Your Peer May Help You Quit Smoking!

Smoking is bad! It will lead to stroke, heart disease, lung cancer, and many other possible diseases. It is merely impossible to find anyone who is not aware of the ills of smoking. Despite hefty taxes, public bans and health warnings, the number of youth picking up this habit is still on the rise. Very often, once a younger starts the first cigarette, chance that he or she would be addicted is high, and this really worries many health experts.

The annual “World No Tobacco Day” was held on May 31, 2008. This year, the theme used by World Health Organization (WHO) is “Tobacco Free Youth”. It aimed to encourage teens to lead a smoke-free lifestyle.

Threats of possible health hazard are unlikely to fear youth, who tend to believe they are invincible. However, if youth is given the right information about cigarettes, they will make the right choice: smoking is bad.

Many have argued that young people smoke because of the influence from the friends surround them. However, a new study found that peer influence could in fact help smoker kick the bad habit.

From 1972 to 2003, two American professors studied thousands of smokers as a social network of relatives, friends and colleagues. Their findings, which were published in June 2008 in the New England Journal of Medicine, reported that groups of friends who smoked would quit not individually but as a whole group. When cluster after cluster of smokers disappeared, those remained would find themselves being isolated with fewer friends.

Smoking cessation groups admitted that their programs would actually work better if they focused on groups, rather than individuals.

Let us hear the confession of a youngster.

“2 months ago, I faced a dilemma. 3 of my close friends at work quit smoking. I then faced a choice: get rid of the cigarettes, or make new smoking friends. I finally chose to quit.”

He further added that he is glad that he is now part of a global phenomenon as clubs, pubs and restaurants around the world is moving to edge smoking out as a lifestyle choice.

Who Is The First Patient To Have Artificial Heart Transplant In Asia?

In 2003, Mr Venkatakrishniah, a 54-year-old Indian diabetic patient, suffered a heart attack. After the bypass surgery, his condition worsened and he could not walk beyond 6 steps. As such, he had to quit his job as an engineer at a state-owned Power Transmission Corporation because he was unable to work.

Under the guidance of a team of US experts from the University of Minnesota, a group of surgeons at Bangalore's Narayana Hrudayalaya implanted in him a ventricular assist device called Ventrassist (Left Ventricular Assist Device) in a four-hour operation on March 20, 2008.

Narayana Hrudayalaya, set up in 2001, was situated in Bangalore. The hospital is well known for its excellence and is one of the world’s largest Pediatric heart hospitals. Two of the surgeons who performed the operation had flown earlier to the University of Minnesota for 3-month training.

After the operation, Mr Venkatakrishniah revealed in an interview that he can now walk, and even climb stairs, and he is planning to work again.

What is Ventrassist? It is a device, 60 mm in diameter and weighs 298 g, is implanted in the lower part of the chest, just below the heart. In order for it to function, an external battery has to be connected to the device by a cable and the battery has to be recharged every 4 hours. Ventrassist is being manufactured by an Australian based company and is a new third generation implantable blood pump designed as an alternative to heart transplantation to people with heart failure.

Normal heart transplants, which may be out of reach for many patients because of the limited number of donor organs available. Furthermore, whether the donor organs are suitable for patients also pose a problem. In India, millions of people suffer heart failure and each year many die in absence of donors.

For the past 8 years, surgeons in the United States and Europe have already implanted such “new-generation” artificial hearts in 220 patients. Bangalore’s operation was the 221st of its kind but it also marked the first in Asia.

Ventrassist used in the Bangalore’s operation cost about 3.4 million rupees, which is certainly not cheap for the patient. Nevertheless, the hospital costs, which added up to about 600,000 rupees in Mr Venkatakrishniah's case, were waived. Despite the high cost, the hospital has already received inquiries from more than 100 patients in India and overseas since the operation.

More information about the Bangalore's operation may be viewed at

What Are the Main Causes of Death Over the Next 20 Years?

Last month (May 2008), a study by World Health Organization (WHO) revealed that the number of deaths from road accidents, cancer and heart disease would increase tremendously over the next 20 years. As indicated in its "World Health Statistics 2008", developing world’s populations get richer and live longer are reasons behind such soar.

According to WHO, the growth of low and middle-income economies will raise mortality rates from non-communicable diseases such as cardiovascular disease and cancer, and road crashes due to increased car ownership; it will make up more than 30 percent of deaths worldwide by 2030.

On the other hand, deaths from factors currently associated with the developing world, such as nutritional deficiencies, malaria and tuberculosis, will fall.

Globally, deaths from cancer will increase from 7.4 million in 2004 to 11.8 million in 2030, and deaths from cardiovascular diseases will rise from 17.1 million to 23.4 million in the same period.

Deaths due to road traffic accidents will increase from 1.3 million in 2004 to 2.4 million in 2030, mainly owing to more motor vehicle ownership and use associated with economic growth in the low- and middle-income countries.

By 2030, WHO predicted that ischemic heart disease, strokes, chronic obstructive heart disease (COHD), and lower respiratory infections such as pneumonia, would be the 4 main causes of death. The rise in COHD is mainly because of the increased tobacco consumption.

In 2004, tobacco-related illnesses caused some 5.4 million deaths. The figure will increase to 8.3 million by 2030, with 80 percent of these cases in developing countries. On average, every tobacco user loses 15 years of life, and rate of smoking is particularly high in Eastern and Central Europe and Southeast Asia.

These 10 countries, namely Bangladesh, Brazil, China, Germany, India, Indonesia, Japan, Russia, Turkey, and United States, contain nearly two thirds of the world’s smokers.

The report also indicated that not more than 5 percent of the world’s population is fully covered by anti-smoking measures like advertising restrictions, health warnings and higher taxation, which do have an impact.

Also pointed out in the report, the increase in deaths from non-communicable diseases would, however, be accompanied by large declines in mortality for the main communicable, maternal, perinatal and nutritional causes, including HIV infection, tuberculosis and malaria.

Nevertheless, deaths worldwide from HIV/AIDS are expected to rise from 2.2 million in 2008 to a maximum of 2.4 million in 2012 before declining to 1.2 million in 2030.

New Way To Predict Heart Disease For Women!

When a person is suspected of having heart disease, he or she would normally be asked to undergo a procedure called angiogram or go for the latest CT scan known as ’64-sliece CT so as to ascertain whether treatment is needed for the potential patient..

However, there is a new way to identify a woman’s heart disease risk by analyzing the nicotine content of her toenail clippings. This new means was revealed in June 2008 in the American Journal of Epidemiology by researchers from the University of California in San Diego.

For the 62,641 women participating in the Nurses' Health Study, researchers correlated their nicotine content in toenail clippings collected in 1982 to the risk of being diagnosed with heart disease between 1984 and 1998.

Women, who were in the top fifth for toenail nicotine content, were thinner, less active, heavier drinkers, more likely to have high blood pressure or diabetes, and a family history of heart attack, comparing with those with lesser nicotine in their toenails. Furthermore, the nicotine content found in the toenails for the 905 women, who had been diagnosed with heart disease, were twice as much on average than those similar women without heart disease. After adjusting for other risk factors, the women in the top fifth for toenail nicotine were nearly 4 times more likely to have heart disease compared to those in the bottom fifth.

The prevailing biomarkers of cigarette smoke exposure such as the amount of cotinine (a nicotine breakdown product) in urine or saliva could only reflect exposure within the past few days. As toenails grow slowly, they may offer a longer-term, more stable estimate of a person's total level of exposure to tobacco smoke.

Toenail analysis could become a useful test to identify high-risk individuals in the future, especially in circumstances where smoking history is unavailable or is subject to bias. Such analysis may also aid our understanding of other tobacco-related illnesses.

As the current study involved only female participants, perhaps future studies should consider including male participants to find out whether similar analysis could be applied to men as well.

Not Enough Sleep May Raise Blood Pressure For Women!

Women who sleep less than 7 hours each night may have a higher risk of developing hypertension (high blood pressure). This finding was reported in the month of October 2007 in the journal Hypertension by researchers from Warwick Medical School in Coventry.

The British researchers studied more than 10,000 adults over a time span of 5 years. In comparison with women who typically slept for 7 hours a night, those who slept 6 hours and those who routinely slept no more than 5 hours were 42 percent and 31 percent respectively more likely to develop high blood pressure.

However, no clear relationship between amount of sleep and blood pressure was found among men. Such findings may suggest there might be a 'gender-specific' relationship between sleep deprivation and high blood pressure.

In the study, data from a long-term health study of 10,300 white British civil servants between the ages of 35 and 55 years old were used. Participants, who were free of high blood pressure in the years between 1997 and 1999 of the study, were reassessed in the years between 2003 and 2005. During these two periods, 76 percent and 68 percent, respectively, of the original group were included the evaluations.

The reassessment by the researchers revealed that 20 percent of the study participants were newly diagnosed with high blood pressure, and the risk was greater among women who had shorter sleep duration. Risk factors for heart disease like smoking, being overweight or having a sedentary lifestyle did partially contribute to the relationship. Nevertheless, an independent link between sleep and blood pressure remained.

Some previous studies have already linked poor sleep quality to an increased risk of high blood pressure, diabetes and heart disease, but most of them focused on people with the breathing disorder sleep apnea.

Some experts suspect that short sleep duration may cause the nervous system to be in a state of hyperactivity, which in turn affects systems throughout the body including the heart and blood vessels. This may eventually raise the blood pressure.

The researchers indicated that further studies are required to confirm the relationship between sleep duration and blood pressure levels, and to find out why these effects might be different in women and men.

Does Baldness Mean Higher Risk of Heart Attack?

Do men with baldness have a greater chance of getting heart disease? This question has prompted a study that tracked more than 5,000 men.

Researchers from the University of Arizona in Tucson reported in April 2008 in the American Journal of Epidemiology that there is little difference in the heart attack risk between men who have full heads of hair and baldness.

In addition, hair loss and thickening of the lining of the carotid arteries (the main vessels that supply blood to the brain) are unrelated. It is known that the increase in the lining of these arteries, known as carotid intimal-medial thickness, is a warning sign of atherosclerosis.

In fact, some health experts have suggested that baldness in men is related to increased levels of the hormone androgen, and that this hormone may be responsible for the development of coronary atherosclerosis, or 'hardening of the arteries' within the heart. A previous study even suggested that vertex baldness (loss of hair at the top of the head) was strongly linked to heart attack risk.

In this study, 767 of the 5,056 male participants aged 52 to 75 had suffered a heart attack previously. About one third had little or no hair loss, 13 percent had frontal baldness, and 54 percent had vertex baldness.

Men with frontal baldness were 28 percent more likely to have had a heart attack, while those with mild vertex baldness was tied to only 2 percent greater risk of heart attack. The researchers also found that such relationship did not get stronger with baldness severity; men with moderate vertex baldness were 40 percent more likely to have a heart attack, and the risk was increased by only 18 percent for men with severe vertex baldness. In addition, there was no relationship found between any type of baldness and carotid intimal-medial thickness.

The new study shows that if the types of baldness are indeed due to high androgen levels, it is unlikely that the hormone would increase the risk of heart attack or atherosclerosis. Therefore, the researchers conclude that male pattern baldness is not a surrogate measure of an important risk factor for heart attacks or for atherosclerosis without symptoms.

Smoking Ban Helps Lower Heart Attack Rate!

According to the World Health Organization (WHO), smoking kills about 4 million people every year. About a quarter of such death that was related to heart disease, are due to cigarettes. However, when smokers are told that ‘smoking may increase the risk of getting heart disease,’ how many of them will be convinced and stop smoking voluntarily. Perhaps, the new findings may change their perspective.

A group of researchers from the Rome Health Authority reported their findings on February11, 2008 in the American Heart Association journal Circulation that the smoking ban by Italy in 2005 has led to a sharp fall in heart attacks.

The researchers compared the rate of heart attacks from the years of 2000 to 2004 to those occurring in the year after the ban (2005) was enforced. It was found that the number of heart attacks in men and women aged 35 to 64 fell 11 percent. This group of people is most likely to be exposed to smoke in cafes, bars and restaurants. It is believed that most of this change is due to the decreased impact of passive smoke.

The team analyzed records from hospital and adjusted for heat waves, flu epidemics, air pollution and other factors that could have contributed to heart attacks. The researchers also measured daily the air quality in 40 public places.

In Italy, about 30 percent of men and 20 percent of women smoke. The Italian authority prohibits smoking cigarettes in all indoor public places such as offices, retail shops, restaurants, pubs and discos.

It seems that the smoking ban in Italy is working and having a real protective effect on population health. In fact, cigarette sales also fell 5.5 percent after the ban. Nevertheless, the researchers attributed the health benefits seen in the study to reduced exposure to passive smoke. Young men and women living in poorer areas appeared to have the greatest health benefit resulting from the ban. Clearly, such laws do improve public health.

It shows that the impact of a health intervention can also be achieved in other countries. Italy, Britain, Ireland and a number of other European countries have already banned smoking in public places. Based on the new findings, researchers strongly urge all other possible countries to ban smoking. In particular, smoking bans in workplace should strongly be enforced.

If You Want To Stay Away From Hypertension, Don’t Drink!

If you are an alcohol lover, you may want to think twice before you start your next cup of drink. Why do I say this?

A recent study conducted by the researcher at the University of Bristol's Department of Social Medicine reported that people who consumed moderate amounts of alcohol might raise their blood pressure more than what was expected before. Their findings were published on March 4, 2008 in the Public Library of Science journal PLoS Medicine.

High blood pressure or hypertension affects more than a billion adults worldwide. If it is not well managed, it can eventually lead to heart attack, heart failure, kidney failure and stroke.

In the study, people with a genetic mutation that makes it difficult to consume alcohol had significantly lower blood pressure than that of those regular or heavy drinkers. People who had no mutation and consumed about 3 drinks per day had 'strikingly' higher blood pressure than people with the genetic change who tended to drink only small amounts or nothing at all.

It was also discovered that there was more than a two-fold risk for high blood pressure among drinkers and a 70 percent increased risk for 'quite modest' drinkers compared to people with the genetic mutation.

This study shows that alcohol intake may increase blood pressure largely, even among moderate drinkers, than previously thought.

In previous studies, heavy drinking had been linked with high blood pressure. Nevertheless, some health experts have even suggested that moderate alcohol intake provides health benefits such as lower cholesterol.

The genetic mutation is common in some Asian populations. These people are discouraged to drink because alcohol causes them facial flushing, nausea, drowsiness, headache and other unpleasant symptoms.

By comparing people with such mutation and volunteers without the genetic variation could help the researchers to better gauge long-term effects of drinking.

The researchers also concern that reporting of alcohol (in other studies) is likely to conceal considerable error, which may be differential. For example, people who have been advised to reduce alcohol intake for medical reasons may under-report alcohol intake.

Does the Child Obesity Epidemic Level Off in United States?

The ever-increasing rate of childhood obesity has been a headache for many developed countries, including United States. It is believed that overweight or obese children would be subject to a higher risk of getting heart disease, diabetes, high blood pressure, etc. when they grow older.

In United States, level of overweight or obese children have held steady after rising without interruption since 1980. However, a recent study by the Federal Centers for Disease Control and Prevention reported in the Journal of the American Medical Association on May 28, 2008 that roughly 32 per cent of children were overweight or obese in years 2003-04 and 2005-06. This is the first leveled off after a 25-year increase.

The study was based on 8,165 children ages 2 to 19 who participated in nationally- representative government health surveys in year 2003-04 and 2005-06. These surveys are based on in-person measurements rather than relying on children’s own reports, as such, they are regarded as the most accurate reflection of obesity levels.

Does this really mean that we should be optimized about the reverse of the epidemic? The responses vary among health professionals and experts. Some suspects that this could just be a statistical fluke. Others said that if the leveling-off is real, it could be because more schools and parents are emphasizing better eating habits and more exercise. Even so, they felt it would be too early to celebrate.

Most experts are looking forward to the CDC’s analysis of data for 2007-08, which is considered as the best evidence for determining what direction children’s rates are really heading, due next year.

No doubt, many people are trying to do things to help halt the epidemic. For example, some schools are providing better meals and increasing physical education, and as a whole, Americans are more aware of the importance of fruits and vegetables. Nevertheless, there are still children that are ignorance of their health. For instance, an obese child revealed to his doctor that he did not consume a single piece of fresh fruit in 3 days.

Unless a substantial decline in prevalence, the impact of the childhood obesity will continue in coming years. It usually takes many years for the obesity-related medical conditions to transform into life-threatening events like heart attacks and kidney failure.

Flying May Not Be Good For People With Obstructive Sleep Apnea!

People with obstructive sleep apnea (OSA) snore and have pauses in breathing during sleep. It occurs when soft tissues in the airways collapse during sleep and temporarily block breathing. The entire process can be repeated hundreds of times a night and it can cause disruption in both breathing and sleep resulting in so-called “sleep fragmentation”. As a result, snorers may feel extremely tire during daytime.

OSA can have profound effects on the cardio-respiratory systems. The blood pressure tends to rise during this period accompanied by changes in the heart rate and rhythm. Research shows that patients with OSA will have a higher chance (1.6 to 2.3 times) of getting a heart attack and stroke than normal patients.

In May 2008, at the American Thoracic Society's 2008 meeting in Toronto, Australian researchers even advise people with OSA to be careful when they are on commercial airline flights. A study conducted by Concord Repatriation General Hospital in Sydney found evidence that patients with OSA may experience higher heart rates and increased bodily need for oxygen during flights compared with healthy people. This would put these people at higher risk of adverse heart events.

The researchers used simulated flight conditions that replicate the oxygen and air pressure levels experienced during commercial flights and compared oxygen levels in the blood and ventilation rates in 10 healthy people and 22 people with severe OSA.

It is normal for the rate of breathing to increase with falling air pressure. Though the breathing intensity of patients with OSA did increase at about the same rate as it does in health people, their physiological stress and demand for oxygen was increased. In other words, the body functions like heart, lung and brain of these patients is subject to greater pressure under cabin conditions.

OSA has become so much common nowadays with the increasing obesity rate, and there are greater numbers of obese passengers on commercial flights. If the results of this study were typical, then half of the patients with OSA would actually require in-flight supplemental oxygen if current guidelines for those with lung disease were strictly followed.

Can One Be Fat And Free From Heart Disease?

Can one be fat and free from heart disease? This interesting question has in fact prompted numerous researches to find out whether exercise or weight has a greater influence on the risk of heart disease.

The latest study by researchers from Boston's Beth Israel Deaconess Medical Centre found that even high quantities of physical exercise would not eliminate the risk of heart disease for overweight or obese women, unless they also lose their body weights. They reported on April 28, 2008 in the Archives of Internal Medicine that being active could only lower but not eliminate risk of heart disease faced by heavy women.

The researcher examined the information from a study of nearly 39,000 women aged 54 on average, and tracked for 11 years on a number of health issues. In the study, 34 percent of the women were physically active based on government guidelines, 31 percent were overweight and 18 percent were obese. At the end of the study period, 948 women were diagnosed with heart disease.

The study found that active women with normal weight had the lowest risk of developing heart disease. Those with normal weight, but inactive lifestyles, had slightly higher risk. Active women who were either overweight or obese had the next highest risk. Overweight or obese women who were inactive had the highest risk of heart disease.

According to the researchers, about 2 in 5 women in the United States at age 50 will eventually develop cardiovascular problems.

When one is overweight or obese, the risk of high blood pressure, diabetes, and high cholesterol is very much higher. Physical activity does make an impact and does counteract all these 3 medical conditions. However, when one is overweight or obese, he or she just cannot get back to that lower risk entirely with just physical activity.

The new finding seems not well accepted by those proponents of ‘fit and fat’ theory. These health experts argued that the study is limited as the information collected was relied solely on women self-reporting their activity levels, a method that is not as reliable as a more objective fitness evaluation.

On the other hand, health professionals in the field of treating overweight patients do feel that the study’s message is important. As levels of obesity increase, heart disease is becoming a big problem. Therefore, anything that can motivate the public to maintain healthy weight is useful!

Are You Familiar With The Heart Attack Symptoms?

Symptoms such as nausea and pain in the jaw, chest or left arm may emerge before heart attack strikes on somebody. Unfortunately, many people are not aware of these symptoms. Hence, they may simply miss their chance of surviving.

A group of researchers at the University of California, San Francisco, School of Nursing recently reported that many people with heart disease do not know the symptoms of a heart attack, even though they are at higher risk of getting one: 5 to 7 times higher than those with no such history. The results of their findings were published on May 27, 2008 in the Archives of Internal Medicine.

44 percent of the 3,522 patients they looked in the study scored poorly on a true-false test measuring how perceptive they were about the heart attack symptoms. These selected patients, who were in the United States, Australia and New Zealand, had previously suffered a heart attack or had undergone a procedure, such as angioplasty, for heart disease.

Generally, women, patients who had taken part in cardiac rehabilitation, people with higher education, younger people and those who were treated by heart specialists rather than family doctors tended to have the best scores on the test.

For the past decades, it was observed that patients who were frequently hospitalized would receive education and counseling from physicians and nurses during their hospital stay. Unfortunately, the structural changes in the healthcare industry have caused patients to shorten their hospital stay and use outpatient facilities instead. This somehow has decreased the time available for the education of patients.

The researchers stressed that people who suffer a heart attack would have a better chance of surviving if they are treated within one hour, but most patients are admitted to the hospital 2 and a half hours to 3 hours after symptoms begin.

In fact, numerous studies have earlier found that patients who have already suffered an earlier heart attack do not seek help any faster than those who had no such health history do. According to the researchers, such findings may not be surprising with the lack of knowledge about the range of symptoms for heart attack as measured in the current study.