Heart Beat: June 2015
Just one added risk factor raises stroke risk in afib patients
Atrial fibrillation (afib) is a risk factor for stroke. But if you have no other risk factors, your stroke risk is moderate. But a recent Danish study found that even one additional risk factor significantly raises your odds of having a stroke if you’re not taking oral anticoagulants, such as warfarin (Coumadin). These other risk factors include conditions such as high blood pressure, vascular disease and diabetes, as well as smoking, a sedentary lifestyle, advanced age and a history of heart attack or a prior stroke. The study, published in the Journal of the American College of Cardiology, suggests physicians take a comprehensive look at all of an afib patient’s risk factors, and understand that the possibility of stroke can increase greatly with just one more risk factor. The researchers note that not all risk factors carry the same weight, so a physician’s judgment is still crucial in deciding whether to put a patient on anticoagulant therapy. If you have afib, and are not taking warfarin or a similar anticoagulant, talk with your doctor about your odds of having a stroke. Then discuss the risks and benefits of anticoagulant therapy. Taking anticoagulants can increase your bleeding risk, but if well-managed, this type of preventive therapy can be safe and effective for many patients.
Agency warns of dangers associated with high-dose ibuprofen
A European health organization is warning patients and doctors about elevated cardiovascular risks associated with high-dose ibuprofen use. Ibuprofen is part of a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). High doses are sometimes prescribed to individuals recovering from serious injuries or to help control inflammation caused by rheumatic diseases, such as rheumatoid arthritis, or musculoskeletal disorders, such as tendinitis. But the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency says physicians should use caution when prescribing high-dose ibuprofen. This is especially true if the patient has any underlying heart or circulatory problems. A high dose of ibuprofen is considered to be 2,400 mg per day or more. The FDA recommends patients take no more than 3,200 mg per day, and only for serious conditions such as arthritis and other chronic diseases. For mild-to-moderate pain, 1,200 to 2,400 mg per day is advised. For all patients, ibuprofen should be taken for the shortest duration and at the lowest effective doses. If you have any type of cardiovascular risk factors, you should discuss the use of any NSAIDs with your physician.
New recommendations set BP treatment target for heart patients
If you have been diagnosed with heart disease, or have had a stroke, it’s important to get your blood pressure under 140/90 mm Hg. That’s the recommendation issued jointly by the American Heart Association (AHA), American College of Cardiology and American Society of Hypertension. The organizations made the recommendation in response to changes in treatment guidelines released in the past two years. The groups, which published their statement recently in the AHA journal Hypertension, say getting a heart patient’s blood pressure below 140/90 will significantly help reduce the risk of heart attack and stroke. The joint statement also urges heart patients to keep track of their blood pressure and make the necessary lifestyle changes—including medication adherence—to help keep their blood pressure under control.
FDA approves medication to help manage chronic heart failure
A drug that has been available in Europe since 2005 was approved earlier this year by the FDA to treat patients with chronic heart failure in the U.S. The medication, ivabradine, was shown to lower the two-year risk for hospitalization or cardiovascular death by 18 percent in patients with heart failure. Ivabradine is indicated for patients whose heart rate is at least 70 beats per minute and who also take beta blockers. In Europe, ivabradine is also prescribed to patients with stable angina who cannot take beta blockers. The primary side effect is a serious slowing of the heart rate. When ivabradine starts being prescribed in the U.S., patients are reminded to report symptoms such as dizziness or fatigue.