Features April 2014 Issue

Heart Beat: April 2014

Exercising More, Sitting Less May Reduce Heart Failure Risk
Sitting for long periods of time, without breaks for physical activity, appears to raise the risk of heart failure in men, according to a study published in the American Heart Association journal Circulation: Heart Failure. Researchers also found that extended periods of sedentary time may even raise heart failure risks in men who exercise regularly. The heart failure risk was almost double in men who sat for at least five hours a day outside of work and got little exercise, compared to men who were more physically active and sat for two hours or less per day outside of work. The study included more than 84,000 men between the ages of 45 and 69. None of the men had heart failure at the beginning of the study. A separate study of more than 100,000 post-menopausal women also found a strong connection between extended periods of sitting or lying down and shorter lifespans due to conditions such as heart failure and cancer. That study was published in the American Journal of Preventive Medicine. Researchers in both studies agree that the message is simple: Sit less and be more active. While daily exercise that could include a 30-minute walk or a workout at the gym is strongly advised, it’s also important to get up and move around throughout the day and evening. Taking a housework break during television commercials or taking a 10-minute walk after dinner will complement your other exercise and may help lower your heart risks.

Eating Too Much Added Sugar Could Raise Fatal Heart Disease Risk
Research shows that consuming too much added sugar is associated with a greater risk for death from cardiovascular disease (CVD). A study published in JAMA Internal Medicine found that the risk of dying from CVD increased with a higher percentage of daily calories coming from added sugars. Researchers examined national health survey data, and found that between 2005 and 2010, about 71 percent of U.S. adults consumed 10 percent or more of their calories from added sugars. And about 10 percent of adults got about 25 percent or more of their daily calories from added sugars. A significant portion of those added sugars are consumed in sweetened drinks, such as soda. The research indicates that regular consumption of sugar-sweetened beverages­—seven servings or more per week—is associated with a higher risks of dying from CVD. The researchers made clear that the added sugars in question were those that do not occur naturally in fruit, for example. These are sugars added in processing or preparing foods.

Prediction Modeling May Lead to More Personalized Heart Care
Detailed prediction models that project long-term outcomes for patients undergoing coronary artery stenting (percutaneous coronary intervention, or PCI) and coronary artery bypass grafting (CABG) surgery may be useful in deciding what treatment strategy is best for individuals with coronary artery disease. A Cleveland Clinic study, led by cardiac surgeon Joseph F. Sabik III, MD, and published in the Annals of Thoracic Surgery, examined the records of more than 23,000 patients who underwent CABG or stenting between 1995 and 2007. Survival models were developed, and all factors appearing in any of the models were programmed into a decision-support tool. The researchers found that patients with more extensive coronary artery disease and those who had more comorbidities experienced better outcomes after undergoing CABG surgery, while patients who had a heart attack or who had more limited coronary artery disease had better long-term outcomes after PCI. In some cases, the decision to use stents or CABG is an obivous one, but there are times when both strategies are viable options. Patients should understand the risks and benefits, as well as the likely long-term outcomes for each approach, Dr. Sabik says. “Our study suggests that patients should be more engaged in their own health care decisions,” he adds. “When meeting with their surgeon or physician, patients should ask how the treatment strategy was determined. Did they consult with a heart team, and did they consider both PCI and surgery?” The heart team includes the patient, primary cardiologist, interventional cardiologist, cardiac surgeon, imaging specialist, nurses and others. Input from several practitioners improves the odds of a favorable outcome for the patient.

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