Heart Beat July 2011 Issue

Heart Beat: July 2011


Men who are tall and obese face a higher risk of potentially dangerous blood clots, according to research published in Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association. Obesity is a well-established risk factor for clots in deep veins, especially those in the legs, and for pulmonary embolism, a clot in the blood vessels of the lungs that can result in sudden death or strain on the heart. Together the two conditions are called venous thromboembolism (VTE). Compared with men 5í7" or shorter and normal-weight men, the age-adjusted risk of VTE was 5.28 times higher in obese and tall men and 2.11 times higher in obese and short men. Researchers noted that the amount of risk conferred by being both tall and obese was comparable to other risk factors for VTE, such as pregnancy and carrying the gene for an inherited predisposition to clotting (known as Factor V Leiden). Because blood must be pumped a longer distance by the calf-muscle group in tall people, there is a higher risk of reduced blood flow in the legs and therefore a greater risk of clotting. This makes it particularly important for tall men to manage their weight and exercise, since height is not a controllable risk factor.


Even short-term use of some painkillers could be dangerous for people who have had a heart attack, according to research published in the May 9, 2011 issue of Circulation: Journal of the American Heart Association. Researchers analyzed the duration of prescription non-steroidal anti-inflammatory drugs (NSAIDs) treatment and cardiovascular risk in a study of more than 83,000 heart attack survivors. Several different NSAIDs were tested and all were associated with an increased risk of death or recurrent heart attack. The medication diclofenac was identified as carrying the highest risk. Other commonly prescribed NSAIDs that carry a risk are ibuprofen and selective COX-2 inhibitors. Talk with your doctor about what alternative painkillers and other medications are safe for you and what you can do lower your risks of a subsequent heart attack.


Having asthma and associated pro-inflammatory conditions can double the risk of type 2 diabetes and pose a 50 percent higher risk of coronary artery disease compared with nonasthmatics. Those are the findings of a study presented at the American Academy of Allergy, Asthma & Immunology annual meeting earlier this year. The message is that asthmatics who have heart disease risk factors should be evaluated carefully for early signs of coronary artery disease and diabetes. Researchers acknowledged that exercise habits among the study participants were not examined and that people with asthma may be more sedentary than others, thus raising the odds of heart disease. Researchers also noted that asthma increases proinflammatory cytokines and therefore may play a role in the development of coronary artery disease. Cytokines are small proteins released by cells and certain cytokines, such as interleukin-6, can trigger inflammation. Similarly, the proinflammatory cytokine T helper-17 also plays a role in increasing the risk of developing rheumatoid arthritis and inflammatory bowel disease.


Despite the positive attention statins have gotten in recent years as protective medications for people at high risk of heart disease, a recent study indicates that only 48 percent of patients who have been prescribed statins are actually taking their prescribed dose on a regular basis within a year after receiving their prescription. The research, published in the journal Medical Decision Making, also found that after 10 years, only 27 percent of patients who were prescribed the cholesterol-lowering drugs were still taking them. Researchers from North Carolina State University noted that the poor adherence figures are particularly distressing because statins have been shown to significantly increase the quality and length of heart patientsí lives. For example, the study found that consistent adherence to statin therapy increases quality-adjusted life years by two years compared with not taking statins at all. A quality-adjusted life year is a way of measuring the effect of health conditions, such as heart disease, on quality of life.