Heart Beat: December 2015
Only One in 10 Heart Failure Patients Referred for Cardiac Rehab
Despite the proven effectiveness of cardiac rehabilitation to help individuals recovering from heart attacks or coping with other cardiovascular challenges, relatively few eligible patients complete the programs. And, a recent study published in the Journal of the American College of Cardiology found that many good candidates for cardiac rehab aren’t even recommended for it. Researchers who analyzed a national registry of hospitalized heart failure patients between 2005 and 2014 found that only 10.4 percent of those patients were referred for cardiac rehab upon discharge from the hospital. One possible explanation is that in 2005, guidelines suggested “exercise training” and not “cardiac rehabilitation” for heart failure patients. The guidelines from the American Heart Association and the American College of Cardiology were updated in 2013, however, to stress cardiac rehab instead of exercise training. Another change likely to boost the numbers of heart failure patients heading to rehab is a modification in the benefits provided by the Centers for Medicare and Medicaid Services (CMS). The organization extended its coverage of cardiac rehab in 2014. If you have been diagnosed with heart failure and your physician hasn’t discussed cardiac rehab, ask whether it would be appropriate for you. Investigate a local cardiac rehab program and talk to those involved about what you can expect when you sign up. Cardiac rehab isn’t just about exercise. You’ll learn about diet, weight control, medication adherence and other equally important topics.
Psoriasis Severity Linked to Level of Arterial Inflammation
The link between psoriasis and increased cardiovascular risk is well established. But a recent study suggests that the amount of psoriasis on the skin may be related to the amount of inflammation in the blood vessels. Greater blood vessel inflammation may contribute to a higher risk of heart attack and stroke. Psoriasis, a chronic skin condition marked by patches of dead skin cells, is an autoimmune disorder like rheumatoid arthritis and lupus. All of these conditions are associated with inflammation throughout the body. Inflammation, in turn, is associated with accelerated atherosclerosis, or “hardening” of the arteries. In the study, published in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology, researchers found that among the study participants, those with the most extensive amount of psoriasis had a 51 percent increase in blood vessel inflammation. The increased blood vessel inflammation existed even in study subjects who were otherwise at low risk for cardiovascular disease. The takeaway message for psoriasis patients, the researchers said, is to make sure they are screened for heart disease risk factors, such as high cholesterol, hypertension, diabetes and obesity. There is no cure for psoriasis, but there are treatments that can help minimize symptoms.
New Brain Imaging Test May Detect Damage Related to Hypertension
Using a new brain imaging technique, researchers have found that some individuals with high blood pressure also have early signs of brain damage. The technique, called diffusion tensor imaging (DTI), is an enhanced version of magnetic resonance imaging (MRI). An MRI creates detailed pictures of the brain and nerve tissues. DTI scans suggest that hypertension may cause damage to nerve tracts connecting parts of the brain involved with certain cognitive skills, decision-making and emotion regulation. In a study presented at the American Heart Association’s 2015 High Blood Pressure Conference, the researchers also announced that study participants with hypertension also performed worse on two tests of cognitive function and memory, compared to study subjects without high blood pressure. The changes are detected in the brain’s white matter, which consists of nerve-cells bundles that connect various gray matter parts of the brain. Previous research has focused largely on how high blood pressure affects gray matter function. Researchers are hopeful that DTI can one day be used to help identify possible therapies that could reduce brain damage and cut the risk of dementia. They also note that these findings further support the importance of controlling high blood pressure through the use of medications and healthy lifestyle behaviors. Hypertension is also a risk factor for stroke, underscoring the unmistakable connection between heart health and brain health.