Heart Beat June 2019 Issue

In The News: June 2019

Lower Your Blood Pressure with a Midday Snooze

Heart

There's news that many people would like to hear. A small observational study of Greek patients presented at the annual meeting of the American College of Cardiology in March 2019 found that taking a daily nap can lower blood pressure. In a group of 212 individuals with hypertension, the researchers found that those who rested every afternoon had significantly lower blood pressures than those who did not nap (128.7/76.2 mmHg, vs 134.50/79.5 mmHg). A regular afternoon snooze lowered systolic blood pressure by 3 mmHg for every hour of sleep. This is enough to decrease the risk of a cardiovascular event by 10 percent or more.

Don't Worry About Scheduling Heart Surgery in July

HeartPainGuy

July is the month when new medical students and residents begin working in hospitals and experienced residents graduate. These significant staff changes can increase the risk of medical errors and complications. But this so-called "July effect" does not exist in cardiac surgery, researchers reported at the annual meeting of the Society of Thoracic Surgeons in January 2019. A review of 470,006 cardiac surgeries, namely coronary artery bypass graftings (CABG), aortic valve replacements, mitral valve repairs and replacements and thoracic aortic aneurysm (TAA) operations, uncovered no meaningful differences in in-hospital outcomes for these procedures done in the first quarter of the academic year (July to September) compared to the fourth quarter (April to June). Nor were there any differences in in-hospital deaths, regardless of the month in which the procedure was performed.

Teaching hospitals actually had lower mortality rates for CABG and TAA replacement in the first quarter compared to the fourth. Close monitoring of new cardiac surgery residents and excellent supervision provided in cardiac surgery education programs likely account for the consistency of results throughout the year, the presenters said.

E-Cigarettes Cut Tobacco Use, but at a High Cost to the Heart

ManInBed

Vaping has been touted by some as a safer alternative to smoking tobacco, but this may be no more than wishful thinking. A study presented at the 2019 Annual Meeting of the American College of Cardiology in March found that e-cigarettes have serious effects on the heart and cardiovascular system. Information gathered from more than 96,400 responders to three years of the Centers for Disease Control and Prevention's National Health Interview Surveys revealed that vapers had a 56 percent higher risk of heart attack, 44 percent more circulation problems, 30 percent more strokes and a 10 percent higher risk of coronary artery disease than non-vapers. Daily vapers were at highest risk, but heart-attack risk also was significantly elevated among those who vaped a few times a week.

About one-third of e-cigarette users reported being current or former smokers. This raises the question as to whether the heart risks arose from cigarette use or e-cigarette use. The study was not able to differentiate. However, it did point out that smokers who switched from tobacco to e-cigarettes or smoke both products were still at significantly elevated risk for cardiovascular events.

More People Than Ever Are Surviving Heart Attacks

smoking

Heart disease kills more people in the United States every year than any other disease, yet widespread use of evidence-based treatments has increased the likelihood of surviving a heart attack. A study of Medicare patients from 1995 to 2014 found a 38 percent decline in hospitalizations for acute heart attack, despite the average age of heart attack rising from 76.9 to 78.2. Among heart-attack patients admitted to the hospital, deaths within 30 days dropped from 20 percent to 12.4 percent, readmissions within 30 days dropped from 21 percent to 15.3 percent and recurrent heart attacks within 12 months dropped from 7.1 percent to 5.1 percent. As published in JAMA Network Open on March 15, 2019, improvements were seen across the board regardless of age, sex, race or Medicaid status, but were not consistent nationwide.

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