Heart Beat July 2018 Issue

Heart Beat: July 2018

Study Finds No Connection Between Heart Failure and Cancer

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Results of a long-term study of male physicians found no association between the development of heart failure and cancer. Researchers analyzed more than 28,000 patients who were disease-free when they enrolled in one of three clinical trials. After a median of 19.9 years, 1,420 of the participants had developed heart failure, 7,363 had been diagnosed with cancer and 177 had developed both. As explained in the Journal of the American College of Cardiology on April 10, no difference in the incidence of cancer between participants who had or did not have heart failure was found. This contradicts the findings of an earlier study, meaning the issue cannot be laid to rest. Nevertheless, the authors of the more current study feel that heart failure patients do not need additional cancer screenings.

Patients Report Improvement in Quality of Life with New Heart Failure Drug

As heart failure advances, patients find their physical and social lives can be heavily impacted. Increasing fatigue affects their ability to do simple tasks and can interfere with intimacy. But a new heart-failure medication that not only extends life, but also reduces hospitalizations and significantly improves patients’ overall health appears to improve quality of life, as well. The drug is Entresto™, a combination of the neprilysin inhibitor sacubitril and valsartan, an angiotensin receptor blocker (ARB). When compared with angiotensin-converting enzyme (ACE) inhibitors, Entresto increased the ability to walk, garden, jog, participate in hobbies, do household chores and participate in sexual relationships. The authors of the study, published online April 4 in JAMA Cardiology, said the improvement in quality of life was equivalent to rolling back the calendar nine years.

Will You Develop Hypertension? Your Resting Heart Rate May Tell You

It’s common for blood pressure to rise with age, but we have learned that it’s not normal. If it were, everyone would develop hypertension over time. Physicians have been unable to predict who will develop hypertension, or when it might occur, because the natural history of hypertension has been largely unknown. But a study published online March 21, 2018 in JAMA Cardiology helped fill in the knowledge gap. Researchers examined the blood-pressure histories of 1,252 adults enrolled in the long-term Framingham Heart Study and found that most generally maintained a systolic blood pressure less than 120 to 125 millimeters of mercury (mmHg). Once their blood pressure passed this mark, however, it accelerated rapidly toward hypertension. The pattern held true whether the patients were in their 40s, 50s, 60s or 70s. This information will allow physicians to keep a closer watch on patients’ blood pressure and discuss using lifestyle changes or medications to lower blood pressure to avert hypertension before their systolic pressure reaches the 120 mmHg mark.

Study Reinforces the Safety of Smoking-Cessation Drugs

Various nicotine replacement therapies and two medications, varenicline (Chantix®, Champix) and buproprion (Wellbutrin™, Zyban), are widely used to help smokers quit their habit. Although these products are not associated with any serious safety concerns, worries about their potential to cause heart attack persisted. These fears prompted the FDA and its European counterpart to request a new safety study. The resulting double-blind, randomized, triple-dummy, placebo- and active-controlled trial published in JAMA Internal Medicine on April 9, 2018, involved more than 8,000 adult smokers in multiple countries. All received at least one dose of study medication or a nicotine patch. More than half were treated for 12 weeks and followed for an additional 40 weeks. At the end of the study period, the incidence of cardiac events in all groups was low. No significant differences were seen in blood pressure, heart rate or time to cardiovascular events among the treatment groups, or between the treatment and placebo groups. The researchers concluded there was no evidence that smoking cessation therapies increase the risk of serious cardiovascular events during or after treatment in typical smokers with various cardiovascular risks.

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