Research for Heart Disease

The AIHW undertakes national surveillance and monitoring of a number of prominent chronic conditions, including cardiovascular disease, along with their comorbidities and associated risk factors. The AIHW seeks to enhance the evidence on the impact of chronic conditions including CVD through these monitoring activities by providing information and advice, addressing key policy priorities and filling key information gaps.

Source: Australian Institute of Health and Welfare1

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Research for Heart Disease

Low-radiation cardiac catheterization: MRI Shows Promise for Heart Procedures

An experimental MRI method may be as safe and swift as standard X-ray procedures for imaging the heart during certain types of surgery. The new finding suggests a radiation-free alternative to the current method.

NIH scientists have been working to develop rapid MRI methods that that can help surgeons see and place cardiac catheters without radiation. MRI uses harmless radio waves and magnetic fields to create pictures.

In the study, 15 patients with heart disorders underwent cardiac catheterization using first X-ray and then MRI guidance. The average procedure time for the 2 approaches was similar. Procedure steps were as successful with MRI as with X-ray guidance.

“This could be the first chapter of a big story,” says Dr. Robert S. Balaban, a heart imaging expert at NIH. “It provides evidence that clinical heart catheter procedures are possible without using radiation, which could be especially valuable in areas such as pediatrics.”

Source: NIH News in Health (NIH)2

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The Heart Truth: A national heart health movement, being led by the NIH's National Heart, Lung, and Blood Institute (NHLBI) in partnership with many other organizations, has achieved progress in getting women to pay attention to their risk for heart disease. According to a recent survey, awareness of heart disease among all U.S. women has nearly doubled in the last 15 years—from 30 percent to 56 percent. Among African American women, awareness has more than doubled (from 15 percent in 1997 to 36 percent in 2012) and increased among Hispanic women from 20 percent in 1997 to 34 percent in 2012.

Continued educational efforts have contributed to increasing awareness of heart disease among women. For 11 years, the NHLBI has been sponsoring The Heart Truth® (www.hearttruth.gov), a national education program for women that raises awareness about heart disease and its risk factors and educates and motivates them to take action to prevent the disease.

Through the program, launched in 2002, the NHLBI leads the nation in a landmark heart health movement embraced by millions who share the common goal of better heart health for all women.

The centerpiece of The Heart Truth is the Red DressSM, which was created by the NHLBI and introduced as the national symbol for women and heart disease awareness in 2002. The Red Dress is a powerful red alert that inspires women to learn more about their personal risk for heart disease and take action to protect their heart health.

https://medlineplus.gov/magazine/issues/winter14/articles/winter14pg20.html

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New Heart Guidelines: New Heart Guidelines Released; Talk to Your Healthcare Provider

Your healthcare provider now has new research information to help guide decisions about your heart health. In November, four clinical guidelines were released that focus on assessing risks to your heart, making lifestyle changes to reduce those risks, and managing elevated blood cholesterol and body weight in adults. The guidelines were released by the American College of Cardiology (ACC) and the American Heart Association (AHA), and other professional societies that worked in collaboration with the National Heart, Lung, and Blood Institute (NHLBI).

Each guideline provides important updated guidance for primary care providers, nurses, pharmacists, and specialty medicine providers on how best to manage care of patients who are at risk for heart-related diseases based on the latest scientific evidence.

"The guidelines, developed by the AHA and ACC in collaboration with and endorsed by other professional societies, provide a valuable updated roadmap to help clinicians and patients manage prevention and treatment challenges in four key areas of concern: cholesterol, lifestyle, risk assessment, and overweight and obesity," says Gary H. Gibbons, M.D., Director of the National Heart, Lung, and Blood Institute (NHLBI).

"We appreciate the outstanding work and dedication of the panelists who helped shape the NHLBI evidence reviews, as well as the collaborative contributions of the professional societies, for their extensive efforts to translate and disseminate these guidelines to the public. The guidelines reflect the most comprehensive and rigorous systematic evidence reviews to date on these topics, and we are pleased that the reviews provided by NHLBI-convened expert panels enabled the professional society partners to move with such deliberate speed. The NHLBI looks forward to continuing to develop accurate and timely evidence reviews, fueled by our investment in primary research on cardiovascular disease as well as implementation science to improve public health."

For more information about these guidelines, talk to your healthcare provider.

https://medlineplus.gov/magazine/issues/winter14/articles/winter14pg20.html

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The Heart Truth: Join The Heart Truth Community

National Symbol

The centerpiece of The Heart Truth® is The Red Dress® which was introduced as the national symbol for women and heart disease awareness in 2002 by the NHLBI. The Red Dress reminds women of the need to protect their heart health and inspires them to take action to lower their risk for the disease.

Each February since 2002, The Heart Truth's Red Dress Campaign has held a Red Dress runway event during Fashion Week in New York City. The event is sponsored by the NIH's National Heart, Lung, and Blood Institute (NHLBI).

To make women more aware of the danger of heart disease, the NHLBI is sponsoring a national campaign called The Heart Truth®, in partnership with many national and community organizations. The program's goal is to raise awareness about heart disease and its risk factors among women and educate and motivate them to take action to prevent the disease and control its risk factors.

Primary Objectives

The program is especially for women ages 40 to 60, the age when a woman's risk of heart disease starts to rise. But its messages are also important for younger women, since heart disease develops gradually and can start at a young age—even in the teenage years. Older women have an interest too—it's never too late to take action to prevent and control the risk factors for heart disease. Even those who have heart disease can improve their heart health and quality of life.

https://medlineplus.gov/magazine/issues/winter14/articles/winter14pg22-23.html

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Statins: Giving Statins a Second Chance

A new study finds that most people who quit statins because of side effects can tolerate them when tried a second time. Statins are drugs that lower cholesterol to prevent heart disease. The study found more than 90 percent of people who quit had success when they tried again (for example, with a lower dose or a different statin).

"There are potentially millions of patients who could take statins again and ultimately reduce their risk of heart disease," says researcher Alexander Turchin, MD., of Brigham and Women's Hospital. He suggests it's something doctors and patients should discuss.

The research team examined the electronic medical records of people who had been prescribed a statin at two Boston hospitals. Researchers developed software that allowed them to scour more than 5 million notes on more than 100,000 patients covering nearly a decade. Researchers say a clinical trial would be an important next step. NIH's National Library of Medicine helped fund the study.

https://medlineplus.gov/magazine/issues/summer13/articles/summer13pg28.html

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Cardiac Bypass Surgery: Treating Diabetes and Heart Disease: Cardiac Bypass Surgery a Better Option

A recent study may impact how doctors treat people with diabetes and heart disease.

Researchers compared two treatments for adults with diabetes who have heart disease in more than one blood vessel. The study confirmed cardiac bypass surgery is a better overall treatment option than an artery-opening procedure called percutaneous coronary intervention (PCI) that included insertion of drug-eluting stents. Surgery patients lived longer and had fewer severe complications.

The National Heart, Lung, and Blood Institute funded the study. Director Gary H. Gibbons, M.D., says the results may help physicians in their efforts to prevent cardiovascular events such as heart attacks and deaths in this high-risk group.

Coronary heart disease can block or reduce the flow of blood to the heart muscle. Doctors try to restore blood flow with one of two types of procedures. Coronary artery bypass graft (CABG) surgery uses a healthy artery or vein from another part of the body to bypass the blocked artery. PCI is non-surgical and less invasive. It uses a balloon to open the artery. A small mesh tube called a stent is then inserted to prop open the artery.

Diabetes is a major risk factor for heart disease and stroke. More than 65 percent of people with diabetes die of some type of cardiovascular disease. During the trial, participants received standard medical care for all major cardiovascular risk factors, such as high LDL cholesterol, high blood pressure, and high blood sugar. Participants were also counseled about lifestyle choices, such as smoking cessation, diet, and regular exercise.

https://medlineplus.gov/magazine/issues/spring13/articles/spring13pg28.html

Prevention Research for Heart Disease

Low-fat diet: For years you’ve heard you should eat less fat. In a recent major study, however, a low-fat diet didn’t lower the risk of breast cancer, colorectal cancer or heart disease in women past menopause. But don’t pile on the butter and fried foods just yet. There’s still plenty of evidence that a low-fat diet full of fruits, vegetables and whole grains can help you live a long, healthy life.

The major study is the Women’s Health Initiative (WHI), one of the largest medical studies ever. One part of the study looked into the effects of a low-fat diet high in fruits, vegetables and grains. Previous studies had suggested, but not proven, that such a diet might reduce the risk of breast cancer, colorectal cancer and heart disease.

“Some of the media reports read as though everybody knew that a low-fat diet would prevent breast cancer, but in the scientific community this was a very open question,” Dr. Ross Prentice explained at a recent conference about the WHI. Prentice, a professor at the University of Washington, was involved in the study’s design.

Women were randomly assigned to follow either a low-fat eating plan or, for comparison, to continue eating as they had been. Those in the low-fat group aimed to reduce their fat intake to 20% of calories (Americans at the time were averaging 34%), increase their fruits and vegetables to 5 or more servings a day and increase their grain servings to 6 or more a day.

Almost 49,000 women were followed for an average of 8.1 years. They had physical exams, filled out questionnaires about their diets and sent in updates about diseases such as cancer and heart disease, among other things.

The study found no major differences in colorectal cancer, heart disease or stroke between the two groups. Although there was a 9% lower risk of breast cancer among the women who reduced the amount of fat they were eating, that difference wasn’t enough to prove it might not just be due to chance.

Prentice still thinks the result is encouraging. He also said he saw some other promising trends in the massive amount of data collected during this trial. For example, women who started at the highest levels of fat decreased their fat intake more and had a reduced risk of breast cancer. Women who had the greatest decrease in the saturated and trans fats they ate saw improvements in their rates of heart disease. These fats weren’t the focus of the study when it was designed, but we know they’re more strongly related to heart disease than the total amount of fat you eat.

Women on the low-fat diet also weighed about 5 pounds less than the comparison group after a year. After 9 years of follow-up, they still weighed about a pound less on average. Those on the low-fat diet had modest improvements in other measures that are proven risk factors for heart disease as well.

But to prove all these connections, Prentice explained, “We need longer follow-ups for a more definitive evaluation.”

To put these results in perspective, what scientists call a negative result—one that fails to prove something—doesn’t prove an idea is wrong. For example, low-fat eating didn’t turn out to be a magic bullet to prevent breast and colorectal cancer, but there still may be a connection. Cancer takes years to develop, and this study may simply not have been long enough to expose it.

Also, there are many things that could have confused the results of this study. Because of recent eating trends, women in the comparison group ate less fat than the researchers expected, so there wasn’t as much difference between the groups as they’d planned for. The women in the intervention group didn’t meet their goals for eating grains, either, and toward the end the difference between them and the comparison group had narrowed. In addition, research shows that people often underestimate how much they eat; that could definitely affect the results. Things might also have turned out differently if the women had been followed for longer—or if younger women or even men had been studied.

So what should you take away from this study? Maybe it’s best not to try thinking about eating and health in such simple terms. Most researchers believe that it’s a lifetime of healthy eating habits that makes the real difference. Dr. Linda Van Horn of Northwestern University pointed out at the conference, “I’ve never seen a study yet that says fruits and vegetables are bad for you.”

In another arm of the WHI, a study in which researchers tracked nearly 94,000 women for an average of 7 years, women who weighed less and exercised more had a lower risk of developing breast cancer. These two factors—controlling your weight and getting physical activity—turn up time and time again in studies looking into heart disease, cancers and a whole host of other health issues.

Dr. Elizabeth Nabel, director of NIH’s National Heart, Lung, and Blood Institute, which supported the WHI, commented, “The results of this study really do not change any established recommendations for women in terms of disease prevention.”

So while simply lowering the amount of fat you eat may not lower your risk of breast or colorectal cancer, eating well and exercising over the course of a lifetime will help your chances of living a long, healthier life.

Source: NIH News in Health (NIH)3

Causal Research for Heart Disease

High Cholesterol: The landmark Framingham Heart Study, funded by NIH, first showed that the higher the cholesterol level in your blood, the greater your risk for heart disease—the number 1 killer of Americans, both women and men.

Source: NIH News in Health (NIH)4

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Migraine: Researchers studied more than 20,000 men for about 16 years. None had a history of cardiovascular disease or other major illnesses when they first enrolled in the study. About 1,500 of the men suffered from migraines.

Over time, the men with migraine had a 24% greater risk of developing major cardiovascular disease compared with men who did not have migraine. The men with migraine also had a 42% increased risk for heart attack.

The relationship between migraine and heart health is complex and unclear. Migraines may simply be a sign of an underlying cardiovascular problem. In any event, because of the apparent link to heart disease, migraine sufferers might be wise to take steps to reduce traditional cardiovascular risk factors, like high blood pressure, obesity, smoking and high cholesterol.

https://newsinhealth.nih.gov/2007/June/docs/02capsules.htm

Genetics Research for Heart Disease

Researchers ID Genes to Help Predict Heart Disease Risk and Statin Benefits

Healthy lifestyle choices can often help prevent or treat heart disease. If lifestyle changes aren't enough, medicines such as statins can help. But genetics also play a role in heart disease risk, particularly genetic variations known as single-nucleotide polymorphisms (SNPs).

Funded in part by the National Heart, Lung, and Blood Institute, researchers asked if a composite of SNPs could predict heart disease risk and determine who might benefit most from statin therapy. Researchers analyzed data from five studies that included more than 48,000 people who experienced nearly 3,500 heart-disease related events. They then calculated a genetic risk score based on 27 heart disease-associated SNPs, and divided each participant into a low, intermediate, and high genetic risk category. Compared with the other groups, people with the highest genetic risk had an increased risk for coronary heart disease, and a 70 percent greater risk for a heart attack. Genetic risk score also predicted the ability of statin therapy to reduce the risk for heart attack or other heart disease-related events.

These findings suggest that people with the highest genetic risk may benefit the most from statin therapy. This may lead to targeted therapies for patients at risk for heart disease.

Source: MedLinePlus Magazine (NIH)5

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References

  1. Source: Australian Institute of Health and Welfare: aihw.gov.au/ reports-statistics/ health-conditions-disability-deaths/ heart-stroke-vascular-diseases/ about
  2. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ oct2012/ capsule2
  3. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2006/ April/ docs/ 01features_01.htm
  4. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2008/ January/ docs/ 01features_01.htm
  5. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ spring16/ articles/ spring16pg24-28.html

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.