Category: Cardiovascular Disease

Categories : Cardiovascular Disease GenderTags :

Women’s Heart Attack Death Risk Higher than Men’s

On By ModernMedia

Compared to men, women have a 20% higher risk of death or heart failure after their first serious heart attack, according to an article in the journal Circulation. Prior research was unclear as to the difference in vulnerabilities to heart attack between the sexes.

The research focused on two types of heart attack; ST-segment elevation myocardial infarction (STEMI) and a less serious but more common type referred to as Non-STEMI or NSTEMI. Women were found to be at greater risk of death after either STEMI or NSTEMI attacks, although accounting for confounding variables narrowed this difference.

Women tended to be older (72) than men (61) at the age of their first serious heart attack, and had more complicated medical histories.

In the hospital setting, women were seen less frequently by a cardiovascular specialist (72.8%, versus 84% for men), prescribed fewer drugs and had fewer surgical procedures.

Lead author Justin A Ezekowitz, MBBCh, MSc, cardiologist and co-director of the Canadian VIGOUR Centre at the University of Alberta in Canada said, “Identifying when and how women may be at higher risk for heart failure after a heart attack can help providers develop more effective approaches for prevention. Better adherence to reducing cholesterol, controlling high blood pressure, getting more exercise, eating a healthy diet and stopping smoking, combined with recognition of these problems earlier in life would save thousands of lives of women—and men.”

Padma Kaul, PhD, co-director of the Canadian VIGOUR Centre, said that the next step is to address inequalities in provision of care: “Close enough is not good enough. There are gaps across diagnosis, access, quality of care and follow-up for all patients, so we need to be vigilant, pay attention to our own biases and to those most vulnerable to ensure that we have done everything possible in providing the best treatment.”

Source: Medical Xpress

Categories : Cardiovascular DiseaseTags :

A Bad Rap? Statins Have “Nocebo” Effect

On By ModernMedia

According to an article by the BBC, new research funded by the Imperial Heart Foundation indicates that a significant portion of statins’ adverse side effects are attributable to the “nocebo” effect. 

Statins are one of the most prescribed tablets in the UK, used to lower low-density lipoprotein (LDL) cholesterol and triglycerides levels, and raise high-density lipoprotein (HDL) cholesterol. The effects help prevent heart attacks and stroke, but nearly a fifth of patients stop taking them due to side effects such as joint pain, muscle ache, fatigue and nausea. In 60 patients were recruited, who had all stopped taking statins due to their adverse effects. On a scale of 0 to 100, those taking placebo tablets reported a similarly high score (15.4) to those taking statins (16.3), compared to a group receiving no tablets (8).  The effect was so strong that many patients discontinued the dummy pills. 

The nocebo effect is the inverse of the placebo effect, where patients experience adverse effects even when they are taking a placebo. This is thought to explain why there is such a high prevalence of penicillin allergies when testing proves otherwise. 

Once the patients were talked through the nocebo effect, most were able to resume statins. It is not known as to why statins have such a powerful nocebo effect, although some attribute this to media creating a “self-fulfilling destiny”.

“If you stopped a man in the street and asked how do you feel about an aspirin or a statin a day, I think people would be much more positive about the aspirin,” said one of the researchers, Dr James Howard.

Categories : Cardiovascular Disease Mental HealthTags :

‘Flight or Flight’ Brain Region Linked to Heart Disease

On By ModernMedia

Research on marmosets as reported in The Conversation has revealed the role that a region of the brain called sgACC plays in emotional arousal. Over-activity of sgACC was already associated with the dampening of pleasure and reward stimulus, seen in depression. 

A threat was presented to the marmosets in the form of a rubber snake and the marmosets were conditioned with a tone to create an association. The tone was later made without the snake to de-associate it from threat. The experimental group had over-activity induced in sgACC, the control group did not.

They found that marmosets who had not had sgACC over-stimulated responding normally to the de-association, calming down more quickly, but the over-activity group displayed fear and elevated blood pressure for much longer.

The over-activity of sgACC was also linked to abnormal heart function – increased heart rate and reduced variability in heart rate even at rest, without the presence of a threat.

Such changes reflect the presence of anxiety. The abnormal heart rates suggests that sgACC promotes the “flight or fight” response.
Brain imaging showed, with over-activity in sgACC, concurrent increased activity in the amygdala and hypothalamus, and reduced activity in the lateral prefrontal cortex, which is also seen in depression. Ketamine, a drug being investigated to treat depression, was shown to treat the depression aspects of sgACC over-activity, but in this case not anxiety – the marmosets remained fearful to stimulus.