The journey to better women's heart health starts with having more data, said Nanette Kass Wenger, MD, MACC, MACP, FAHA, professor of cardiology at Emory University School of Medicine, during the Simon Dack Keynote Lecture, which opened the 67th Scientific Session of the American College of Cardiology.
Years before “Go Red for Women” and the red dress pin became symbols of the campaign to end heart disease and stroke in women, Nanette Kass Wenger, MD, MACC, MACP, FAHA, wasn’t going red. For the Emory University professor of cardiology, it was more like seeing it.
Wenger, founding consultant of the Emory Women’s Heart Center, gave the Simon Dack Keynote Lecture to open the 67th Scientific Session of the American College of Cardiology, and her talk, “Understanding the Journey: the Past, Present, and Future of CVD in Women,” revealed the uncomfortable truth: recent declines in cardiovascular death (CV) for women have been possible because science is finally paying attention to them.
Back in the 1970s, when Wenger began educating the public about women’s vulnerability to heart attacks—and the effects of alcohol, smoking, and some medications—CV disease was seen as “man’s disease.” For example, the first conference for women on coronary heart disease by the Oregon Heart Association in 1964 had been about men, specifically husbands, and what wives could do to keep them healthy.
But the data didn’t lie. Starting in early the 1980s and peaking in 2000, the gap in CV deaths between men and women kept getting wider—as the new millennium started, about 500,000 women died each year, compared with about 440,000 men. Since then, numbers for both have fallen, and in 2013, the death total for women from CV causes fell below that of men, with both below 428,000. “We are delighted to be in second place, and we hope to stay there,” Wenger said.
It took a “paradigm shift,” Wenger said, and it started with the idea that medical research had to include women as research subjects to see if outcomes would be different in women. “This change in mindset—the advent of gender-specific medicine—has had a stunning outcome,” she said. Too often, Wenger said, the only studies specific to women were what she calls “bikini medicine,” those limited to the breast, ovaries, or the female genital area.
Conference Identifies Gaps
A breakthrough came in January 1992, when the National Heart, Lung, and Blood Institute...Read more..
But it's not really clear where the advantage comes from.
From cross-country skiing to speed skating, the Winter Olympics is full of breathless feats of endurance. And for a large number of Olympic athletes, the breathlessness isn’t just over who will win the next medal—it’s from asthma.
But if you think the condition could hold Olympians back, think again: Athletes with asthma are more likely to win medals than their competitors.
Up to one in four winter Olympians have asthma, a condition that constricts the airways and makes it difficult to breathe normally. That’s no surprise to John Dickinson, a professor at the University of Kent’s School of Sport and Exercise Sciences. He’s studied asthma in elite competitors for years and says that the number of athletes with the condition can skew even higher in endurance sports: up to 70 percent in swimmers and 50 percent in cross-country skiers.
Endurance sports might attract athletes who have asthma, he says, but they can also cause breathing problems in and of themselves. Normally, people breathe through their nose, which warms and humidifies the air, filtering out gnarly particles and noxious chemicals along the way. But during endurance events, says Dickinson, most athletes temporarily turn into mouth-breathers.
“You get unconditioned air going into the airway,” he says. This, in turn, wreaks havoc on the lungs, drying out their air sacs and fueling inflammation. Asthma can result—and as his research with athletes shows, it often does.
These athletes manage to make it to the Olympics despite all that wheezing and coughing, and even outperform challengers without asthma. That’s especially true during the Winter Games.
In a 2012 literature review, asthma expert Kenneth D. Fitch crunched the numbers. He found that during the Salt Lake City Winter Games in 2002, 5.2 percent of athletes had asthma, but that group won 15.6 percent of the medals. He observed the same effect in Torino in 2006 (7.7 percent of athletes with asthma won 14.4 percent of the medals) and Vancouver in 2010 (7.1 percent of athletes with asthma won 11.8 percent of the medals).
Could athletes’ asthma inhalers explain their dominance? Dickinson has spent years trying to find out.
Consider a salbutamol inhaler, one of the most common types. (You may know it as albuterol or Ventolin.) It’s a beta-2 agonist inhaler that relaxes the bronchial passages, making it easier for people with asthma to...Read more..
Your heart (and your patient’s hearts), one of the most important organs in your body, receives recognition this month. Not for all of the hard work it does each and every day pumping blood throughout your body, but to raise awareness of heart disease.
The American Heart Association reports that 1 in 3 Americans die from heart disease with 92.1 million adults living with some form of it. Show your heart some love this month by learning the risk factors and what you can do to lower risk.
While some factors, like genetics, aren’t modifiable or controllable, it’s important to protect yourself against heart disease by identifying your risks and assessing your health status.
“Being overweight, inactive, smoking, high stress, and family history increase the risk of heart disease and heart attack,” said George Waters, board certified cardiologist at Sturdy Cardiology Associates.
If you have an unhealthy diet chock full of saturated fat, salt and cholesterol, you’re putting yourself at risk for the development of heart disease and obesity. Even more so, if you don’t engage in physical exercise, you have an increased risk of high blood pressure, high cholesterol, risk of blood clots and heart disease.
It is incredibly important to embrace the goal of encouraging your patients to quit smoking and we can help. MD Spiro is here to work with you on your smoking cessation programs to help assist in having your patients quit for good this time!
Knowing the symptoms of a heart attack and identifying your risk are the first steps in prevention.
“You must also work to incorporate healthy lifestyle habits,” Waters said. “Eating a healthy low-saturated fat diet, getting regular exercise, quitting smoking, and seeing your doctor on a regular basis are all important steps in prevention.”
Be sure to include fresh fruits, vegetables, fish, whole grains, nuts and legumes into your diet while limiting sodium, sugar-sweetened beverages, processed meats and saturated fats.
Commit to a small goal of physical exercise each day — 30 minutes of aerobic exercise a day as well as strength and stretching workouts can improve heart health.
If you are a smoker, quit. Quitting smoking reduces your risk for heart attack each year you remain a nonsmoker.
As a primary care provider, it is important to market to your patients to schedule their annual exam and provide them the tools to quit smoking. These exams will provide the monitoring...Read more..
Moving chronic obstructive pulmonary disease (COPD) patients from hospitals to their homes could improve the sustainability of Canada’s health system while improving individual outcomes, says the Canadian Foundation for Healthcare Improvement (CFHI).
Data from health systems participating in the INSPIRED study conclude that offering Canadian COPD patients the right support services in their homes improved their quality of life while reducing hospital readmissions by 64 percent and emergency room visits by 52 percent.
“Too often, people with chronic diseases like COPD end up in hospital because the care they need is not available in the community,” CFHI President Maureen O’Neil said in a news release. “INSPIRED provides the services patients and their families tell us they need to manage their disease outside of hospital, and now we are expanding this innovative collaboration to benefit more patients.”
INSPIRED was developed at Capital Health in Halifax, Nova Scotia, to help patients manage their illness more effectively in their homes and communities. It is based on extensive input from patients and caregivers, and relied on specific healthcare teams that identified COPD patients who were able to participate in the program.
Those selected received written action plans for managing their COPD, phone calls after every discharge and at later intervals, at-home self-management education and psychosocial support, and advanced care planning when necessary. Patients were also given a phone number to call for support.
That approach has slashed emergency-room visits and hospital readmissions among more than 2,000 COPD patients in the provinces of Alberta, Manitoba, New Brunswick, Nova Scotia, Ontario and Prince Edward Island since the program’s establishment in 2014-15.
“These results are important because they show we can keep people with chronic disease out of the hospital by partnering with them to reinvent the way we deliver care so it meets their needs,” said Maria Judd, vice president of programs at CFHI. “All Canadians who use and pay for the healthcare system — not just those with a chronic disease — will benefit from the emergency department and hospital bed capacity this approach will free up as it spreads across the country.”
The economic cost of asthma in the United States is nearly $82 billion a year, federal health officials report.
That figure includes medical expenses and costs associated with work and school absences and deaths.
However, the true cost of asthma is probably underestimated because the U.S. Centers for Disease Control and Prevention study did not include people with untreated asthma.
The new analysis was based on federal government data, collected from 2008 to 2013. It showed that about 15.4 million people were treated for asthma each year. The annual per-person medical cost of asthma was $3,266.
Of that per-person amount, $1,830 was for prescriptions, $640 for office visits, $529 for hospitalizations, $176 for hospital outpatient visits and $105 for emergency room care.
Asthma-related deaths cost $29 billion a year, with an average of 3,168 deaths a year.
Asthma resulted in 8.7 million lost work days and 5.2 million lost school days a year, for a combined annual cost of $3 billion.
The findings were published online Jan. 12 in the Annals of the American Thoracic Society.
"The cost of asthma is one of the most important measures of the burden of the disease," study lead author Tursynbek Nurmagambetov, a health economist at the CDC, said in a journal news release. "Cost studies can influence health policy decisions and help decision makers understand the scale, seriousness and implications of asthma so that resources can be identified to improve disease management and reduce the burden of asthma."
The findings show "the critical need to support and further strengthen asthma control strategies," Nurmagambetov said.
The U.S. National Heart, Lung, and Blood Institute has more on asthma.
Annals of the American Thoracic Society, news release, Jan. 12, 2018
The natural decline in lung function over a 10-year period was slower among former smokers with a diet high in tomatoes and fruits, especially apples, according to a study from the Johns Hopkins Bloomberg School of Public Health, suggesting certain components in these foods might help restore lung damage caused by smoking.
The researchers found that adults who on average ate more than two tomatoes or more than three portions of fresh fruit a day had a slower decline in lung function compared to those who ate less than one tomato or less than one portion of fruit a day, respectively. The researchers inquired about other dietary sources such as dishes and processed foods containing fruits and vegetables—such as tomato sauce—but the protective effect was only observed in fresh fruit and vegetables.
The paper, which is part of the Ageing Lungs in European Cohorts study funded by the European Commission and led by Imperial College London, also found a slower decline in lung function among all adults with the highest tomato consumption, including those who had never smoked or had stopped smoking. The findings appear in the December issue of the European Respiratory Journal.
"This study shows that diet might help repair lung damage in people who have stopped smoking. It also suggests that a diet rich in fruits can slow down the lung's natural aging process even if you have never smoked," says Vanessa Garcia-Larsen, assistant professor in the Bloomberg School's Department of International Health and the study's lead author. "The findings support the need for dietary recommendations, especially for people at risk of developing respiratory diseases such as COPD."
For the study, the research team assessed the diet and lung function of more than 650 adults in 2002, then repeated lung function tests on the same group of participants 10 years later. Participants from three European countries—Germany, Norway, and the United Kingdom—completed questionnaires assessing their diets and overall nutritional intake. They also underwent spirometry, a procedure that measures the capacity of lungs to take in oxygen.
The test collects two standard measurements of lung function: Forced Exhaled Volume in one second, which measures how much air a person can expel from their lungs in a second; and Forced Vital Capacity, the total amount of air a person can inhale in six seconds. The study controlled for factors such as age, height, sex, body mass index,...Read more..
We know moms aren't supposed to drink alcohol during pregnancy, but could soda be just as bad? Studies are pointing to new evidence that excessive consumption of sugary drinks during pregnancy could cause health problems for the child later in life.
New research published in the Annals of the American Thoracic Society suggests that children ages 7 to 9 are more likely to develop asthma if they consumed excessive amounts of sugary drinks in early childhood - or if their mother did the same during pregnancy.
"Previous studies have linked intake of high fructose corn syrup sweetened beverages with asthma in school children, but there is little information about when during early development exposure to fructose might influence later health," said lead study author Sheryl L. Rifas-Shiman, MPH. Scientists had yet to investigate the effects of exposure before birth.
During their third trimesters, 1,068 mothers completed questionnaires detailing their food and beverage consumption. The researchers looked closely at reports of drinking soda, fruit juice, and other sweetened drinks to determine their results. They analyzed this information in the context of overall fructose consumption - including sugar consumed from food - to determine whether sugary drinks had a significant effect.
Nineteen percent of children studied ended up with asthma. Mothers who consumed sugary drinks were 63 percent more likely to have a child with asthma, and mothers who consumed overall high levels of fructose were 61 percent more likely.
The researchers hypothesize that the correlation is due to fructose's potentially inflammatory effect on the lungs.
The study results note that since this is a purely observational study, it cannot prove that the sugary drinks caused the asthma - rather, only that there is a correlation.
Additionally, the correlation involved large amounts of fructose, rather than your occasional sugary drink. Your safest bet is still to avoid drinking soda daily, along with avoiding these other 8 foods and drinks while you're pregnant.
Every year, on the third Thursday of November, smokers across the nation take part in the American Cancer Society Great American Smokeout event. Encourage someone you know to use the date to make a plan to quit, or plan in advance and then quit smoking that day. By quitting – even for 1 day – smokers will be taking an important step toward a healthier life and reducing their cancer risk.
Why We Need the Great American Smokeout
About 36.5 million Americans still smoke cigarettes, and tobacco use remains the single largest preventable cause of disease and premature death in the world. While cigarette smoking rates have dropped (from 42% in 1965 to 15.1% in 2015), cigar, pipe, and hookah – other dangerous and addictive ways to smoke tobacco – are very much on the rise. Smoking kills people – there’s no “safe” way to smoke tobacco.
Quitting smoking has immediate and long-term benefits at any age. Quitting is hard, but your patients and those that you love can increase their chances of success with help. Getting help through counseling or medications can double or triple the chances of quitting successfully. And who better to help out with your smoking cessation program then MD Spiro.
You can read about the history of the Great Smokeout here.
For other resources to leverage with your patients, please check out the materials available to help assist your patients to quit smoking today.