Category Archives: Heart and Vascular Health
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.
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.
Study: ‘White Coat Effect’ on Blood Pressure is Real
The “White Coat Effect” is real, according to a new study in the British Journal of General Practice. The effect, wherein a person’s blood pressure is higher when taken by a doctor than when taken by a nurse, has long been assumed, but this is the first study to confirm it. The study analyzed the results of more than 1,000 people who had their blood pressure taken by both a physician and a nurse, finding the results of the physician-administered tests were noticeably higher. "Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up, but not where clinical decisions on blood pressure treatment depend on the outcome,” said Christopher Clark, MD, of the University of Exeter Medical School, in a release. “The difference we noted is enough to tip some patients over the threshold for treatment for high blood pressure, and unnecessary medication can lead to unwanted side-effects.” Clark also noted that researchers should also take these findings into account when performing studies on topics such as hypertension. Read more on heart health.
Black, Latina Breast Cancer Patients More Likely to Struggle with Health Care-Related Debt
Black and Latina breast cancer patients are far more likely than their white counterparts to have medical debt as a result of treatment or to skip treatments due to costs, according to a new study in the Journal of Clinical Oncology. In a survey of 1,502 patients, researchers determined that 9 percent of whites, 15 percent of blacks, 17 percent of English-speaking Latinas and 10 percent of Spanish-speaking Latinas reported medical-related debt four years post diagnosis. The study said the findings should “motivate efforts to control costs and ensure communication between patients and providers regarding financial distress, particularly for vulnerable subgroups.” Read more on health disparities.
Lawsuit Challenges New York City’s Ban on E-Cigarettes
A “smoker’s rights” group called New York City Citizens Lobbying Against Smoker Harassment has filed a legal challenge to the city’s ban on electronic cigarettes—or e-cigarettes—in restaurants, parks and certain other public places. The group contends that since e-cigarettes do not contain tobacco or produce smoke, they should not be subject to New York City’s Smoke-Free Air Act. The city council expanding regulations to include e-cigarettes last year and the U.S. Food and Drug Administration has announced its intention to propose government regulations over their use. In the lawsuit, the group wrote that "E-Cig regulation is, even in the Council's words, at best, tangentially related to the subject of smoking, in much the same way that toy water guns are at best tangentially related to authentic firearms.” However, city council spokeswoman Robin Levine said by email to Reuters that "Our legislation ensures the goals of the Smoke-Free Air Act are not undermined and protects the public against these unregulated substances.” Read more on tobacco.
Overweight Teens Should Start Healthy Eating by Cutting Down on Salt
Overweight or obese teenagers who eat lots of salty foods shows signs of faster cell aging, according to research presented at the American Heart Association’s Epidemiology & Prevention/Nutrition, Physical Activity & Metabolism Scientific Sessions 2014. Previous research found that protective ends on chromosomes (telomeres) naturally shorten with age, but the process is accelerated by smoking, lack of physical activity and high body fat. This study is the first to examine the impact of sodium intake on telomere length.
In the study, 766 people ages 14-18 were divided into the lowest or highest half of reported sodium intake. Low-intake teens consumed an average 2,388 mg/day, compared with 4,142 mg/day in the high-intake group. Both groups consumed far more than the 1,500 mg/day maximum (about 2/3 teaspoon of salt) recommended by the American Heart Association. After adjusting for several factors that influence telomere length, researchers found that in overweight/obese teens, telomeres were significantly shorter with high-sodium intake. In normal weight teens, telomeres were not significantly different with high-sodium intake.
“Even in these relatively healthy young people, we can already see the effect of high sodium intake, suggesting that high sodium intake and obesity may act synergistically to accelerate cellular aging,” said Haidong Zhu, MD, PhD, lead author of the study and assistant professor of pediatrics at Medical College of Georgia, Georgia Regents University in Augusta, Ga. “Lowering sodium intake may be an easier first step than losing weight for overweight young people who want to lower their risk of heart disease. The majority of sodium in the diet comes from processed foods, so parents can help by cooking fresh meals more often and by offering fresh fruit rather than potato chips for a snack.” Read more on heart health.
DOT Awards Grants to Improve Transportation for American Indian and Alaska Native Tribes
The U.S. Department of Transportation is awarding $5 million to 42 American Indian and Alaska Native tribes in 19 states for projects to improve transit service, in addition to $25 million in funds announced recently to help improve public transit service on rural tribal lands and better connect tribal members and other residents with jobs, education, and other opportunities.
“We fully recognize that residents on tribal lands and in surrounding communities often face significant transportation challenges, as many cannot afford to own a vehicle, or fill the tank, and yet must travel long distances to reach basic services,” said Federal Transit Administration head Therese McMillan. “We want to ensure that everyone who needs a ride to earn a paycheck, attend school, see the doctor, or buy groceries has that opportunity.” Read more on transportation.
Health Providers Should Prescribe Sleep for People with Metabolic Disorders
A new study in The Lancet Diabetes & Endocrinology finds that insufficient or disturbed sleep is associated with metabolic disorders such as type 2 diabetes and obesity, and addressing poor quality sleep should be a target for the prevention—and even treatment—of the disorders. According to the study authors, addressing some types of sleep disturbance—such as sleep apnea—may have a directly beneficial effect on patients' metabolic health, but a far more common problem is people simply not getting enough sleep, particularly due to the increased use of devices such as tablets and online games. The authors say that early studies are starting to provide evidence that there is a direct causal link between loss of sleep and the body's ability to metabolize glucose, control food intake, and maintain its energy balance. Read more on obesity.
Some Will Be Able to Enroll After March 31 Affordable Care Act Deadline
Some people will be able to enroll for coverage under the Affordable Care Act after the official enrollment deadline of March 31, according to new guidelines expected to be issued by the Obama administration. The new guidelines would allow people had previously tried to enroll by were prevented by systems problems such as technical difficulties, according to Reuters. "Open enrollment ends March 31. We are preparing for a surge in enrollment, and if consumers are in line on the 31st and can't finish, we won't shut the door on them. To be clear, if you don't have health insurance and do not start to sign up by the deadline, you can't get coverage again until next year," said U.S. Department of Health and Human Services spokeswoman Joanne Peters in a statement. Read more on the Affordable Care Act.
Study: Alcohol-Related Vehicle Crashes Greatly Underreported
Alcohol is a far greater factor in U.S. motor vehicle deaths than has been reported, according to a new study in the Journal of Studies on Alcohol and Drugs. Using Fatality Analysis Reporting System (FARS) data from the U.S. National Highway Traffic Safety Administration, researchers determined that in the decade from 1999 to 2009 while only a little more than 3 percent of the death certificates for traffic deaths included alcohol as a contributing cause, about 21 percent of the deaths were legally drunk. Approximately 450,000 Americans were killed in traffic crashes during the period. The time that it takes coroners to take and process blood alcohol tests could be a reason for the underreported figures. Ralph Hingson, Sc.D., of the U.S. National Institute on Alcohol Abuse and Alcoholism, said the vast discrepancy demonstrates the need for more reliable data. "We need to have a handle on what's contributing to the leading cause of death among young people," he said in a release. "You want to know how big the problem is, and if we can track it. Is it going up, or going down? And what policy measures are working?" Read more on alcohol.
NIH Identifies Genetic Markers Tied to Stroke, Cardiovascular Disease
Researchers and the National Institutes of Health have identified a genetic variant linked to increased risk for stroke, as well as a metabolic pathway tied to several common diseases, which taken together could improve how doctors identify and treat major diseases. “Our findings have the potential to identify new targets in the prevention and treatment of stroke, cardiovascular disease and many other common diseases,” said Stephen R. Williams, PhD, a postdoctoral fellow at the University of Virginia Cardiovascular Research Center and the University of Virginia Center for Public Health Genomics, Charlottesville. The genetic markers were found through the analysis of nearly 5,000 genomes. The results were published in the journal PLoS Genetics. About 600,000 Americans die of heart disease each year—one in every four deaths—and stroke is the fourth-leading cause of death in the United States. Read more on heart health.
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.
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
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.
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.
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.