Heart Beat August 2017 Issue

Heat Beat: August 2017

Aspirin Therapy May Be Riskier Than Previously Thought for Older Adults

Heart Beat

Taking a daily aspirin to protect against a stroke or heart attack poses a higher risk of disabling or fatal bleeding in people over the age of 75, according to a study published recently in The Lancet. Researchers noted, however, that the risk of gastrointestinal bleeding can often be minimized if older adults on aspirin therapy also take a proton-pump inhibitor (PPI). PPIs are medications that help reduce the amount of acid produced by the stomach. They are usually prescribed to treat acid reflux or stomach ulcers. Low-dose aspirin therapy is a widely recommended preventive measure for people who have been diagnosed with cardiovascular disease. This is called secondary prevention. Aspirin is an antiplatelet medication that interferes with the blood-clotting process. By reducing the odds of blood clots forming in your arteries, you also lower your chances of having a heart attack or an ischemic stroke. But some clotting is necessary. If you have a cut, you want your blood to clot so that a small injury doesn’t cause massive blood loss. Gastrointestinal bleeding is a potential side effect of aspirin therapy. Researchers said that while the bleeding risk was well known, the study revealed the risk was far greater than previously understood among older adults. However, about half the bleeds were gastrointestinal bleeding events. Previous studies have shown that proper PPI use can prevent about 80 percent of gastrointestinal bleeds caused by antiplatelets. If you are on aspirin therapy, talk with your doctor about its risks and benefits, and ask about whether you should also take a PPI.

Wireless Patch May Be Better Than Traditional Holter Monitor at Detecting Afib

When someone survives a stroke for which there is no definitive cause (cryptogenic stroke), the patient may be advised to wear a Holter monitor. This is a device that is worn for 24 hours or more to measure the rhythm of the heart. The goal is to diagnose a common heart rhythm disturbance called atrial fibrillation (Afib), which is a major risk factor for stroke. According to a recent British study presented at the European Stroke Organization Conference, a wireless patch worn by cryptogenic stroke survivors appears to be better able to identify patients with Afib. In the study, stroke patients were divided into groups wearing either the Holter monitor or the wireless patch. Afib was detected in seven out of 43 patients in the patch group who completed the study, but the rhythm disturbance was picked in only one out of 43 patients in the Holter group. Researchers also found that the Holter monitor was much less user friendly than the patch, which is worn on the chest for 14 days. A holter monitor is worn for 24 hours. It includes a device about the size of a small camera that is worn around the neck or on a belt. It is attached with wires to several electrodes placed on the upper body. Researchers said they believe this longer-term monitoring will diagnose more cases of Afib and become a standard diagnostic tool in the near future. Other similar monitors being studied include one that is implanted in the chest for a year.

AHA Advisory: Replace Saturated Fat With Healthier Fat to Cut Heart Disease Risk

The role saturated fat consumption plays in your risk of heart disease has been debated by experts armed with seemingly conflicting research in recent years. But the American Heart Association (AHA) is reaffirming its recommendation that people reduce their intake of saturated fat, such as that found in red meat, full-fat dairy products and tropical oils (coconut, palm and others). Instead, you should replace the unhealthy fat with polyunsaturated vegetable oil. Studies have shown that making such a switch could reduce cardiovascular disease risk by 30 percent—a figure that is comparable to the cholesterol-lowering statin medications. Coconut oil, which is widely perceived to be healthy, is associated with an increase in LDL (“bad”) cholesterol in recent studies. Healthy polyunsaturated fats are found in corn, soybean and peanut oils, while monounsaturated fats are found in olive, safflower, and canola oils. The AHA recently issued an advisory urging consumers to make these changes in their diet, noting that healthy eating isn’t simply a matter of reducing or eliminating unhealthy foods. Adding healthy foods, such as healthy cooking oils, can provide protective benefits for heart health.

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