels—have become so common of late that in 2013 sales of the testosterone gel Androgel exceeded those of Viagra. However, a recent study indicates that men under the age of 65 with a history of heart disease see their heart attack risk double shortly after beginning testosterone therapy. The joint study from the UCLA Fielding School of Public Health, the National Institutes of Health and Consolidated Research Inc. appears in the journal PLOS ONE. Researchers decided to perform this larger study after three smaller studies raised concerns about the connection. "We decided to investigate cardiovascular risks of this therapy in a large health care database since these previous studies were modest in size and only focused on men 65 and older," said the study's senior author, Sander Greenland, MD, a professor of epidemiology at the UCLA Fielding School of Public Health and a professor of statistics in the UCLA College of Letters and Science. "Our study allowed us to examine cardiovascular risk in men under the age of 65 and to replicate the findings in men over 65." Read more on heart health.

Jan 22 2014
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Public Health News Roundup: January 22

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Survey: Latinos See Diabetes as Greatest Family Health Concern
A new NPR/Robert Wood Johnson Foundation/Harvard School of Public Health poll found that Latinos see diabetes as the biggest health concern for their families. Almost 19 percent of Latinos surveyed cited diabetes as the top worry, including across both immigrant (19 percent) and non-immigrant (22 percent) populations. Cancer, at 5 percent, was the second-biggest concern. In addition to health and health care, the poll also asked about communities, financial situation and discrimination. According to the U.S. Centers for Disease Control and Prevention, Hispanic adults are 1.7 percent more likely than non-Hispanic whites to be diagnosed with diabetes, and 1.5 percent more likely to die from it. Read more on health disparities.

Heart Attack Patients in ER Off-Hours Seeing Higher Mortality Rates
Heart attack patients who present during off-hours—at night and on weekends—are more likely to die, according to a new study from the journal BMJ. Their emergency care is also more likely to take longer than it would during normal hospital hours, including inflation of the coronary artery, which can take an additional 15 minutes. After analyzed records on 1,896,859 patients, researchers at the Mayo Clinic determined that heart attack patients who present during off-hours had a 5 percent relative increase in mortality—or an additional 6,000 U.S. deaths. The study’s authors concluded that emergency departments "should focus on improving their off-hour care, with the goal of providing consistently high quality care 24 hours a day and seven days a week." Read more on heart health.

Study: HPV Vaccination Rate Remains Low, More Physician Recommendations Needed
Only 14.5 percent of girls ages 11 and 12 have received at least one does of the human papillomavirus (HPV) vaccination, with only 3 percent having completed a three-dose series, according to a new study in the American Journal of Preventive Medicine. The study from the Moffitt Cancer Center indicates that increasing the rate of physician recommendations, which so far remains low, could do much to up the vaccination rate and cut the risk of cancer. The vaccination protects against the two types of HPV that cause 70 percent of cervical cancer cases. “This study demonstrates that the change in consistent HPV vaccine recommendations to early adolescent females was modest, and for older adolescent females was virtually nonexistent, from three to five years after the vaccine became available,” explained Susan T. Vadaparampil, PhD, MPH, associate member of the Health Outcomes and Behavior Program at Moffitt. “Physician recommendation is central to increasing HPV vaccination rates because it is one of the most important predictors of whether a patient gets the HPV vaccine.” Read more on cancer.