Wednesday, January 30, 2008

When The World's First Heart Transplant Operation Was?

Heart transplant operations are not uncommon nowadays. With the current available technology and know-how, performing a heart transplant is not really a big issue, as long as there is suitable organ.

But, do you know when the world’s first heart transplant operation was?

Medical history was indeed rewritten 40 years ago in the middle of the night at a Cape Town hospital. Christiaan Barnard, a South African surgeon, was the very first doctor who carried out the heart transplant.

The patient in the first heart transplant is Louis Washkansky, a 53-year-old diabetic with incurable heart disease who had suffered three heart attacks.

Dr. Barnard had already practised the basic surgical technique for the transplant in the laboratory. But the technique was pioneered by other surgeons on animals. What he needed was just one donor to put this knowledge into practice.

On the night of the December 2, 1967, a 25-year-old woman was fatally injured in a car accident. Her blood type matched that of Washkansky's and her father agreed that her heart could be donated for the surgery. However Washkansky did not survive for long and died 18 days later after developing double pneumonia as a result of the immuno-suppressive drugs he was taking.

Dr. Barnard had never thought that he could turn himself from a unknown surgeon in South Africa to a renowned surgeon around the world. The failure in operation had, however, made him the target of criticism for rushing into the operation when so little was still known about immuno-suppression.
Nevertheless, the criticism did not prevent this type of operation from becoming popular; some 100 heart transplant attempts were carried out in the following year.

Professor Barnard was described by his colleagues as a very dynamic and exciting person, and they found him very challenging to work for. While continuing transplanting heart, he was pioneering other techniques such as 'piggyback' transplanting in which a second heart was put into a patient while leaving the first in place. He also became the first to carry out a heart-lung transplant.

Having no one to conform, Professor Barnard admitted he had often practiced passive euthanasia and regularly clashed with South Africa's government over apartheid issues.

Professor Barnard died from an asthma attack in 2001 while on holiday in Cyprus, at the age of 78.

Monday, January 28, 2008

Watching TV May Increase Blood Pressure Among Obese Children!

The issue of childhood overweight and obesity is a big problem for most countries. This is because obesity has long been identified as a risk factor for developing heart disease.

Watching TV is another problem among children who spend long hours sitting in front of the TV set instead of doing some physical exercises. But, are you aware that spending long hours in front of TV is more likely to raise blood pressure of obese children? This is the finding of a recent study conducted by the University of California, San Diego and published in the American Journal of Preventive Medicine. The researchers believe that increased psychological stress and junk food eaten while watching TV could be the factors that lead to the rising blood pressure.

The study found that obese children who watched 2 to 4 hours of TV each day were 2.5 times more likely than their peers who watched less TV to have high blood pressure, and kids who watched more than 4 hours daily had more than triple the risk of having high blood pressure.

There is no doubt that TV watching time clearly influences obesity, which can ultimately contribute to high blood pressure. In order to investigate this relationship, 546 children between 4 and 17 years old, who were seeking treatment for obesity, were evaluated. 43 per cent had high blood pressure.

Most of the study participants with high blood pressure watched 2 hours or more of television. The researchers also found that time spent watching television was also associated with the severity of obesity. While watching TV, kids may also be eating more fatty and salty foods that could directly contribute to high blood pressure.

In addition, children who watch more TV experience more perceived psychological stress. Evidence shows that stress can alter how the brain communicates with other organs, affecting blood pressure and body fat accumulation and distribution.

As such, it is essential to limit children's TV viewing to less than 2 hours a day, which is also the recommendation by the American Academy of Pediatrics. This is even important for children who are overweight and obese.

Another issue that that blood pressure is often ‘not measured’ in children. Even if it is measured, it is ‘often not done correctly’. Perhaps it is time for the parents of children to take up this issue with their child's doctor.

Sunday, January 27, 2008

Higher Heart Disease Risk For Takers Of Oral Contraceptives!

Taking oral contraceptives is a common measure adopted by women to avoid pregnancy. But a recent study revealed that women who use oral contraceptives will subject to a higher risk of having hardened arteries being developed. It is known that hardened arteries can lead to heart attack or stroke.

The research was conducted by the University of Ghent in Belgium and presented on November 6, 2007 at a meeting of the American Heart Association in Orlando, Florida. According to the report, women who used the hormones were more likely to have plaques, or a build-up of fatty tissue, on their arteries than women who didn't use oral contraceptives.

A total of 1,300 Belgian women between the ages of 35 and 55 were taken into the study, 81 percent of them had used oral contraceptives for an average period of 13 years. The researchers used ultrasound scans to look at the femoral artery in the leg and the carotid artery in the neck. To their surprise, they found incidence of atherosclerosis among these otherwise healthy women who had taken the pill. They also noted that the rates of the disease increased dramatically with every decade of usage, rising by between 20 and 30 per cent for every 10 years of use.

It is known that atherosclerosis, or furring of the arteries, typically occurs with age. Heart attack or stroke are some of the possible complications that occur when unstable pieces of plaque break off and block a blood vessel leading to the heart or brain.

As a matter of fact, the first generation of women who did use this form of birth control are now entering their 60s and the findings could mean that we are on the cusp of an increase in heart disease among them.

It is hoped that women should not suddenly stop taking the pills. Instead, they should look at reducing other risk factors for cardiovascular disease. They should watch their blood pressure and cholesterol levels, exercise and eat right. Meanwhile, if they can also limit their exposure to oral contraceptives, it would be good, too.

Thursday, January 24, 2008

How Does Alcohol Lower Blood Sugar?

Diabetes is not only a risk factor of heart disease but also a serious medical disorder. Diabetics who do not have their blood sugar levels managed properly will lead them to many other complications and in some serious situations, blindness, amputation and even death can just happen to them.

In the past, drinking alcohol beverages has been known to lower blood sugar levels in diabetics. And now, results of a new study on animal, conducted by a group of researchers from the Karolinska Institute in Stockholm, revealed the mechanisms involved. The findings that were published in the journal Endocrinology show that alcohol produces a massive redistribution of blood flow within the pancreas.

According to what was observed in the study, alcohol seems to send more blood to a region of the pancreas called the islets. The islets contain cells whose main function is to produce insulin, the key hormone that lowers blood sugar levels in the body.

Using various techniques, the researchers showed that pancreatic islet blood flow is increased by about 4 folds in rats after an injection of ethanol. Overall blood flow to pancreas, by contrast, was not affected. The alcohol injection also led to increased insulin secretion, resulting in low glucose levels.

Further study also showed that alcohol induced pancreatic blood flow changes by affecting a chemical called nitric oxide and the vagus nerve, a nerve that is responsible for sending many important signals in the body.

Based on the results obtained from the study, the researchers recommend doctors to advise their diabetic patients, especially those with liver problems, to be very careful with alcohol, if they are taking drugs to lower blood glucose, since these drugs may increase the effects of alcohol.

Tuesday, January 22, 2008

Knowing Heart Disease Risk May Prompt You Adopting Heart-Healthy Lifestyle

In order to reduce the risk of a heart attack and heart-related death, one should try to lower levels of bad cholesterol (LDL) while raising levels of good cholesterol (HDL). Regretfully, most patients do not obediently follow recommendation from their doctors so as to change their lifestyle or taking their cholesterol reducing medications.

However, when the doctor tells the patients who are at risk of coronary heart disease exactly what their risk is and how they can help lower their risk, they seem to respond better to preventive treatment. This is the findings of a recent study conducted by a group of researchers at the McGill University in Montreal, Quebec and published in the Archives of Internal Medicine.

The researchers actually found that people who had discussed openly with their doctor about their coronary risk profile achieved better improvement in their cholesterol levels than those who did not discussed with their doctor. As found out by the study, about one-third of people, who are not convinced that they need their cholesterol medications, stop taking them.

In order to ascertain whether boosting patients' knowledge of their heart risk profile might help them to adopt heart-healthy lifestyle, the researchers randomly assigned 3,053 adults being treated for cholesterol problems into 2 groups: one group received usual care while the other group received a 1-page computer printout displaying the probability that they will develop heart disease in the next 8 years based on their current lifestyle, blood pressure, cholesterol levels, and other risk indicators. The printout group also received ongoing feedback on how much they could cut their risk through lifestyle modification and drug therapy.

There were 2,687 patients completed the 12-month study. Those in the intervention group who kept track of their heart risk profile had small but significantly greater improvements in their cholesterol profiles.

In addition to communicating risk, there are also other means that can be used to improve adherence to heart-healthy lifestyle. These include enhancing self-monitoring and using support of family and friends.

Monday, January 21, 2008

Are Americans Having Heart Problem Because Of 9/11?

9/11 attack, occurred 6 years ago, had still borne deeply in our memory. It had undoubtedly created fears of terrorism to Americans. The psychological stress thus developed had also given heart problems to Americans even if they had no direct personal connection to the attacks on New York and Washington; this is what researchers have found.

A study, conducted by the University of California, Irvine and published in the January 2008 edition of the Archives of General Psychiatry, reported that there was a 53 percent increase in heart problems, such as high blood pressure and stroke in a 3-years period after Sept 11, 2001. The study is the first of its kind to demonstrate the long-term effect of the 9/11 attacks on cardiac health.

The 3-year study involved 1,500 adults surveyed at random whose health information had been recorded before the attacks. Researchers quizzed participants about their stress responses in the weeks after the attacks and issued annual follow-up questions ending in late 2004.

Most participants, who had no pre-existing heart problems, watched the attacks on live television while one-third had no personal connection to them. The results persisted even when risk factors such as smoking and obesity were taken into account.

It seems that the media exposure for 9/11 attacks helped to convey enough stress to people who responded in a way that contributed to their cardiovascular problems. Chronic worriers were the most at risk from heart problems, as revealed in the report.

Friday, January 18, 2008

How Many Youngsters Do Not Take Fast Food?

Have you ever asked youngsters whether they like to take fast food? 'Yes!’ I bet this was the answer you got from them most of the time. This is not surprising because in Singapore, a latest survey has revealed that 9 out of 10 Singaporean adolescents eat at Western fast-food restaurants and among them, more than three-quarters do so once a week.

During October 2007, a group of master's students at the National Institute of Education (NIE) conducted a survey of 265 students aged between 12 and 19, and reported that the youngsters actually base their food choices on 3 main factors: taste, appeal and convenience.

Taking too much fast food will not only put extra weight on the body but also raise the risk of heart disease and many medical conditions. These young people are just not getting enough information on how unhealthy and unbalanced these trans fat-laden fast foods were. They missed out on important information regarding what they are actually eating and whether it is good for them. Once the youngsters have developed unhealthy lifestyles, they will actually suffer when they grow older because they will get sick too young and they will spend more on the medical expenses.

This is, indeed, a serious problem. Data shows that 9 percent of children in Singapore are overweight, and 3 to 5 percent are obese. People with BMI between 25 and 30 are classified as overweight and above 30 as obese. BMI (Body Mass Index) is a measure of body fat based on one's height and weight. Nevertheless, Singapore is not alone as the fast-food phenomenon has already swept across Asia.

Schools have already taken steps to encourage school children to take up more physical activities during school hours. Therefore, the biggest problem in schools lies not in lack of exercise during school hours, but what children do after school. As such, schools will have to work with the community and parents to address the issue.

Wednesday, January 16, 2008

Aspirin May Not Be Effective For Women In Lowering Risk Of Heart Attack

Aspirin therapy has widely been used to prevent heart attacks for both men and women. But there may be considerable variation between men and women in the effectiveness of aspirin therapy in reducing the risk of heart attacks.

A recent study, conducted by a group of researchers from University of British Columbia, Vancouver and published online in BMC Medicine, indicated that women may be much less responsive to aspirin than men.

By identifying 23 clinical trials, the researchers examined the effectiveness of aspirin therapy in preventing heart attacks for a total of 113,494 participants. The researchers reported that aspirin therapy, when compared to placebo, provided a modest reduction in the risk of non-fatal heart attacks (28 percent), but did not reduce the risk of fatal heart attacks.

However, considerable variation in the effectiveness of aspirin across the trials was noted. It was found that roughly 27 per cent of the total variation in reports of non-fatal heart attacks could actually be explained by the proportion of men and women in the trial.

According to what the researchers had found, studies that included men had the largest risk reduction in non-fatal heart attacks (38 percent), while trials that mostly included women failed to show a significant reduction in the risk of non-fatal heart attack.

Based on the data analyzed, the researchers concluded that aspirin is less efficacious in women for the reduction of heart attacks. They also raised the possibility that women are more susceptible to aspirin resistance.

Monday, January 14, 2008

Prices For Healthy Foods Are Getting Higher And Higher!

Healthy lifestyle is the key for heart disease prevention. This is an undeniable fact. But when we talk about healthy lifestyle, we cannot do away with healthy diet. In other words, healthy food forms an integrated part of our healthy life.

But regretfully, the prices of fruits and vegetables are now climbing faster than inflation, according to a new study conducted by researchers at the University of Washington. The findings, published in the Journal of the American Dietetic Association, also revealed that junk food is actually getting cheaper.

The researchers examined the prices of 372 foods and beverages at Seattle supermarket chains in 2004 and 2006 and found that low-calorie and nutrient-rich foods, mainly fruits and vegetables, were far more expensive than sweets and snack foods, based on comparison of calorie for calorie. While the price of the lowest-calorie fruits and vegetables was more than US$18.16 (S$26.33) per 1,000 calories, the most calorie-rich foods cost US$1.76 per 1,000 calories.

In fact, the average price of the lowest-calorie foods, including green vegetables, tomatoes and berries, increased by almost 20 per cent over 2 years. In the same time period, there was a 2-per cent drop in the cost of the most calorie-laden fare, such as butter, potato chips, cookies and candy bars. The 20-per cent increase in the cost of the lowest-calorie foods may very likely put those Americans who need these healthful foods the most out of reach.

This study highlighted a key obstacle to healthy eating. In addition, the fact that calorie-dense foods are the least expensive and most resistant to inflation, may also help explain why the highest rates of obesity continue to be observed among groups of limited economic means.

The researchers urged Americans to change their personal behavior and the government to make policy shifts that can help people eat more healthful foods, such as changes in the way they subsidizes the agricultural industry.

Sunday, January 13, 2008

Staying Fit Is The Way To Longevity!

Obesity may lead to many medical disorders like diabetes, hypertension, heart disease, etc. that may ultimately lead one to death. Nevertheless, a group of researchers at the University of South Carolina has found that people over the age of 60 who exercise are fit to live longer than their sedentary peers, regardless of weight and body mass.

Staying fit seems to be the way to live longer!

The study, published in the Journal of the American Medical Association on December 4, 2007, showed that obesity and sedentary habits increased the risk of death in middle-aged adults. It tested the premise for the first time among older adults.

The researchers observed that fit individuals who were obese had a lower risk of all-cause mortality than did unfit normal-weight or lean individuals. Such data therefore suggested that fitness levels in older individuals influence the association of obesity to mortality.

The 1979-2001 research focused on the relation between cardiovascular fitness and adiposity and death rates among 2,063 adults aged 60 years and older. A total of 450 people who were older, less fit and at greater risk of heart disease than those who survived died during the study. Treadmill exercise was utilized to assess the physical fitness, while body mass index (BMI), waist circumference and percentage of body fat were used to measure obesity.

It is important to note that the researchers did not advocate that obesity and fat distribution should be ignored. They just wanted to alert people that they should look at other important things besides simple weight. Fitness is just one of them!

So start exercising! This was the advice given by the researchers to the out-of-shape older adults.

They recommended older adults should take up light to moderate exercise for duration of 30 minutes a day, 5 days a week. It does not matter whether this will help lose a lot of weight. But, this certainly will help one keep fit and it will indeed improve one's health and function.

According to the study, 22 percent of the US population or 70 million people will be older than 65 years old.

Friday, January 11, 2008

Lifestyle Could Lead To Massive Death In Next Decade!

In a commentary published on November 21, 2007 in the British journal Nature, a master plan was unveiled by international health experts aiming to avert at least 36 million premature deaths worldwide from 'lifestyle' diseases by 2015.

It is expected that some 388 million people around the world, 80 percent of them come from poorer nations, will die over the next decade from non-communicable diseases if people preserve the current unhealthy lifestyle.

Based on the WHO (World Health Organization) data, 44 percent of the premature deaths will originate from cardiovascular disease, diabetes, lung disease and some cancers. This is twice as many as from all infectious diseases combined. The prevention of disability and death from chronic non-communicable diseases (CNCDs), however, is not receiving sufficient attention.

The researchers felt that by changing behavior and access to known drug treatments, most of the diseases targeted by the initiative could actually be avoided. For example, 17 million of the deaths that could be averted through the recommended measures would be among people under 70 years old. The initiative is supported by members of the Oxford Health Alliance, including the UK Medical Research Council, the Indian Council of Medical Research, and the US National Institutes of Health (NIH).

Smoking, sedentary lifestyle and obesity are identified as the top culprits, but longer lifespan also play a role in some of the diseases.

Using the model on the Grand Challenges in Global Health programme targeting infectious disease, spearheaded in 2003 by the Bill and Melinda Gates Foundation, the new 'Grand Challenges' effort lists 20 policy and research priorities to reduce the number of death from CNCDs.

Some of the recommendations include:
  • Raising the 'political priority' of CNCDs and promoting healthy lifestyles;
  • Strengthening regulations to discourage consumption of tobacco, alcohol and unhealthy foods;
  • Developing codes to monitor responsible conduct in the food, beverage and restaurant industries;
  • Studies that explore the links between CNCDs, poverty and urbanisation;
  • Redistributing health care resources based on burden of diseases;
  • Putting a big emphasis on prevention.

Wednesday, January 09, 2008

Reduce Your Salt Intake Now!

Salt is something that we need everyday for our food but it is also a 'poison' that could slowly lead us to death without any warning. This is because excessive sodium (the main component of salt) in our body will increase the chance of getting not only hypertension but also heart disease and stroke.

The American Medical Association (AMA) has, therefore, urged the US federal government to take immediate action to reduce excess salt in food. It is believed that this will help save thousands of lives in the future.

Research also shows that most Americans consume 2 to 3 times the amount of sodium required for the body. About 75 to 80 percent of their daily intake of sodium come from processed and restaurant foods. AMA believes that if the salt intake can be reduced by 50 percent over the next 10 years, at least 150,000 lives a year could be saved.

United States is not the first country to make such request to their citizens. Countries like Finland and Britain have already taken actions on salt and promising results have been seen.

Monday, January 07, 2008

No Salt Added Diet Will Help Lower Blood Pressure!

If one avoids pre-salted foods and does not add salt to foods, his or her blood pressure will be reduced by a modest but statistically significant amount. This is the finding of a study conducted by Shiraz University in Iran and published in the medical journal BMC Cardiovascular Disorders.

Blood pressure and 24-hour urinary sodium excretion in 60 individuals were assessed before and after instructing them to follow 'no salt added' diet for 6 weeks. 20 subjects who did not follow the diet were used as a control group. All of the subjects were similar in age, gender, weight, blood pressure, and initial urinary sodium excretion. The average age was 49, half were men, and all of the patients had mild to moderate hypertension.

After 6 weeks, a significant reduction in urinary sodium excretion was noted in those on the diet, compared with those not on the diet.

It was found that when the sodium content in the urine of their subjects was reduced by about 35 per cent, the daytime blood pressure was lowered by 12.1 mm Hg systolic and 6.8 mm Hg diastolic in patients with high blood pressure (hypertension) not taking anti-hypertensive medications. Blood pressure readings at night were found to be slightly lower.

The blood pressure reductions were seen even in the 50 per cent of the patients who consumed a medium amount (3 to 7 grams/day) of dietary salt and the 25 percent of the patients who ate 7 or more grams per day. Only 21 per cent of the subjects took less than 3 grams of salt daily.

The researchers concluded that these results do provide strong support for universal salt reduction in all hypertensive individuals. Since hypertension is a risk factor for heart disease, reducing blood pressure will mean the risk of developing heart disease can be reduced.

Nevertheless, they felt that a larger scale, population based studies is necessary to further evaluate the effect of a 'no salt added' diet.

Saturday, January 05, 2008

Think Before Going For Weight Loss Surgery!

A new research, published in the Archives of Surgery, had shown that people who have undergone so-called bariatric surgery for obesity have a higher death rate than other people of the same age. The cause of death is due to suicide and coronary heart disease, in particular.

Researchers from the University of Pittsburgh studied the data for all Pennsylvania residents who underwent a bariatric operation such as stomach stapling or gastric bypass between 1995 and 2004. They then compared the number of death of these patients with that of those in the general population.

It was found that there were a total of 440 deaths after 16,683 weight loss procedures during the study period. Male gender and advancing age were both associated with the increased death rates.

For all age groups, the death rate was much higher in bariatric surgery patients than in the general population. But for patients between the age of 25 and 34, the difference was particularly pronounced. Their death rates for male and female patients were 13.8 and 5.0 per 1,000 persons per year, respectively. In comparison, the death rates in the general population were 1.3 and 0.6 per 1,000 persons per year.

Coronary heart disease was found to be the most common cause of death. 16 suicides were also found with 10 of them were women. Comparing with the data from the general population, researchers estimated that only 3 suicides deaths would have been expected in this number of people.

The researchers also suggested that a better control of high blood pressure, diabetes, high cholesterol, and smoking, as well as efforts to prevent weight regain by diet and exercise, and psychological support to treat depression and prevent suicide could reduce the excess deaths after bariatric surgery.

Thursday, January 03, 2008

Higher Risk Of Death After Heart Attack For Diabetics!

In the medical Journal "Heart", a group of researchers from the Karolinska Institute, Stockholm, Sweden, reported that patients with diabetes have higher short- and long-term mortality rates after heart attack than those without diabetes. The pattern has remained even after modern therapeutic principles have been introduced.

A total of 70,882 people younger than the age of 80 years, 14873 of whom are diabetics, were assessed by the researchers for their death rates and treatment patterns in the periods of 1995 to 1998 and 1999 to 2002.

The data obtained from the study show that the 1-year mortality rate decreased from 16.6 per cent to 12.1 per cent in non-diabetic patients for the period between 1995 and 2002. In diabetic patients, 1-year mortality rates declined from 29.7 per cent to 19.7 per cent.

Nevertheless, heart attack patients with diabetes were more likely to die than those attack patients without diabetes. Diabetics had an adjusted relative 1-year mortality risk of 1.44 in 1995-1998 and 1.31 in 1999-2002 respectively.

Both the pre-admission and in-hospital treatment have no doubt improved. But because of their medical conditions, diabetic patients were less likely to receive immediate clot-busting therapy and revascularization procedures. They also less often received aspirin and lipid-lowering treatment at discharge.

According to the researchers, there are still plenty of opportunities for further improvements in the care of diabetic patients who suffer heart attack.

Excess mortality in heart attack patients with diabetes can partly due to the underlying co-illnesses, but it can also attributed to 'a less than optimal use of established treatment modalities, especially lipid-lowering therapy and early revascularization'.

Tuesday, January 01, 2008

Anti-Diabetes Drug That May Increase Risk Of Heart Attack!

FDA (Food and Drug Administration) in United States recently issued a warning of increased risk of heart attacks on an anti-diabetes drug, Avandia, manufactured by the British company GlaxoSmithKline. The move has forced the manufacturer to agree on adding warning in the drug's labeling about potential increased risk for heart attacks, according to a statement issued by FDA on November 14, 2007.

Some 7 million people around the world has taken the drug and half of them are in the United States. This also generates some 3.3 billion dollars of annual global sales for Glaxo.

Why warning has been issued suddenly for such a popular drug?

Based on an analysis of some 42 short-term clinical studies, published In May 2007 in the New England Journal of Medicine, it was concluded that Avandia increased the risk of heart attacks by 43 percent. In July 2007, a committee of independent experts consulted by the FDA, however, decided that the risks did not warrant withdrawing the drug from the market.

Then another study, published in September 2007 in the Journal of the American Medical Association, was the first to examine the risks of heart problems and death stemming from the use of Avandia by Type 2 diabetes sufferers who had been taking the drug for at least a year.

The results of 4 clinical trials of more than 14,000 patients showed that Avandia taken over a prolonged period increased the risk of cardiovascular problems by some 42 percent.

FDA has expedited their review on the cardiovascular risks of this drug so that they could inform patients and doctors of their findings at the earliest possible time. Meanwhile, patients with Type 2 diabetes with underlying heart disease or at risk of heart attack are warned by FDA to talk to their doctors before taking the drug.