Tuesday, December 30, 2008

Is Resetting Clock Linked to Heart Attack Risk?

Every year, some 1.5 billion people around the world are subjected to the seasonal clock changes. But, are you aware that the act of adjusting clock has something to do with the heart attack risk?

Researchers from Karolinska Institute in Stockholm reported in the New England Journal of Medicine that because of sleep deprivation, there is a 5-percent increase in heart attacks in the week after clocks are reset for summertime.

In the spring, the risk of suffering a heart attack has been increased significantly in the week after clocks are set forward, while in the autumn, the risk of getting a heart attack has been reduced by 5 percent on average when clocks are set back an hour. In Europe, the clocks are set forward on the last Sunday of March and the clocks are set back an hour on the last Sunday in October.

Basing on the data from a comprehensive register of all heart attacks in Sweden between 1987 and 2006, the so-called “Karolinska Study” found that the changes in heart attack rates are closely related to the effect of sudden time change upon the sleeping patterns and biological rhythms. As such, the sleep quality and sleep duration is affected for those who are unable to adjust to the changes. In fact, growing body of evidence has shown that disruption of the biological rhythms and sleep problems could increase the risk of cardiovascular disease.

The shift in the spring disrupts the biological rhythm and sacrifices an hour of potential sleep, but the autumn shift will actually cause a disruption of the chronobiological rhythm and a possibility for some extra sleep. In other words, there are 2 different mechanisms working against each other for the autumn shift.

According to researchers, Monday has been considered as the most dangerous day of the week for getting heart attack. In fact, some previous studies have attributed such phenomenon to the sudden increase in activity and stress for the week ahead.

Meanwhile, the Karolinska study also explained why people suffer sleep deprivation when clock is reset: People usually get up later and go later to bed during the weekend, so if one goes to bed later on Sunday but still need to get up early on Monday, he or she will end up with a sleep deprivation.

Sunday, December 28, 2008

Can Chemicals Used in Plastic Containers Also Lead to Heart Disease?

In 2003, more than 2 million metric tons of bisphenol A (BPA) were produced worldwide. Since then, the demand for this compound has increased by between 6 and 10 percent yearly. BPA is a chemical commonly used in baby bottles and plastic food containers.

A report published in the September 17 issue of the Journal of the American Medical Association (JAMA) linked BPA to diabetes, heart disease and liver abnormalities in adults. 1,455 adults were involved in the study.

According to the researchers, adults with the highest concentrations of BPA in their urine had nearly tripled the chances of cardiovascular disease, as compared to those with the least amounts of BPA in their systems. Meanwhile, they also found that adults with the highest BPA levels also had more than double the odds of getting diabetes.

In other words, higher urinary concentrations of BPA were shown to be associated with increased probabilities of developing cardiovascular disease, diabetes, and liver-enzyme abnormalities.

BPA is found in detectable levels in more than 90 percent of Americans not only through food but also through drinking water, dermal exposure, dental sealants and inhalation of household dusts.

In fact, a report published earlier during September 2008 by a group of toxicologists at the National Institute of Health (NIH) also revealed that the chemical found in many food containers, plastic bottles and dental fillings could have dangerous effects on the development of the brain and prostate gland fetuses and newborn babies. It is believed that BPA would interfere with estrogen, which is the hormone that plays a key role in fetal and childhood development.

Nevertheless, in a hearing on September 16, 2008 in Washington into the safety of BPA, Food and Drug Administration (FDA) insisted that BPA is safe because at the current levels of exposure, a margin of safety does exist, which is sufficient to protect consumers including adults and children.

Likewise, the industry group American Chemistry Council also maintains that BPA should not cause any health hazard at the levels currently contained in some consumer products, which is also in line with the conclusion of governments worldwide. They feel that more follow up studies are necessary to support a conclusion that BPA would cause any disease.

Thursday, December 25, 2008

Is It Possible for a Teenager to live without a Heart for nearly 4 Months?

An American teenager of age 14 managed to survive for 118 days without a heart. She suffered from dilated cardiomyopathy, which is a condition that the patient's heart becomes weakened and enlarged and could not pump blood efficiently. This type of heart disease would require her to undertake a heart transplant for her survival.

On November 19, 2008, doctors in Miami announced that the young patient was kept alive by a custom-made artificial blood-pumping device, and they believe that this was the first time a child had survived in this manner for such a long period. In fact, an adult patient in Germany had been kept alive for 9 months without a heart.

At a news conference at the University of Miami/Jackson Memorial Medical Centre, the young girl seemed very weak and admitted that the experience was very scary. She just felt that she was like a fake person who did not really exist. Meanwhile, she was so afraid that the device might just malfunction at any moment.

Earlier on July 2, she had a heart transplant at Miami’s Holtz Children’s Hospital but the new heart failed to work properly and the doctors had to remove it quickly. Then, the doctors had to implant 2 heart pumps, made by Thoratec Corp of Pleasanton, California, to keep her blood flowing while she was fighting a host of ailments and recovering her strength. After almost 4 months, she had another heart transplant on October 29. Though she remained hospitalized, she was mobile during the period of 118 days, to be exact.

The young patient also suffered renal failure and a kidney transplant was carried out the day after the second heart transplant. Though her prognosis was good, there is a 50 percent chance that a heart transplant patient will require a new heart some 12 or 13 years after the first surgery.

Monday, December 22, 2008

Is High Resting Heart Rate Linked to Diabetes and Obesity?

Heart rate is the number of heartbeats per minute. It can be determined by taking the pulse. Resting heart rate is a person’s heart rate at rest. It varies with age, size, sex, and overall cardiovascular condition. The best time to get one’s resting heart rate is in the morning before getting out of bed.

It is the sympathetic nervous system (SNS), which is a network of neurons in the body operating without conscious thought that regulates the heart rate. It is believed that the large intestine, blood vessels, pupil dilation, perspiration and blood pressure are affected by heart rate.

A recent report, published in the American Journal of Hypertension in December 2008, revealed that high resting heart rates might be linked to the development of diabetes and obesity. Researchers in Japan found that people with resting heart rates of over 80 beats per minute had a higher chance of developing insulin resistance, diabetes and cardiovascular disease.

As one of the first few studies to examine the impact of heart rates on human body’s metabolism, the project involved 614 participants who were followed over a period of 20 years. These participants were divided into 4 groups: people with heart rates of below 60, 60-69, 70-79, and over 80.

In comparison with people with heart rates below 60, those having heart rates of above 80 were 1.34 times more likely to be obese, 1.2 times more likely to develop insulin resistance, and 4.39 times more likely to end up diabetic.

Such findings help depict the link between obesity and the SNS, which might in turn also help understand their casual role in the development of heart attack and stroke, two of the leading causes of death worldwide.

The researchers believe that the excessive nerve activities may be the cause that a person becomes obese since they reduce the amount of fat burnt in the body.

Friday, December 19, 2008

A New Generation of Artificial Heart Will Avail by 2011!

Shortage of transplant donors for heart is a worldwide phenomenon. It is estimated to be a worldwide shortage of 20,000 heart donors every year. As such, several research teams from United States, Japan, South Korea, and Europe are expediting their pace for the development of a total artificial organ, which can permanently replace the human heart.

After spending 15 years to develop a total artificial organ, a European research team revealed that a fully implantable artificial heart has been developed and they are now moving from pure research to clinical application. Such prosthetic heart is ready to be manufactured and should be ready for human use by 2011.

The artificial organ has a shape like a real heart and has the same blood flow rhythm. The prototype uses the same technology as prosthetic heart valves that have already been used around the world, and is developed by Mr Carpentier, a leading heart transplant specialist.

The existing artificial hearts have the problem of rejection by the patient’s immune system or blood clotting. In order to solve such problem, the new artificial organ is made from chemically treated animal tissues.

It is meant for heart disease patients who have a massive heart attack or with late-stage heart failure, and for those who cannot be treated by drug therapy, ventricular assistance, have heart transplant failed, or heart transplant is not available.

So far, the artificial heart has been tested using digital simulation and on animals. The trials have indicated no complications.

The existing artificial heart is a thumb-sized device implanted in the patient’s chest that sucks blood from the heart and pumps it into the aorta. The device has to be recharged every 4 hours using an external battery. In United States and Europe, heart surgeons have implanted such ventricular assistance devices (VAD) in 220 patients since 2000.

Tuesday, December 16, 2008

Not More Than 2 Drinks for Women to Avoid Irregular Heartbeat!

Previous studies indicated that the consumption of a moderate amount of wine or other alcoholic drinks might help prevent heart disease.

In fact, a paper published on March 7, 2008 in the “American Journal of Medicine” indicated that people who commenced their drinking in middle age were 38 percent less likely to get a heart attack or other serious heart problem than abstainers were, even if they were overweight, had diabetes, hypertension (high blood pressure) or other heart risks.

Nevertheless, what is the optimal amount one should drink? Well, if you were a woman, consuming a drink or 2 will not put you at risk of getting irregular heartbeat, or what is also known as atrial fibrillation.

Several previous studies had already shown that medium to heavy drinking would lead to higher risk of atrial fibrillation among men. However, such link did not seem to establish among women, because not enough women were included in those studies.

A recent study, conducted by the researchers from Brigham and Women's Hospital and Harvard Medical School, reported that having more than 2 alcoholic drinks is associated with an increased risk of atrial fibrillation. The findings were published on Dec 3, 2008 in the Journal of the American Medical Association (JAMA).

Based on 34,715 women aged 45 and older and in good health at the start of the trial, the researchers found that alcohol consumption of up to 2 drinks per day would not lead to higher risk of incidental atrial fibrillation among these women. On the other hand, a small group of women who drank 2 or more alcoholic beverages per day had a risk of atrial fibrillation that was 1.6 times more than those non-drinking women.

In this study, questionnaires were used to assess alcohol consumption at the beginning of the trial and at follow-up checks. The irregular heartbeat was reported by individual woman via annual questionnaires and was confirmed later through a medical checkup.

However, the researchers indicated that careful interpretation should be carried out on their findings. This is because the number of women in some subgroups was rather small, and there is a possible threshold effect in the relationship between alcohol consumption and risk of atrial fibrillation among women.

Saturday, December 13, 2008

What Kind of Gene Could Prevent Heart Disease?

Heart failure, also known as congestive heart failure, is a condition in which the heart cannot supply adequate blood flow to the rest of the body's organs. Such condition is caused by significant or prolonged stress to the heart. It could simply occur following a heart attack, high blood pressure, certain infections, and because of genetic causes.

Statistics show that heart failure affects some 23 million people worldwide and kills about 600,000 every year.

Recently, a tiny piece of genetic material that plays a key role in heart failure has been identified by an international research team who also shows how an experimental compound prevents the condition in mice.

Using a treatment from Regulus Therapeutics, the scientists were able to block or silence the tiny strands of ribonucleic acid called microRNA. Regulus Therapeutics is a joint venture between US biotech companies Alnylam Pharmaceuticals Inc and Isis Pharmaceuticals Inc.

These genetic fragments are responsible for regulating the making of genes into proteins, and in this case, it was discovered that a failing heart had 3- to 5-times more of a particular microRNA called miR-21. The findings of the new study were reported on November 30, 2008 in the journal Nature.

To begin with, the researchers analyzed hundreds of microRNAs within human and mouse heart samples to identify miR-21 as a key cause of heart failure. Then, they gave some mice an experimental compound known as antagomir to block miR-21. In these mice, the heart failure was prevented while mice that did not get the drug developed heart failure. As compared with the mice that did not receive the treatment, mice with heart failure that later got the compound did improve.

In other words, cardiac disease could be prevented as well as cured because the results from the study showed that heart function and tissue damage improved in both cases.

This new study was viewed as a landmark event in the advancement of microRNA therapeutics as a new class of innovative medicines. Several big drug makers have already invested into RNA technology to search for promising biotech assets.

Earlier in November 2008, a United States team had also shown how a different bit of RNA known as microRNA-101 meant the difference between an easily treated tumors and an aggressive cancer.

Thursday, December 11, 2008

Toxin Gas Turns Out to be Remedy for Heart Failure!

Being a leading cause of hospitalization for the elderly, heart failure is a condition in which the heart muscle cannot pump enough blood to meet the body’s needs. This can be caused by previous injury to the heart muscle from a heart attack, diabetes, high blood pressure or obesity.

Hydrogen sulfide is colorless and highly toxic. It is a flammable gas that not only has rotten-egg smell, but also is potentially dangerous for miners and sewer workers.

In a recent study, researchers from Emory University School of Medicine, in Atlanta, Georgia found that small dose of hydrogen sulfide helps protect laboratory mice from heart failure through its ability to regulate blood pressure and reduce inflammation.

The findings, presented in November 2008 at the American Heart Association's annual conference meeting at New Orleans, Louisiana, revealed that hydrogen sulfide appears to stimulate heart muscle cells and produce their own antioxidants and molecules that stave off programmed cell death caused by loss of blood flow.

In order to create a model of cardiac failure, the researchers blocked the laboratory mice’s left coronary arteries either temporarily for an hour or permanently to cause part of their heart muscles to die. Then, some of the mice were treated with a solution of hydrogen sulfide administered intravenously once a day for a week, while others left untreated to become the control group.

After a period of 4 weeks, researchers tested both groups’ heart capacity through their ‘ejection fraction’, a measure of heart function. Mice treated with the toxic gas showed an ejection fraction of 33 percent higher than those mice in the control group (36 percent compared to 27 percent).

Such results indicated that hydrogen sulfide can actually blunt the impact of heart failure on heart function and mortality in a mouse model of heart failure, and it is hoped that such experimental treatment could benefit humans one day.

Tuesday, December 09, 2008

Sleep Adequately to Prevent Heart Disease!

If a person reduces his or her sleep duration, then his or her risk of getting heart disease would be higher.

A recent study indicated that sleeping less than 7.5 hours a night would increase the chance of cardiovascular risk, including heart attack and stroke, by 33 percent. The paper was published by researchers from Jichi Medical University on November 12, 2008 in the Journal of the American Medical Association's Archives of Internal Medicine.

The sleep of 1,255 people with hypertension (also known as high blood pressure) was monitored by the Japanese researchers for an average period of 50 months. Their daytime and nighttime blood pressure, sleep duration, and cardiovascular disease events like heart attack, stroke and sudden cardiac death were tracked.

In the study, there were 99 incidents of cardiovascular disease being recorded. It was also found that the rate for people who slept less than 7.5 hours was 2.4 per 100 person-years. Those who slept more had a lower incident rate of 1.8 per 100 person-years. Meanwhile, the researchers also discovered that people whose blood pressure rose at night were more prone to heart disease.

The researchers believed that shorter duration of sleep is actually a predictor of incident cardiovascular disease in elderly individuals with hypertension.

In the meantime, inadequate sleep has also been linked to higher chances of diabetes, obesity and several risk factors for cardiovascular disease, which includes nighttime hypertension and sleep-disordered breathing.

Sunday, December 07, 2008

Are You Having High Blood Pressure Without Knowing It?

High blood pressure is also known as hypertension. It has been found by previous research that people with high blood pressure will be at a higher risk of getting heart disease, kidney disease, stroke and dementia.

As defined by the World Health Organization (WHO), high blood pressure is defined as being 140 over 90 mm of mercury or more. Mercury is the fluid used in the blood pressure gauges. The first number (140 mm), known as systolic, measures maximum heart pressure while the second (90 mm), known as diastolic, measures pressure when heart is in a resting phase (diastolic).

Many people who already have hypertension are just not aware of the condition. In fact, a recent study by Warwick Medical School in Britain and other institutes in Europe reported that more than half of people in 3 European countries who were diagnosed with high blood pressure did not know they had the condition. In addition, half of those who were aware that they had hypertension had managed to have their problems under control.

The findings were published in the International Society of Hypertension's Journal of Hypertension on November 12, 2008.

1,604 persons from Southwest London, Limburg in Belgium and Abruzzo in Italy, who participated in the study, answered questions regarding healthcare and lifestyle habits.

24 percent of the participants were found to have high blood pressure, yet only 44 percent of them were aware of their condition. Among these people, less than half had reduced their blood pressure to below 140 over 80 mm of mercury, the widely accepted benchmark of health.

According to the researchers, management of hypertensive problem is considered better in Britain than in many other European countries, partly because doctors in Britain have incentives to help patients reach targeted blood pressure. However, the incidence of high blood pressure is still rising, as too many patients are still not adequately treated.

Thursday, December 04, 2008

No MP3 Headphone Near Heart Disease Patients Equipped with Defibrillator!

Listening to MP3 songs and music using MP3 digital music players with headphone has become a lifestyle of today’s youth. Lately, it seems to gain popularity among older generations as well. Nowadays, it is rather difficult to find a mobile phone that is without MP3 player.

From now on, people who like to listen to music using MP3 player with headphone should be more careful. This is because a new study revealed that the headphone used in MP3 player, if placed within an inch of lifesaving cardiac devices such as pacemakers or implantable defibrillators, the operation of those devices may be interfered.

Presented the findings at an American Heart Association conference during November 2008, the researchers from the Medical Device Safety Institute at Beth Israel Medical Center in Boston, Massachusetts found that neodymium appears to cause the devices to function improperly. This could thus pose a potential great risk to heart disease patients who rely on the devices. Neodymium is a magnetic substance that can be found in the MP3 player headphones.

By exposing to headphones, a defibrillator could temporarily be deactivated. As such, headphones accompanying the popular MP3 digital music players must be at a distance of at least 1.2 inches (or 3 centimeters) away from the implanted devices, according to the study.

Meanwhile, the scientists caution heart disease patients, who use heart devices, not to put the MP3 player headphones in their pocket or to hang them over their chest. They also advise friends or family members of heart disease patients with implantable defibrillators to avoid wearing headphones and not to rest their head right on top of the devices used in their family members or friends.

Nevertheless, the researchers determined that outside studies did not find any adverse reactions to pacemakers and defibrillators from other portable electronic devices like iPod, Bluetooth headsets, iPhone, electric blankets or hand-held airport metal detectors.

Incidentally, both iPod and iPhone are MP3 players and headphones used in other digital music players can be used in iPod and iPhone too. I wonder why there is such a different reaction. Perhaps further studies should be carried out to ascertain such disparities.

Tuesday, December 02, 2008

More Power Means More Functions For Pacemaker!

A pacemaker is a small device, which can be installed under the skin of a person’s chest or abdomen, for helping control abnormal heart rhythms. By using electrical pulses, such devices can prompt the heart to beat a normal rate.

Arrhythmia is the name given to describe abnormal heart rhythms. When a person has symptoms related to arrhythmias, his or her heart rhythms can be too slow, fast or simply irregular. With the help of a pacemaker, a person with abnormal heart rhythm could resume a more active lifestyle.

It has always been the wish of doctors to incorporate more functions into the pacemakers to help monitor the heart. However, to add new functions into pacemaker means more power is required, and the only way to increase the power is to use larger-size and heavier battery. Unfortunately, such change would certainly make patients feel uncomfortable and arouse rejection from the patients.

Good news has emerged recently when researchers have developed a tiny generator that can harvest the excess energy of a beating heart to help power a pacemaker or defibrillator, according to a paper presented at the American Heart Association's annual meeting during November 2008.

By capturing enough surplus heart energy, the experimental micro-generator, developed by the researchers from Southampton University Hospital in Britain, can in turn provide 17 percent of the power required to run a pacemaker. This means that new generation of devices that lasted significantly longer would be available soon and more functions that can help monitor the heart can be added.

Right now, the researchers have already started their work on how to improve the materials used in the generator in order to enhance the energy harvesting.

Sunday, November 30, 2008

How Effective Is Crestor In Preventing Heart Disease?

Being manufactured by AstraZeneca, Crestor is a cholesterol-lowering medicine that aims to reduce levels of bad cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, and in the meantime increase levels of good cholesterol (high-density lipoprotein, or HDL). It has been approved for use in over 95 countries with nearly 15 million patients being prescribed presently worldwide.

By lowering the bad cholesterol, it is possible to help prevent heart disease and hardening of arteries. These two conditions can develop heart attack, stroke, as well as vascular disease. Nevertheless, how effective is this medicine?

Presented during November 2008 at an annual meeting of the American Heart Association in New Orleans and published online by the New England Journal of Medicine, the study known as “JUPITER” revealed that Crestor could actually reduce by 44 percent the risk of heart problems among patients who currently do not face a high risk of getting a heart disease.

The study involved 17,802 men and women, of the age of 50 and more, who took 20 milligrams of Crestor on a daily basis. It was found that the combined risk of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from cardiovascular causes was reduced by 44 percent as compared with placebo among men and women with elevated hs-CRP but low to normal cholesterol levels.

By the way, CRP is a protein that is produced by the liver. It plays an important role in inflammatory processes and serves as a biological marker to measure the risk of artery blockage.

Also shown in the study, patients who took Crestor also had the combined risk of heart attack, stroke or death from heart disease reduced by 47 percent. Meanwhile, their risk of heart attack was cut by more than half, the risk of stroke was reduced by nearly half and the total mortality of the participants was lowered by 20 percent.

It was also recorded in the study that a daily dose of 20 milligrams of Crestor was well tolerated in nearly 9,000 patients during the course of the trial, and there was no difference between treatment groups for major adverse events, including cancer or myopathy.

Friday, November 28, 2008

Can Risk of Early Death from Heart Disease or Cancer Be Reduced?

“One should adopt healthy lifestyle” in order to prevent from heart disease, and other medical disorders such as cancer, diabetes, hypertension (high blood pressure), stroke, and so on and so forth. Nevertheless, how many of us will really take this seriously and keep that in mind?

Based on the data provided by 80,000 women in the United States who were between 34 and 59 years old, a long-term study by the Harvard School of Public Health began in 1980. The findings, which were published on September 17, 2008 online by the British Medical Journal (BMJ), indicated that women who eat right, exercise and never smoke tobacco were more than halve the risk of dying from heart disease or cancer.

During a period of 24 years, the volunteers participated in the study filled out detailed questionnaires regarding their physical activity, diet, weight, alcohol intake, and disease history. At the end of 2004, 8,882 of the women in the group had died. Record showed that 1,790 and 4,527 of these women died from heart disease and cancer respectively.

According to the calculation made by the researchers, smoking alone accounted for more than a quarter of the deaths. In fact, 55 percent of the death figure could have been avoided if these women had maintained slim, avoided fatty foods and exercised regularly, in addition to not smoking.

The study also found that a glass of wine or beer with dinner every night would offer some help in heart disease prevention. This confirmed earlier research.

Based on the results from the study, the researchers concluded that even small changes in the lifestyle could have a substantial impact on the reduction of mortality rates. Perhaps, people should start changing their lifestyle right away.

Wednesday, November 26, 2008

Why Obese Children Could End Up with Heart Disease or Stroke?

In the evolution of heart disease and stroke, there is a saying that “one is as old as his or her arteries”. This does mean that his or her state of arteries is more important than his or her actual age.

A recent paper, presented on November 11, 2008 at the American Heart Association's Scientific Sessions 2008 in New Orleans, revealed that neck arteries of obese children and teenagers experienced similar strain as those of middle-aged adults. The researchers from the University of Missouri School of Medicine and Children's Mercy Hospital, Kansas City, Kansas found that the state of the arteries in these children is more typical of a 45-year-old than of someone their own age.

Data from 34 boys and 36 girls who were likely 'at-risk' because of obesity, abnormal cholesterol and/or a family history of early heart disease were analyzed. These teenagers had an average age of 13, and 89 percent of them were white.

Ultrasound was employed to measure the thickness of neck arteries (carotid arteries) that supply blood from the heart to the brain. When increased carotid artery intima-media thickness (CIMT, in short) occurs, there is a strong possibility that fatty buildup of plaque has taken place, which can clog the arteries and lead to a heart attack or stroke.

The analysis on the data obtained in the study indicated that the children’s ‘vascular age’ was approximately 30 years older than their actual age. A person’s vascular age refers to the age at which the level of artery thickening would be normal for his or her actual age.

In the meantime, the researchers also discovered that a higher body mass index (BMI) and higher blood pressure would have the biggest impact on CIMT.

It was suggested in the study that further research is necessary to determine whether the build-up of artery thickness would decrease if obese children undertake weight loss and exercise.

The researchers believe that something could be done to help those obese children, as the buildup in the vessels was found not hardened and calcified. If the vessel walls and blood flow in adults could be improved through medical treatment presently available, it is highly possible that health experts could come up with some solutions to help obese children even more in the prevention of heart disease and stroke.

Monday, November 24, 2008

Can Electrocardiogram Predict Heart Disease?

Angina is a common symptom of coronary artery disease. It is a condition characterized by sharp chest pain or discomfort. It occurs when an area of the heart muscle does not receive enough oxygen-rich blood. Sometimes, the pain may also occur in the neck, arms, shoulders, jaw or even back, and it can feel like indigestion too.

People usually regard electrocardiogram (or better known as ECG or EKG) as one that is given only to patients who are having attack of angina. It is estimated that about 1 in 50 people in Britain experience angina.

A paper published on November 14, 2008 in the British Medical Journal indicated that a routine examination by a doctor works almost as well as ECG in predicting heart disease.

During the ECG test, electrodes are placed on a patient’s skin and the electrical activity of the heart is recorded over time so that abnormal rhythms could be detected. Although ECG has been shown to be effective in revealing damage, its ability in predicting future heart disease was unknown.

As such, a team of researchers at the London Queen Mary's School of Medicine and Dentistry carried out a study that examined 8,176 patients with suspected angina but with no prior history of heart disease.

A standard clinical assessment, which looked at criteria including age, sex, ethnicity, duration of symptoms, description of chest pain, smoking status, and history of hypertension (high blood pressure) and medicines, was carried out on all the patients.

ECG was given to all the patients while they were at rest, and some 60 percent of them were arranged to have an exercise ECG that was performed while they were in motion. All the patients were monitored during the following year.

The researchers found that half of all heart incidents, which occurred during that period, happened in patients whose ECG tests had not shown any indication of heart disease. Meanwhile, they also found that a routine clinical assessment was almost as good an indicator of future heart problems.

Such findings might highlight the importance of taking a detailed medical history and making a thorough physical examination. ECG might be helpful for some patients by the additional information it provides, but it is a pity that it does not predict heart disease risk for everyone.

Saturday, November 22, 2008

Can Living Near Green Space Prevent Heart Disease?

Some earlier studies had already shown that living near green space would improve people’s states of health. However, a new report released on November 7, 2008 by the University of Glasgow indicated that some of the impacts are bigger than thought.

According to the study, parks, forests and playing fields could greatly narrow the health gaps between the rich and poor. In fact, the size of the difference in the health gap is surprising and represented a much bigger effect than what the researchers had been expecting.

In the study, the health impact of parks, forests, and playing fields were examined by dividing England into 5 sectors based on the amount of adjacent green areas and then death rates between rich and poor were compared. It was found that the health gap in the greenest areas between the richest and poorest people as measured by death rates was about half as big as that in the least green areas.

Helping people get rid of stress and allowing them to have more physical activity would naturally help them reduce the risk of heart disease. This is exactly what the parkland and open space could offer and make a difference.

For the very first time, research had shown that physical environment could create such an impact in such a good way with a combination of exercise and restoration. As such, the governments are urged to promote and invest in green areas.

The researchers believe that green spaces are other viable tools for governments to narrow the health gap between the rich and the poor. This is because over long term, government could have a substantial saving on the health care spending if they promote outdoors recreation and hence boost health for their people.

Thursday, November 20, 2008

Listen to Your Favorite Music to Prevent Heart Disease!

Listening to music could be an alternative way to help people with hypertension lowers their blood pressure. This was the findings of a study by the University of Florence in Italy reported at the American Society of Hypertension meeting in New Orleans in May 2008. Although high blood pressure is a risk factor for heart disease, the study did not provide any evidence that linked directly with heart disease.

Recently, a research team at the University Of Maryland School Of Medicine, who was also involved in a 2005 study that noted the cardiovascular benefits of laughter, reported that listening to favorite music could actually help maintain a healthy heart.

Their findings were announced at the 2008 Scientific Sessions of the American Heart Association in New Orleans on November 11, 2008. The researchers claimed that they had shown for the first time the emotions aroused by music enjoyed by the listener could be beneficial to a healthy blood vessel function.

The study, which involved 10 healthy, non-smoking volunteers, had noted highly significant differences both before and after listening to joyful music as well as between joyful and anxious music.

In fact, they found that by allowing these volunteers to listen to music that gave them a sense of joy, their inner-lining tissues of blood vessels would expand, which aided blood flow to increase. Such response matched those found in the 2005 study of laughter.

In order to minimize desensitization of emotions felt by listening to their favorite music, participants were told not to listen to the pieces for a minimum of 2 weeks before the test. The reason behind this was that when they listened to the pieces they really enjoyed, they would get an extra boost of whatever emotion generated.

It was found that after listening to joyful music, the diameter of the average upper arm blood vessel was increased by 26 percent. On the other hand, the diameter was narrowed by 6 percent after listening to music that caused anxiety.

Furthermore, the study also noted that the physiological impact of music might also affect the activity of the ‘feel good’ brain chemicals known as ‘endorphins’.

It is hoped that the findings would inspire people to incorporate ‘listening to favorite music’ as a preventive strategy for heart disease prevention in their daily lives.

Tuesday, November 18, 2008

Another Way to Lose Weight – Nutrigenetic Diets

Most people are aware that the more weight they gain the higher chances that they might be short-listed as victims of heart disease, diabetes, stroke, and even certain types of cancer. Unfortunately, weight can still be accumulated in one’s body gradually and un-noticeably. Once one becomes overweight or even obese, it would be extremely difficult for him or her to lose the unwanted weight.

A recent study outlined a way to help overweight individuals lose weight and keep it off by using personalized diets based on the individual’s genetic makeup. The researchers from Sciona, the Boulder, a company based in Colorado, reported in online journal BioMed Central: Nutrition Journal in 2007 that people who went on ‘nutrigenetically tailored diets’ were more apt to stick to the diet, and had greater success in the long term.

The study was partially funded by Sciona, which makes the testing system used to develop a person's nutrigenetic diet.

In the study, the case histories of 50 'nutrigenetic' dieters were compared with those of 43 patients who did not receive a nutrigenetically tailored diet.

All of these patients were attending a weight loss clinic in Athens, Greece by following a traditional weight management program involving a Mediterranean diet with exercise and regular follow-up clinic visits. Nevertheless, the researchers modified the standard Mediterranean diet of the nutrigenetic group to tailor the genetic results of each patient.

There was no much difference between the 2 groups in term of the amount of weight loss. After about one year, the nutrigenetic dieters continued to lose weight but a slight average weight gain was observed among the traditional diet group.

After another 300 days, it was found that the nutrigenetic dieters were about 5 times more likely to have maintained their weight loss than were the traditional dieters, and the nutrigenetic dieters also had improvements in their blood sugar levels.

In conclusion, the researchers suggest that adding a genetic, personalized component to a weight loss program might improve motivation and compliance. Moreover, the personalized diet is more suitable as the content of macro- and micro-nutrients were optimized for an individual during a period when overall food consumption is reduced and energy expenditure increased.

Sunday, November 16, 2008

How Grapes Could Help Prevent Heart Disease?

People with high blood pressure (also known as hypertension) have a higher possibility of getting heart disease including heart attack and heart failure, stroke, and kidney failure.

A recent study found that grapes helped laboratory rats, which were fed with salty diet, lower their blood pressure reduced and improve heart function. The study was sponsored in part by the California Table Grape Commission who provided financial support and supplied the grape powder; the National Heart, Lung and Blood Institute, and part of the National Institutes of Health.

The researchers from the Cardioprotection Research Laboratory at the University of Michigan, who carried out the study reported on October 29, 2008 in the Journal of Gerontology: Biological Sciences that their findings may help people with high blood pressure.

Meanwhile, they were also pleased to note that their findings support their theory that something within the grapes has a direct impact on cardiovascular risk. This is well beyond the already known fact that a diet rich in fruit and vegetables could lower blood pressure.

In the study, the effects of ordinary grapes were examined on rats that develop high blood pressure when fed a salty diet.

A powder from red, green and purple table grapes and a high-salt diet were given to some rats while others were fed the grape powder and a low-salt diet. Using grape powder, which contained the same nutrients in fresh grapes, would allow the scientists to measure the rats’ intake carefully.

18 week later, lower blood pressure, better heart function, reduced inflammation throughout their bodies, and fewer signs of heart muscle damage were observed among rats that ate the grape-enriched diet when comparing to rats that ate a salty diet with no grapes.

The grape powder used in the study comprised about 3 percent of the rats' diet. For humans, this should be about 9 servings of grapes a day. By the way, one serving is about 15 grapes, so it means people have to consume about 135 grapes per day.

It is believed that flavonoids, which are beneficial chemicals found in grapes, green tea, cocoa and tomatoes, could be responsible for the lowering of blood pressure.

Furthermore, flavonoids have already been shown in other studies to have heart-health benefits. In fact, various studies sponsored by chocolate makers, almond and walnut producers have shown some sorts of heart benefits, including reducing inflammation in blood vessels and lowering the risk of heart attacks and stroke.

Friday, November 14, 2008

Don’t Eat Fast, Eat Till Full if You Don’t Want to Get Fat!

Fearing of getting fat seems to be a great concern for many people as they are fully aware that once they become overweight, chances that they would develop heart disease, diabetes, high blood pressure and other medical complications would be higher. Therefore, they seek all means to reduce or at least maintain their weight. Perhaps people should now also eat slowly and not eat until they feel full to avoid gaining weight.

In a recent study, Japanese researchers from Osaka University announced that people who eat fast and eat until they feel full are 3 times more likely to grow fat, as compared with those who eat slowly and modestly. Their findings were published online on October 21, 2008 by the British Medical Journal (BMJ).

The participants, 1,222 men and 2,165 women aged between 30 and 69, were asked to closely monitor their own eating habits and BMI (body mass index), a benchmark of obesity.

From the data collected, about half of the men and just over half of the women ate until they were full, and just under half of the men and a little more than a third of the women ate quickly.

The researchers indicated that men and women who ate until full were twice as likely to be overweight when comparing to those who did not eat until full. Meanwhile, those who ate both fast and until they felt full were 3 times as likely to be overweight.

In the study, people who ate until full and those who reported eating swiftly, were tracked separately, and researchers found that those who ate until full had a higher calorie intake than those who ate fast.

According to the explanation made by other health experts, the drive to eat quickly is a genetic survival mechanism. In other words, humans are prone to over consume energy when it is available.

There are few reasons that would make such eating behavior to grow. Firstly, the sociology of food consumption changes with fewer families eating together. Secondly, more people eat while distracted, for instance, they eat while watching television programs. Finally, people eat fast food while on the go.

Meanwhile, the increased availability of fast food, which is energy-dense and served in substantially larger portions, could explain why people tend to eat beyond satiety.

Wednesday, November 12, 2008

Study Seeking Way to Prevent Deadly Blood Clot in Stent Implanted Patients!

Every year, about 800,000 to 1 million American patients have one or more stents implanted inside their bodies to keep the artery open after it has been cleared out by angioplasty. While there is less than 1 percent has a clot form near the stent, there are still many complications, ranging from clots to strokes, heart attacks and even deaths.

In order to find out the best way to prevent potentially deadly blood clots from forming in heart patients who have artery-opening stents implanted, several competing drug and medical device makers are joining hands to start a new study, which also involves academic researchers and federal regulators, to find out how long patients should take blood-thinning medicine.

Since early this year, the trial has already been planned but the initial details were announced only on October 15, 2008 at a medical conference. The study will involve and be partly supported by the 4 United States competitors in the stent market plus 4 drug makers.

The multi-center study, which is expected to begin enrolling patients later 2008 or early 2009, will involve about 25,000 to 30,000 patients who have had one of the tiny, metal-mesh tubes implanted in a heart artery.

Most of these patients have today’s widely used drug-coated stents that will over time release a medication meant to prevent the artery from re-clogging. On the other hand, at least 5,000 of the participants will get older, bare-metal stents.

According to the investigators, patients in the study will get now-standard preventive treatment for a year after getting a stent implanted. Such treatment involves an anti-clotting drug and at least 81 mg of aspirin a day.

At the end of the one-year study, those who have no complications will be randomized, with half of them continuing on the dual blood-thinning therapy for an additional 18 months and the rest stopping it. Researchers will then determine which group had more heart attacks, strokes and deaths, as well as clots inside the stents.

Monday, November 10, 2008

Can TCM Protect Kidney Damage in Diabetics?

When urine of diabetic patients contains a certain protein, which is a sign of kidney damage, or if their blood pressure is high, the doctors will normally prescribe them with medication to lower their blood pressure and protect their kidneys. Otherwise, patients who already have some form of kidney damage can end up with kidney failure.

However, these medications do produce side effects in some patients such as cough, which can be so bad for them that doctors might have to take off the medication. As such, other options should be explored for these patients.

Researchers at the Singapore General Hospital (SGH) in Singapore announced in April 2008 that they would conduct a study involving 60 diabetic patients. The purpose is to find out how well traditional Chinese medicine (TCM) could prevent kidney damage in diabetics, in comparison with the normal Western drug.

Over a period of 3 months, all the 60 patients in the study will be given the usual medication to lower their blood-sugar levels and for other conditions such as high cholesterol. However, these patients will be divided into 2 groups: half of them will be prescribed with enalapril, a commonly prescribed Western drug that protects kidney, and the other half will be given a concoction of 9 TCM herbs.

If the study can yield favorable results, TCM could well become a feasible alternative for those patients who cannot tolerate the normal medication.

In fact, a similar one-year study in Shanghai, China has shown that TCM prescription works as good as the standard drugs in protecting kidneys without the side effects.

Meanwhile, another 2 studies will be done by SGH to find out how effective the TCM can do for patients with blood disorders that cause a low platelet and anemia.

SGH are putting effort to conduct TCM-related research in 3 areas: patients for whom conventional medicine has failed, patients with chronic diseases, and cancer. If encouraging results could be found, those affected patients can at least be given with another option.

Saturday, November 08, 2008

What Types Of Cereals Should Be Banned From Kids?

According to a new analysis by Yale University in New Haven, Connecticut, the breakfast cereals meant for children are less healthy than cereals for adults, and worst still, those that are ‘marketed the most aggressively to kids’ have the worst nutritional quality.

Through the study of 161 brands of cereals, the researchers published their report in the Journal of the American Dietetic Association indicating that the health claims by the cereal producers were often misleading. For instance, cereals sold as ‘low fat’ or ‘low sugar’ did not have low calories, and those brands sold as ‘whole grain’ though had more fiber, they also had as much salt, sugar, and fat as any other brands and had the same calorie content.

They also noted that children are often encouraged by both the food industry and public health authorities to eat breakfast, especially ready-to-eat cereals.

With an aim to comparing the nutritional quality of cereals targeted for children and those for adults, the researchers screened 161 brands of cereals, 46 percent of which were meant for kids. To be qualified in the study, the particular brand of cereal should have a character on the box, toys or games inside, or the company’s web site listed that brand as a children’s cereal.

The research team found that children’s cereals in fact had more sugar, sodium, carbohydrate and calories per gram than non-children’s cereals, and less protein and fiber, too. Meanwhile on average, more than one-third of the weight of children’s cereals consisted of sugar, comparing to less than one-quarter of the adult cereals.

While 56 percent of the non-children’s cereals met nutrition standards for foods sold in school, only 34 percent of the kid’s cereals did.

The growing number of overweight and obese kids would definitely worry their parents because the extra weight in these kids may just make them the possible candidates for heart disease, diabetes, high blood pressure, and many other sicknesses, as they grow older.

The advice from the researchers is that parents hoping to choose healthy cereals for their kids should search for those containing 4 or less grams of sugar per serving (about 1 teaspoon), at least 4 grams of fiber per bowl of cereal. Most importantly, once the parents decide to ban the heavily marketed cereals from their kids should stick to their decision. If they ever give in once, they are going to make their kid nag them even more.

Thursday, November 06, 2008

How Does Bee Gees’ Song Relate to CPR?

Do you find it interesting? When I saw a report titled “CPR with Stayin’ Alive Tune”, I was very surprise and I bet you would too. How did these two different entities relate to each other? By the way, CPR stands for cardiopulmonary resuscitation.

Guess what, a small research conducted by the University of Illinois medical school found that doctors and students could maintain close to the ideal number of chest compressions when they did CPR and at same time listened to the song Stayin’ Alive.

Stayin’ Alive is a song by the Bee Gees, released as a single in 1977, and was considered as one of The Bee Gees' most popular and recognizable songs. It was played in the opening scene of the popular disco film, ‘Saturday Night Fever’.

According to announcement made by the researchers on October 16, 2008, the old disco song, at 103 beats per minute, has almost the perfect rhythm to help jump-start a stopped heart. This is very close to 100 chest compressions per minute, as recommended by The American Heart Association.

Although CPR can triple survival rates for cardiac arrest when performed properly, many people hesitate to do it because they either are not certain about or have difficulty maintaining the proper rhythm. Stayin' Alive, which has a way of being stuck in one’s head, can help with this.

15 students and doctors were involved in the study, which consisted of two parts. First, they did CPR on mannequins while listening to the song on iPods, and the chest compressions were timed with the song’s beat. 5 weeks later, they did the same drill without the music but they were asked to think of the song while performing the compressions. The average number of compressions recorded was 109 for the first and 113 for the second time.

This showed that the song actually helped people who already know how to perform CPR, and this should warrant larger, more definitive studies with real patients or untrained people, according to the researchers.

In fact, The American Heart Association has been using the song as a training tip for CPR instructors for about 2 years.

A 28-year-old medical resident who participated in the study said he has revived real patients by keeping the song in his head while doing CPR. He admitted that he was not really a disco fan and he has been told that he has a complete lack of rhythm. However, he was surprise the song worked for him.

Tuesday, November 04, 2008

How Is Obesity Paradox Related to People with Heart Disease?

As there are about 65 percent of Americans are either obese or overweight, the Centers for Disease Control (CDC) have in fact classified obesity as an epidemic in the United States. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and National Institutes of Health (NIH), obesity costs Americans more than $117 billion annually in health care.

If a person is obese, he or she will have a higher risk, ranges from 50 to 100 percent, of premature death than people of normal weight. Obesity is a risk factor for other diseases such as high blood pressure, heart disease and Type-2 diabetes.

However, recent studies have shown that obese people with chronic diseases have a better chance of survival than normal-weight individuals do. This finding is known as “obesity paradox”. Such an unexpected decrease in illness and death with increasing body weight or BMI is originally described in people with heart failure and in patients having angioplasty.

A study by researchers from St Luke's-Roosevelt Hospital in New York City found that overweight and obese adults with high blood pressure and coronary artery disease also had a lower risk of heart attack, stroke or death, compared with the normal-weight people. Nevertheless, the rationales behind such phenomenon are still unclear. Their findings were published in the American Journal of Medicine.

The effect of overweight and obesity on heart-related outcomes was investigated in 22,576 people who participated in a large study. These people had treated high blood pressure and coronary artery disease.

People who were overweight (BMI between 25 and 30), class I obesity (BMI between 30 and 35) and class II-III obesity (BMI 35 or greater) actually had lower risk of heart disease, stroke, or death than those who weighed normal (BMI between 20 and 25).

The researchers also noted that the so-called “obesity paradox” did occur in both men and women across all age groups, even though the blood pressure was better controlled in normal-weight patients.

While improved outcomes appear to be consistently linked to increased BMI, other health experts do caution that one should not conclude that weight reduction is detrimental in overweight populations.

Despite the “obesity paradox”, findings of numerous studies still clearly support the benefits of weight reduction in obese patients with heart disease.

Sunday, November 02, 2008

Can China Be Spared From Epidemics of Lung and Heart Disease?

With the consistent high economic growth over the years, the living standards of Chinese people have been raised. This means that they can now eat better food usually with high fat, and their waistlines are correspondingly expanded. They also enjoy sedentary lifestyles because they travel more by car instead of bicycle they used to, and spend more time watching television.

In fact, more than 25 percent of Chinese adults were now considered overweight or obese, according to a report published in the US journal Health Affairs in July 2008.

A recent study published in “The Lancet” medical journal on October 20, 2008 warned that if efforts are not made to tackle the worsening diets and other unhealthy lifestyles of Chinese, epidemics of lung and heart disease seem unavoidable.

In the paper, the researchers believed that the pace and spread of behavioral changes including changing diets, decreased physical activity, high rates of male smoking and other high-risk behaviors has already accelerated to an unprecedented degree.

For instance, 177 million Chinese adults suffer from hypertension, partly because of high salt consumption. Another 300 million people smoke (majority of them men), and 530 million are exposed to second-hand smoke.

If present smoking rate is left to continue, it is estimated that 100 million Chinese men will die between 2000 and 2050, with many of their family members spending their life savings with an attempt for treatment.

Hypertension, unhealthy high-fat diet and smoking are possible risk factors for heart disease and, smoking, including second-hand smoke is closely related to lung disease.

Therefore, the China's government is urged to take necessary action (for example, launch campaigns) to discourage smoking and the intake of salt and fat. If steps are not taken in time, the burden of chronic diseases, preventable morbidity and mortality and associated health-care costs could then increase substantially. As a result, China would have to face a looming health crisis in the very near future.

Friday, October 31, 2008

Can Next-generation Heart Stent Perform Better than the Old One?

Stents are tiny metal wire-mesh tubes, with or without coated drugs. These devices can be inserted into blood vessels to keep them open so that blood flowing is ensure, and heart attack is prevented.

A new study found that patients using the so-called next-generation artery-opening device known as Xience drug-eluting stent had far fewer heart attacks and heart-related deaths after one year. The researchers from Columbia University in New York published their findings on April 22, 2008 in the Journal of the American Medical Association.

The study of 1,000 patients known as Spirit III compared results of Abbott’s Xience with Boston Scientific’s Taxus stent. It was reported that Xience proved significantly better at preventing scar tissue from re-narrowing treated blood vessels, a measure called in-segment late loss.

It also performed as well as Taxus in lowering rates of target vessel failure, a measure of re-treatment required either because the device did not work, or because of heart attacks or death. Furthermore, it also reduced major adverse cardiac events, including heart attacks and heart-related deaths by as much as 42 percent after one year.

The results of the study had no doubt convinced people that we are entering an era where we can make user of some safer and more effective drug-eluting stents.

Meanwhile, a team of researchers from Nanyang Technological University (NTU) in Singapore has been working on soluble stents for 5 years and they expect such stents can be tested on heart patients in Singapore within the next 2 years.

The soluble stents can dissolve completely over time and releases drugs or proteins to prevent side effects such as blood clots. As there is no foreign body remains in the blood vessel, it can heal much faster. This could lower the risk of the vessel becoming clogged over the next few years.

Wednesday, October 29, 2008

Fruit Juice May Be Superior Than Fruit To Prevent Heart Disease

Fruit and vegetables should form part of everyday’s diet if one wishes to prevent heart disease and maintain a healthy body. Yet, most of the health experts would advise us not to take fruit juice because it may cause a person to gain weight.

However, a recent study by French researchers from the Universite Montpellier reported in May 2008 that grapes, apples and their juices could prevent atherosclerosis being developed in hamsters eating a high-fat diet, high-cholesterol diet.

The term atherosclerosis refers to buildup of fatty plaque deposits in the arteries that can lead to heart attacks or stroke.

The study found that fruit juices had a more powerful anti-atherosclerotic effect than the fruit itself. This is probably the first time that processing fruits can have a major impact on its health benefits.

In the study, hamsters were fed with grapes, grape juice, apples, apple juices or water, along with a diet designed to promote atherosclerosis. The aim is to investigate how juice might influence the content of phenolic compounds, which are powerful antioxidants contained in fruits. Meanwhile, a control group of animals ate normal chow.

The hamsters, which were fed with fruits, had the amount equivalent to 3 apples or 3 bunches of grapes daily for a human, while the amount of juice given to another group of hamsters was equivalent to 4 glasses daily for a person weighing 70 kilos.

The researchers noted that apples and grapes had roughly the same phenol content but the purple grape juice had 2.5 times more phenols than apple juice.

When comparing with hamsters given water, those consumed fruit or fruit juice had lower cholesterol levels, less oxidative stress, and less fat accumulation in their aorta (the main vessel supplying oxygenated blood to the body). In terms of health effects, purple grape fruit rank high, followed by purple grapes, apple juices and apples.

According to the researchers, while the amounts of phenols contained in a food have a direct effect on its antioxidant properties, other antioxidant compounds in the fruits such as Vitamin C, carotenoids could also contribute to their effects. Such findings do provide encouragement that fruit and fruit juice may have significant clinical and public health relevance.

Monday, October 27, 2008

Want To Lose Weight, Use Pedometer!

When a person is overweight, chances that he or she would become victim of heart disease is much higher. In order to prevent heart disease, overweight or obese people are anxiously finding means to help them cut down the extra weight they have.

United States researchers from the University of Michigan reported in their study on January 15, 2008 in the “Annals of Family Medicine” that walking can actually help people lose weight, especially if they use a pedometer to ensure they are going far enough.

A pedometer (also known as Tomish-meter or step counter) is a device, which counts each step a person takes by detecting the motion of their hips. Originally, it was used by people engaged in sports and physical fitness but now it becomes popular as an everyday exercise measurer and motivator.

The modern pedometer is usually portable and electronic or electromechanical; a typical one is shown below:




It was observed in the study that people who walked 20 to 40 minutes a day lost a small but steady amount of weight. According to the researchers, the increase in physical activity can have health benefits independent of weight loss. In fact, increasing physical activity is expected to lower the risk of cardiovascular problems and blood pressure, and will help dieters keep lean muscle tissue when they are dieting.

A total of 9 studies involving 307 men and women were reviewed in the study. The participants took part in the studies of pedometer use, which ranged from 4 weeks to a year.

Participants in all the studies except one lost some weight (about 0.05 kilo a week on average). The weight loss was found to be 'remarkably consistent' across all of the studies, and this added up to 2.25 kilos over a year.

It is believed that changing eating habits could help even more. People could add between 2,000 steps per day to more than 4,000 steps per day. For an average person, 2,000 steps equals to about 0.6 km.

Saturday, October 25, 2008

How Adma Is Linked To Heart Risk in Diabetics?

Adma is the abbreviation for asymmetric dimethylarginine. It is a naturally occurring component of human blood plasma, and it can inhibit a compound that is capable of dilating blood vessels.

Diabetes has been identified as a risk factor for heart disease. A recent study by Steno Diabetes Center, Gentofte, Denmark found that people with Type-1 diabetes and kidney disease are at higher risk of heart-related events and progressive kidney disease because of the high blood levels of Adma.

In fact, previous research has already shown that high blood levels of Adma do reduce the ability of the blood vessels to widen, and this would lead to an increased risk of heart and blood vessel disease.

In the new study, researchers investigated how the value of Adma could be related to heart and kidney events in 397 Type-1 diabetic patients with diabetic kidney disease and 175 diabetic controls without kidney disease.

For patients with diabetics with kidney disease, those with Adma levels above the median were more likely (43.4 percent) to suffer a fatal or nonfatal major cardiovascular event such as heart attack than those with Adma levels below the median (19.4 percent).

Moreover, patients with Adma levels above the median also experienced a faster decline in their kidney function than those with lower Adma levels. Meanwhile, the researchers also indicated that patients with higher Adma levels were 3.2 times more likely to develop end-stage renal disease (the most advanced form of kidney disease) than those with lower levels of Adma.

The overall mortality was found to be 67 percent higher for patients with higher Adma levels than those with lower Adma levels.

If other future studies could also confirm similar finding, then Adma might be used by doctors to identify relevant Type-1 diabetic who are at particularly high risk of adverse heart and kidney-related events.

Thursday, October 23, 2008

Modified CPR Could Save More Life!

Cardiopulmonary resuscitation (CPR) is a life-saving medical procedure that is useful in retrieving a victim who experiences certain life-threatening emergencies including heart attack, cardiac arrest, or respiratory arrest that cause the breathing or heartbeat to stop.

Standard CPR involves compressions of the chest, but the modified one involves pumping both the abdomen and the chest at the same time. It was found that such modified CPR could double the survival rate of victims who collapse with a heart attack

A 5-year study in Poland jointly conducted by Katowice's Silesian School of Medicine, Nowy Targ's City Hospital, and Dabrowa Gornicza's City Hospital has found that this modified form of CPR revived 38 percent of patients, compared to 16 percent saved by the standard CPR. Meanwhile, the rate of those discharged from hospital after a sudden-collapse was also improved from 10 percent to 24 percent.

These results were presented in September 2007 at the European Society of Cardiology Congress in Vienna, which had more than 25,000 attendees.

In the study, the modified method had been performed on the 207 patients with an average age of 71, who had suddenly collapsed and become unconscious from 2002 to 2006. Then results were compared with that of a group of 138 similar patients, with an average age of 69 on whom standard CPR had been used in 2000 and 2001.

Standard CPR is no doubt a resuscitative procedure to treat those experiencing sudden cardiac arrest, however, it is effective in only 5 to 10 percent of patients due to insufficient arterial pressure generated by chest compressions alone. In view of this, the researchers introduced simultaneous abdominal compressions.

According to the study, the modified method not just raised the survival rate, but also caused fewer complications than standard CPR. Hence, they recommended that it should be made an element of training courses in resuscitation.

One should also note that CPR is unlikely to restart the heart. Its purpose is to maintain a flow of oxygenated blood to the brain and the heart so that tissue death could be delayed and chances for a successful resuscitation without permanent brain damage could be extended.

Tuesday, October 21, 2008

How Would Hostility Raise Heart Disease Risk?

Before we get into the topic, we need to understand 3 terms: free radical, antioxidant and oxidative stress. Let us look at how they are related.

Technically, oxidative stress is a condition, which occurs when production of free radicals in the human body exceeds the body's ability to neutralize and eliminate them. Free radicals would start chain reactions that disturb the body’s ability to neutralize them, hence resulting in tissue or cell damage. Oxidative stress has been associated with heart disease, cancer and other illnesses.

Antioxidants could stop these chain reactions by removing free radical intermediates and inhibit other oxidation reactions by being oxidized themselves. Antioxidant vitamins like vitamin C and E can help counteract oxidative stress. On the other hand, activities like smoking and pollution can actually increase it.

A study has indicated that hostility could raise a person’s risk of heart disease by depleting the level of certain heart-healthy antioxidants.

The researchers from the University of Minneapolis, who carried out the study, suggested that antioxidants could help explain why hostile individuals are more likely to smoke and drink, and poor diet and smoking can deplete antioxidants.

In their study, the researchers investigated 3,579 men and women of the age between 18 and 30 years old who were participating in the so-called Cardiovascular Risk Development in Young Adults study. Their levels of several different carotenoids and tocopherols (vitamin E) were measured.

It was found that people having high levels of hostility at the beginning of the study were more likely to have lower levels of several types of carotenoids 7 years later, but hostility did not predict levels of tocopherols or lycopene. The increased risk was found to be, nevertheless, small but significant.

Lifestyle factors such as diet, smoking and drinking probably play a part in explaining why hostility reduces levels of antioxidants, but the researchers are not clear whether the differences are importantly related to the risk of coronary heart disease. Therefore, further study is necessary.

Sunday, October 19, 2008

Is Wealth Really Associated with Stroke Risk?

According to the American Heart Association, every year there are about 780,000 Americans suffering strokes; about 27 percent of which occur before the age of 65.

If someone tells you that “a person’s risk of getting stroke depends on how rich he or she is”, do you believe? Initially, I was doubtful about the statement because many health experts have in fact linked many health hazards like heart disease, diabetes, hypertension, obesity, stroke, etc. with the prevailing wealthy lifestyles.

Nevertheless, the statement was supported by a study conducted by Erasmus Medical Center, Rotterdam, The Netherlands and its findings were published in the American Heart Association's journal “Stroke”.

The researchers found that people who aged 50 to 64 years old and wealthy seems to protect them against stroke, but wealth appears to make little difference in stroke risk after the age of 65.

In other words, lower wealth, education and income are associated with increased stroke risk up to the age of 65, and wealth is the strongest predictor of stroke among the factors sought by the researchers.

In the study, the effect of income (annual earnings), wealth (total of all assets minus liabilities) and education on stroke risk were assessed in 19,445 Americans in the ongoing University of Michigan Health and Retirement Study (HRS) that surveys Americans of the age of 50 and above every 2 years.

All of these participants were free from stroke when they were assessed in 1992, 1993 or 1998. During an average of 8.5 years, 1,542 people in the study were found to have a stroke. According to the researchers, the stroke risk of the 10 percent of people with the lowest wealth at the age of 50 to 64 was 3 times higher than that of those with the highest wealth.

It appears that the lack of material resources, in particularly wealth, would strongly affect people’s chances of a first stroke. This also means that closing the wealth gap for people of the age of 50 to 64 could actually help reduce the large disparities in stroke.

It is believed that wealth would increase access to medical care as well as other material and psychosocial resources. However, the researchers were quite surprised to see that stroke risk was not significantly different between the 2 wealth groups for both men and women who aged 65 and above.

Friday, October 17, 2008

Let Your Baby Sleep Enough To Avoid Overweight!

Childhood overweight or obesity has been a hot topic among people. This is because the extra weight accumulated in the body of these youngsters may greatly increase their risk of become victims of heart disease, diabetes, hypertension (high blood pressure), stroke, and even cancer in their life later.

Many causes, for example, over-eating and physical inactivity, can actually help a person gain weight or become obese. Nevertheless, a recent study revealed that babies with insufficient sleep could become overweight too!

Published in the “Archives of Pediatrics and Adolescent Medicine”, the findings from the so-called “Project Viva” study indicated that infants who sleep an average of less than 12 hours per day have doubled their risk of being overweight by the age of 3, compared to babies who get at least 12 hours of sleep per day

The adverse effect of shorter sleep duration was especially obvious among children who also watched at least 2 hours of television per day.

Previous research has already linked short sleep duration to obesity in older children, adolescents and adults, but the current study examined the relationship between the hours of sleep during infancy and weight in childhood.

The mothers of 915 infants who were involved in the study were asked at 6 months, 1 year, and 2 years how many hours their child slept in a 24-hour period, including naps. At the age of 3, 9 percent of children were overweight, which was defined as having a body mass index (BMI) for age and sex in the 95th percentile or greater.

After removing the influence of other variables like demographics, maternal characteristics, breast-feeding duration, and birth weight, the researchers found that infants who slept an average of less than 12 hours per day were almost twice as likely to be overweight.

Moreover, a much higher association between sleep duration of less than 12 hours per day and television viewing of more than 2 hours per day was also noted. Such combination significantly raises the chances of becoming overweight by nearly 6 times.

Based on the findings, the researchers suggested that childhood overweight prevention should target not only on the reduction in television viewing but also on making sure adequate sleep duration.

Wednesday, October 15, 2008

Music Listening is a Viable Option to Lower Blood Pressure!

To some people, listening to music may just be a hobby, but to people with high blood pressure (hypertension), it could be a way to help them lower their blood pressure.

A study by the University of Florence in Italy reported at the American Society of Hypertension meeting in New Orleans in May 2008 that people with mild hypertension had their blood pressure significantly reduced by listening to classical, Celtic or India (raga) music for 30 minutes a day for a month.

Listening to music could be soothing. It has already been associated with controlling patient with pain or anxiety and was reported acutely reducing blood pressure. For the very first time, however, daily music listening does show an impact on ambulatory blood pressure. Ambulatory blood pressure refers to readings taken repeatedly over the course of a day.

The researchers enrolled 48 adults who aged 45 to 70 and took medication for controlling mild hypertension into the study. These participants were divided into 2 groups. The first consisted of 28 who listened to 30 minutes of 'rhythmically homogeneous' classical, Celtic or raga music on a daily basis while practicing slow and controlled breathing exercises. The remaining 20 participants were put in the control group and no changes were made on their daily routine.

Blood pressure readings obtained one and four weeks later showed that systolic blood pressure (the top number in the blood pressure reading) dropped significantly for the music listeners. In contrast, people in the control group experienced only small, non-significant reductions in blood pressure.

The statistics in the current study indicated that something as simple, easy and enjoyable as daily music listening combining with slow abdominal breathing might help people naturally lower their blood pressure.

The health experts have predicted that some 56 billion people worldwide will be hypertensive by 2025, despite the global focus on prevention. People with high blood pressure are known to have a higher risk of getting heart disease, stroke, kidney failure, etc.

As such, the new findings would instill confidence to health professionals who could explore music listening as a safe, effective, and non-pharmacological treatment option or a complement to the prevailing therapy.

Monday, October 13, 2008

Watch Out Your Waist, Ladies!

Weight used to be a health concern for people because many diseases may be developed as a result of overweight. However, a recent large United States study suggested women with large bellies may die earlier of cancer and heart disease than other women, regardless of their weight.

In the medical journal “Circulation”, researchers from the National Institutes of Health and Harvard Medical School reported that middle-aged and older women who were abdominally obese (with a waistline of 35 inches or more) were more likely than those thinner one to die of heart disease or cancer during the study period.

In the past, studies have shown that abdominal obesity appear to be at risk of clogged arteries, diabetes and high blood pressure, and it has also been linked to certain cancers like kidney cancer and colon cancer.

Over a period of 16 years, the researchers tracked more than 44,000 women in the United States and found that those with abdominal obesity had doubled their chances of dying of heart disease or stroke, as compared with women who had waistlines smaller than 28 inches. Meanwhile, women with largest waists had a 63 percent higher risk of dying of cancer than those women with small waists.

Furthermore, the study also found that the risk of a large waist were independent of a woman’s overall body mass index (BMI). In fact, those women with waistlines of 35 inches or more were subject to a higher risk of dying of heart disease or stroke.

While maintaining a healthy weight remains important in the prevention of chronic diseases and premature death, and should continue to be encouraged, it is also essential to keep a healthy waist size to prevent abdominal obesity.

Excess abdominal fat has been regarded by experts as unhealthy because of its metabolic effects. Too much fat in the abdomen would raise cholesterol levels, promote insulin resistance (a precursor to Type-2 diabetes), and spur body-wide inflammation. People with these conditions may just end up with heart disease and certain cancers.

Saturday, October 11, 2008

Why Overweight Diabetics Should Go For Low-Carbohydrate Diet?

By following low-carbohydrate (low-carb) diet, overweight Type-2 diabetics can actually keep their weight and blood sugar under control over the long term. Diabetes, if not handled appropriately, can easily lead to heart disease and many other medical disorders.

Swedish researchers from the Blekingesjukhuset diabetes clinic in Karlshamn, Sweden limited carbohydrate intake of the participants in their study to 20 percent of total calories. The most significant effect of this low-carb diet is the absence of hunger. As explained by the researchers, the reduction in food intake will naturally force the body to use its own stores of fat for fuel resulting in weight reduction.

Starch-rich bread, pasta, potatoes, rice, and breakfast cereals were strictly prohibited, and the carbohydrate intake of 80 to 90 grams a day was limited mainly to vegetables, salad and crisp bread. This would actually minimize the glucose spikes making necessary for diabetics to take insulin.

Previously, the researchers had already found that the weight loss and glucose control were superior among the 16 obese diabetics who followed a low-carb diet compared with 15 similar patients who adopted a diet containing 55 to 60 percent of energy from carbohydrates over a 22-month period.

The current study recorded a total of 44 months of follow up data. In the findings, which were published in May 2008 in the BioMed Central journal Nutrition and Metabolism, they reported that 5 out of the 16 patients have retained or reduced body weight since the 22 month point and all but only one have lower weight at 44 months than at start. They further revealed that the glucose levels also dropped soon after the start of the diet and have stayed down over the 44-month period.

In conclusion, the advice given to obese patients with Type-2 diabetes who followed a 20 percent carbohydrate diet with certain restriction in calorie intake has a lasting effect on the body weight and glycemic control.

Thursday, October 09, 2008

Why Women Should Watch Their Level of Thyroid Function?

Thyroid is one of the largest endocrine glands in the body. Its function is to control how quickly the body burns energy, how sensitive the body should be to other hormones, and makes proteins.

In April 2008, researchers form Norwegian University of Science and Technology in Trondheim reported in the Archives of Internal Medicine those women, who had slightly low thyroid function, might subject to a higher risk of dying of heart disease. Even women with normal thyroid function but at the low end of the range were more likely to die of heart disease.

Thyroid function can be measured indirectly, by checking a hormone called thyrotropin, or thyroid stimulating hormone (TSH for short). TSH is released by another gland known as the pituitary gland. High TSH level is an indication that implies low thyroid function, which can cause symptoms such as sluggishness, hair loss, weight gain and a feeling of being cold.

Clinically, an estimated 10 percent of older women are suffering from low thyroid function, but this can be corrected by taking a daily thyroid hormone pill.

17,311 women and 8,002 men were studied and these subjects had no known thyroid disease, cardiovascular disease or diabetes at the beginning of the study. Over the next 8 years, it was found that 1.3 percent of the women and 2.3 percent of the men died of heart disease. What strike the researches was that the higher the TSH levels, the higher the risk of heart death. The link, however, was only significant in women but not men, and it was true even for levels that had been considered normal and healthy.

This study clearly shows that mortality resulted from coronary heart disease increases in women with increasing levels of thyrotropin within the reference range. The results also indicate that relatively low but clinically normal thyroid function may increase the risk of fatal coronary heart disease.

In fact, thyroid hormones may affect the heart and arteries in several different ways: they affect heart and blood vessel muscle cells, cholesterol and other functions. As such, doctors are advised to take seriously readings of thyroid hormone levels.

Although patients who get replacement thyroid hormones do lose weight, show improved cholesterol levels and see improvements in artery health, there is no study ever conducted to determine whether replacing thyroid hormone might actually affect heart disease risk.

The researchers also recommended more studies to see if treating low thyroid function could reduce the risk of heart disease.

Tuesday, October 07, 2008

Healthy Elderly Lifestyle is the Key to Long Life!

Aging population is an impending phenomenon not only in United States but also in many other countries. If one wants to live longer in good health with good physical function, he or she has to maintain a healthy lifestyle.

For 25 years, researchers from Brigham and Women's Hospital and Harvard Medical School in Boston tracked about 2,400 male doctors whose average age was 72 when they took part in the study in the early 1980s.

Published on February 11, 2008 in the Archives of Internal Medicine, the study found that those, who exercised 2 to 4 times a week, did not smoke, maintained normal body weight and blood pressure, and avoided diabetes, had a 54 percent chance of living to 90. People having at least one or any combination of these factors were also beneficial, but those who did nothing had only a 4 percent chance of reaching the age of 90.

According to the researchers, people who lived to at least 90 enjoyed better physical function and mental well-being late in their lives than those who died at a younger age. In fact, genetics accounts for only about 25 to 30 percent in determining how long people can live, with other factors playing a bigger role.

In another study appearing in the same journal by Boston University School of Medicine and Boston Medical Center, the researchers looked at 523 women and 216 men age 97 or older. They found that about a third of these participants lived to this advanced age despite having developed age-associated disease before age 85 such as chronic obstructive pulmonary disease, dementia, diabetes, heart disease, high blood pressure, osteoporosis, Parkinson's disease or stroke.

In quantifying how certain behaviors affect longevity, another British study, which tracked 20,000 people, revealed in January 2008 that those who exercised, avoided smoking, drank moderately and ate many fruit and vegetables lived 14 years longer on average than people who did none of these things.

It is rather difficult for an individual to initiate lifestyle changes. He or she may prefer to take a pill, which is much easier. Therefore, the onus is on an individual! If there were anything that one could do for a healthy lifestyle, then it would be ‘do not smoke and do exercise’!

Sunday, October 05, 2008

Which is Superior, Angioplasty or Bypass?

I always hear people around me debating about the superiority of angioplasty and coronary artery bypass grafting. Some insisted angioplasty is good because it carries lesser risk than bypass, while others argued that bypass could prevent heart patients from getting a repeat procedure or surgery over a longer period.

Coronary Angioplasty (or angioplasty, in short) is a technique to treat coronary heart disease and angina. It involves opening narrowed or blocked blood vessels known as coronary arteries of the heart.

Angina is chest pain or discomfort that occurs when an area of the heart muscle does not get enough oxygen-rich blood. A person with angina may feel pressure or squeezing in the chest. The pain may also occur in the shoulders, arms, neck, jaw, or back.

While angioplasty is a procedure, coronary artery bypass grafting (in short, bypass) is a type of heart surgery. It is sometimes called CABG ("cabbage"). During the operation, the surgery reroutes, or "bypasses," blood around clogged arteries by using a segment of a healthy blood vessel from another part of the body to improve blood flow and oxygen to the heart.

In October 2007, a new study revealed that bypass is indeed better than angioplasty at relieving chest pain and preventing the need for a repeat procedure. On the other hand, both angioplasty and bypass could provide patients with heart disease who need a procedure or surgery to clear their clogged coronary arteries the similar 10-year survival rates.

1.2 percent of patients undergoing bypass and 0.6 percent of those being treated with angioplasty incurred strokes. Angina was relieved over a 5-year period in 84 percent of bypass patients comparing with 79 percent of the angioplasty group.

Meanwhile, the researchers also found that 43 percent of patients treated with angioplasty and less than 10 percent of patient undergone coronary bypass required repeat procedures after 5 years.

Nevertheless, as noted by the researchers, emergence of new and refined techniques has made such a comparison to “remain a moving target”. In fact, new studies have already begun to investigate how the availability of drug-coated stents used in angioplasty affects the comparative efficacy of these techniques.

Friday, October 03, 2008

Heavy Mother May Give Birth To Babies with More Fat, Less Muscle!

There are a growing number of obese pregnant women. Meanwhile, more and more North American and European infants weigh 4,000 grams or more at birth, and these heavy infants are more likely to become obese when they grow up. We all know that obesity is a risk factor for developing heart disease, diabetes, high blood pressure, stroke, cancer, etc.

In one of the first studies to compare the body composition of newborn babies to their mothers’ pre-pregnancy body mass index (BMI), researchers from the University of Oklahoma Health Sciences Centre in Oklahoma reported in April 2008 that babies with overweight or obese mothers have more fat and less muscle than those with normal-weight mothers.

The researchers used the Pea Pod (a body composition system made by Concord, California-based Life Measurement Instruments) to measure the percentage of body fat, fat-free body mass, and total fat mass in 72 babies no older than 35 days.

Instead of using several different machines and took hours to complete, the Pea Pod can actually gauge body composition in just 5 minutes. Though the machine is expensive and just 15 are in use worldwide, the researchers predicted that more and more hospitals would begin using them.

In the study, the researchers noted that there was no differences in average birth weight between babies whose mothers with normal BMIs and those whose mothers were overweight or obese.

However, it was found that babies of the 39 overweight or obese mothers had significantly higher percentages of body fat (13.6 verse 12.5 percent), higher fat mass (448.3 grams verse 414.1 grams), and lower fat-free mass (3,162.2 grams verse 3,310.5 grams) than those born to the 33 normal-weight women.

As indicated out in the study, babies who have heavy mothers may face a higher risk of getting diabetes as they have less muscle mass.

While gauging babies’ body composition at birth could indeed provide a clearer picture of their health than weight alone, the most important thing is still to find out what should be done to those babies with a high percentage of body fat. As suggested by the researchers, one good way to encounter this is to encourage their mothers to breastfeed, as research does showed that formula-fed babies tend to be fatter.

Wednesday, October 01, 2008

Can Alcohol Really Help Prevent Heart Disease?

People who have never drunk alcohol may wish to consider picking up this habit. Does this contradict to the advices that we used to get: drinking alcohol is bad for our health?

In fact, a recent study conducted by the researchers from the Medical University of South Carolina in Charleston showed non-drinkers who begin the occasional drinking live longer and are less likely to develop heart disease.

The researchers reported on March 7, 2008 in the “American Journal of Medicine” that people who commenced their drinking in middle age were 38 percent less likely to get a heart attack or other serious heart problem than abstainers were, even if they were overweight, had diabetes, hypertension (high blood pressure) or other heart risks.

In the study, medical records of 7,697 people, between 45 and 64, who began as non-drinkers as part of a larger study were studied. Over a period of 10 years, 6 percent of these volunteers began drinking, though the reason for them to start drinking was unknown.

Over the next 4 years, the new drinkers were tracked and when compared them to the persistent non-drinkers, it showed that there was a 38 percent drop in new cardiovascular disease. Even after factoring in heart disease risks like cholesterol, education levels, exercise, high blood pressure, obesity, race and smoking, the findings still held. In fact, some volunteers who had more than one risk factor still benefited from adding alcohol.

Findings also showed that less than one percent of people drank more than what is recommended, a drink or 2 a day by most guidelines. Meanwhile, the researchers also noted that half of these drinkers were wine drinkers only. Actually, wine-only drinkers showed that they received a much bigger benefit.

The same research team has also started a new study in which non-drinkers would be randomly assigned to start either having a glass of wine a day, a glass of grape juice, or grape juice spiked with antioxidants, compounds believed to help prevent heart disease.

Nevertheless, people are advised not take the findings as an excuse for them to drink freely.

Monday, September 29, 2008

Is Comprehensive Screening Good Enough to Detect Sudden Cardiac Death?

Is comprehensive heart screening sufficient for young people who are engaging in aggressive exercises such as Marathon running, military training, etc? Should they also undergo additional testing with treadmill exercise and echocardiography (cardiac ultrasound)?

What is sudden cardiac death? As defined by American Heart Association, sudden cardiac death (SCD) or cardiac arrest is the sudden, abrupt loss of heart function in a person who may or may not have diagnosed heart disease. It just occurs immediately or shortly after the symptoms appear.

Every year, sudden cardiac death causes about 166,200 deaths among adults in the United States before reaching a hospital or emergency room.

For people below the age of 35, SCD has many causes. Not all of these causes are due to cardiac problems and only some of these can be detected by screening. Patients who die suddenly are commonly caused by cardiovascular disease, in particular, coronary heart disease (CAD), but it rarely happens to younger age group.

No doubt treadmill ECG stress testing can be used to detect CAD. Nevertheless, it does have its own limitations. For example, it has a false positive result of 10 to 20 percent. In other words, if CAD occurs in 1 per 1,000 people screened, out of 25,000 persons tested, 25 might have CAD. This means that 2,500 to 5,000 might have false positive stress results, and these people have to undergo further testing, such as nuclear imaging and coronary angiography, which may have other risks such as radiation exposure.

It is unjustified to place such a big percentage of people to these risks, as this would certainly outweigh the benefit of detecting a few with CAD. Obviously, stress testing should only be used for those at higher risk such as older men or those with significant risk factors for heart disease.

For youngsters, a more common cause of SCD is hypertrophic cardiomyopathy (HCM). It is an inherited condition with abnormal thickening of the heart muscle. People with HCM will show ECG abnormalities.

In fact, adding ECG to a history and physical examination in athletes, and referring only those with ECG abnormalities for more tests was proved to be an effective mean to minimize the risk of SCD due to HCM. Such approach has also been shown by studies in Italy and endorsed by the International Olympic Committee and European Society of Cardiology.

Meanwhile, prevention and control of risk factors like diabetes, high cholesterol, hypertension (high blood pressure), obesity, and smoking through healthy lifestyles should be encouraged to reduce SCD.