WASHINGTON: A research team led by an Indian researcher has identified a key enzyme’s role in reducing heart disease which could pave way for new target therapies to reduce plaques in the arteries.

It is due to the formation of plaques in the coronary artery, which supplies blood to the heart, that heart diseases develop.

Plaques form when monocytes, which are cells from the blood, enter the wall of the artery and consume large amounts of the ‘bad’ cholesterol, or LDL. The monocytes then become artery-clogging foam cells.

For foam cells to get rid of their cholesterol is to by making it available to HDL, or ‘good’ cholesterol, for removal.

Cholesteryl ester hydrolase (CEH), a key enzyme present in the foam cells regulates the amount of cholesterol that can be removed by HDL.

A macrophage foam cell contained fat droplets that are surrounded by CEH showing how the enzyme associates itself with fat and releases cholesterol to be picked up by HDL.

The study led by Shobha Ghosh, Ph.D., an associate professor of internal medicine, researchers at the pulmonary division in the VCU School of Medicine examined, for the first time, how cells in the artery wall make cholesterol available for removal by HDL.

In the research transgenic mice were used which were fed a high fat and cholesterol-rich diet. Because of this, the team was able to show that by increasing the removal of cholesterol from the artery clogging foam cells, the mice with the human gene for CEH developed significantly less heart disease.

“Currently the emphasis for managing heart disease is on reducing the ‘bad’ cholesterol or LDL in the circulation. Our study demonstrates that if you can increase the removal of cholesterol from the plaques, even without changing the LDL levels, there is still a significant reduction in the plaques,” Ghosh said.

“These findings not only change the current thinking of managing heart disease but also clearly open avenues for the development of new therapies,” she said.

“By identifying CEH as a new therapeutic target, we expect that in the future patients with heart disease will have more options to aggressively treat heart disease. In addition, by determining the levels of CEH in human blood cells, we hope to be able to predict susceptibility to heart disease in the future,” she added.

The finding may also help in predicting a patient’s susceptibility to heart disease.

Ghosh said that in the study the efforts were on the examination of macrophage foam cells, which are responsible for storing large amounts of cholesterol and lead to the clogging of the arteries by forming plaques.

Source: The Times of India

People are drawn to vegetarianism by all sorts of motives. Some of us want to live longer, healthier lives or do our part to reduce pollution. Others have made the switch because we want to preserve Earth’s natural resources or because we’ve always loved animals and are ethically opposed to eating them.

Thanks to an abundance of scientific research that demonstrates the health and environmental benefits of a plant-based diet, even the federal government recommends that we consume most of our calories from grain products, vegetables and fruits. And no wonder: An estimated 70 percent of all diseases, including one-third of all cancers, are related to diet. A vegetarian diet reduces the risk for chronic degenerative diseases such as obesity, coronary artery disease, high blood pressure, diabetes and certain types of cancer including colon, breast, prostate, stomach, lung and esophageal cancer.

Why go veg? Chew on these reasons:

1. You’ll ward off disease. Vegetarian diets are more healthful than the average American diet, particularly in preventing, treating or reversing heart disease and reducing the risk of cancer. A low-fat vegetarian diet is the single most effective way to stop the progression of coronary artery disease or prevent it entirely. Cardiovascular disease kills 1 million Americans annually and is the leading cause of death in the United States. But the mortality rate for cardiovascular disease is lower in vegetarians than in nonvegetarians, says Joel Fuhrman, MD, author of Eat to Live: The Revolutionary Formula for Fast and Sustained Weight Loss. A vegetarian diet is inherently healthful because vegetarians consume no animal fat and less cholesterol and instead consume more fiber and more antioxidant-rich produce — another great reason to listen to Mom and eat your veggies!

2. You’ll keep your weight down. The standard American diet — high in saturated fats and processed foods and low in plant-based foods and complex carbohydrates — is making us fat and killing us slowly. According to the Centers for Disease Control and Prevention (CDC) and a division of the CDC, the National Center for Health Statistics, 64 percent of adults and 15 percent of children aged 6 to 19 are overweight and are at risk of weight-related ailments including heart disease, stroke and diabetes. A study conducted from 1986 to 1992 by Dean Ornish, MD, president and director of the Preventive Medicine Research Institute in Sausalito, California, found that overweight people who followed a low-fat, vegetarian diet lost an average of 24 pounds in the first year and kept off that weight 5 years later. They lost the weight without counting calories or carbs and without measuring portions or feeling hungry.

3. You’ll live longer. If you switch from the standard American diet to a vegetarian diet, you can add about 13 healthy years to your life, says Michael F. Roizen, MD, author of The RealAge Diet: Make Yourself Younger with What You Eat. “People who consume saturated, four-legged fat have a shorter life span and more disability at the end of their lives. Animal products clog your arteries, zap your energy and slow down your immune system. Meat eaters also experience accelerated cognitive and sexual dysfunction at a younger age.”

Want more proof of longevity? Residents of Okinawa, Japan, have the longest life expectancy of any Japanese and likely the longest life expectancy of anyone in the world, according to a 30-year study of more than 600 Okinawan centenarians. Their secret: a low-calorie diet of unrefined complex carbohydrates, fiber-rich fruits and vegetables, and soy.

4. You’ll build strong bones. When there isn’t enough calcium in the bloodstream, our bodies will leach it from existing bone. The metabolic result is that our skeletons will become porous and lose strength over time. Most health care practitioners recommend that we increase our intake of calcium the way nature intended — through foods. Foods also supply other nutrients such as phosphorus, magnesium and vitamin D that are necessary for the body to absorb and use calcium.

People who are mildly lactose-intolerant can often enjoy small amounts of dairy products such as yogurt, cheese and lactose-free milk. But if you avoid dairy altogether, you can still get a healthful dose of calcium from dry beans, tofu, soymilk and dark green vegetables such as broccoli, kale, collards and turnip greens.

5. You’ll reduce your risk of food-borne illnesses. The CDC reports that food-borne illnesses of all kinds account for 76 million illnesses a year, resulting in 325,000 hospitalizations and 5,000 deaths in the United States. According to the US Food and Drug Administration (FDA), foods rich in protein such as meat, poultry, fish and seafood are frequently involved in food-borne illness outbreaks.

6. You’ll ease the symptoms of menopause. Many foods contain nutrients beneficial to perimenopausal and menopausal women. Certain foods are rich in phytoestrogens, the plant-based chemical compounds that mimic the behavior of estrogen. Since phytoestrogens can increase and decrease estrogen and progesterone levels, maintaining a balance of them in your diet helps ensure a more comfortable passage through menopause. Soy is by far the most abundant natural source of phytoestrogens, but these compounds also can be found in hundreds of other foods such as apples, beets, cherries, dates, garlic, olives, plums, raspberries, squash and yams. Because menopause is also associated with weight gain and a slowed metabolism, a low-fat, high-fiber vegetarian diet can help ward off extra pounds.

7. You’ll have more energy. Good nutrition generates more usable energy — energy to keep pace with the kids, tackle that home improvement project or have better sex more often, Michael F. Roizen, MD, says in The RealAge Diet. Too much fat in your bloodstream means that arteries won’t open properly and that your muscles won’t get enough oxygen. The result? You feel zapped. Balanced vegetarian diets are naturally free of cholesterol-laden, artery-clogging animal products that physically slow us down and keep us hitting the snooze button morning after morning. And because whole grains, legumes, fruits and vegetables are so high in complex carbohydrates, they supply the body with plenty of energizing fuel.

8. You’ll be more “regular.” Eating a lot of vegetables necessarily means consuming more fiber, which pushes waste out of the body. Meat contains no fiber. People who eat lower on the food chain tend to have fewer instances of constipation, hemorrhoids and diverticulitis.

9. You’ll help reduce pollution. Some people become vegetarians after realizing the devastation that the meat industry is having on the environment. According to the US Environmental Protection Agency (EPA), chemical and animal waste runoff from factory farms is responsible for more than 173,000 miles of polluted rivers and streams. Runoff from farmlands is one of the greatest threats to water quality today. Agricultural activities that cause pollution include confined animal facilities, plowing, pesticide spraying, irrigation, fertilizing and harvesting.

10. You’ll avoid toxic chemicals. The EPA estimates that nearly 95 percent of the pesticide residue in the typical American diet comes from meat, fish and dairy products. Fish, in particular, contain carcinogens (PCBs, DDT) and heavy metals (mercury, arsenic, lead, cadmium) that can’t be removed through cooking or freezing. Meat and dairy products can also be laced with steroids and hormones, so be sure to read the labels on the dairy products you purchase.

11. You’ll help reduce famine. About 70 percent of all grain produced in the United States is fed to animals raised for slaughter. The 7 billion livestock animals in the United States consume five times as much grain as is consumed directly by the American population. “If all the grain currently fed to livestock were consumed directly by people, the number of people who could be fed would be nearly 800 million,” says David Pimentel, professor of ecology at Cornell University. If the grain were exported, it would boost the US trade balance by $80 billion a year.

12. You’ll spare animals. Many vegetarians give up meat because of their concern for animals. Ten billion animals are slaughtered for human consumption each year. And, unlike the farms of yesteryear where animals roamed freely, today most animals are factory farmed — crammed into cages where they can barely move and fed a diet tainted with pesticides and antibiotics. These animals spend their entire lives in crates or stalls so small that they can’t even turn around. Farmed animals are not protected from cruelty under the law — in fact, the majority of state anticruelty laws specifically exempt farm animals from basic humane protection.

13. You’ll save money. Meat accounts for 10 percent of Americans’ food spending. Eating vegetables, grains and fruits in place of the 200 pounds of beef, chicken and fish each nonvegetarian eats annually would cut individual food bills by an average of $4,000 a year.

14. Your dinner plate will be full of color. Disease-fighting phytochemicals give fruits and vegetables their rich, varied hues. They come in two main classes: carotenoids and anthocyanins. All rich yellow and orange fruits and vegetables — carrots, oranges, sweet potatoes, mangoes, pumpkins, corn — °©owe their color to carotenoids. Leafy green vegetables also are rich in carotenoids but get their green color from chlorophyll. Red, blue and purple fruits and vegetables — plums, cherries, red bell peppers — contain anthocyanins. Cooking by color is a good way to ensure you’re eating a variety of naturally occurring substances that boost immunity and prevent a range of illnesses.

15. It’s a breeze. It’s almost effortless these days to find great-tasting and good-for-you vegetarian foods, whether you’re strolling the aisles of your local supermarket or walking down the street at lunchtime. If you need inspiration in the kitchen, look no further than the Internet, your favorite bookseller or your local vegetarian society’s newsletter for culinary tips and great recipes. And if you’re eating out, almost any ethnic restaurant will offer vegetarian selections. In a hurry? Most fast food and fast casual restaurants now include healthful and inventive salads, sandwiches and entrées on their menus.

Source: Alternet

Canada’s leading health groups are urging food makers to slash sodium levels in processed foods from bread to frozen chicken nuggets to reduce an “epidemic” of high blood pressure gripping the country.

Forty-six per cent of women and 38 per cent of men over age 60 need to take blood pressure lowing drugs to prevent stroke, heart and kidney disease.

Lowering sodium consumption to healthy levels would reduce the number of Canadians with hypertension by almost one in three — or more than one million fewer hypertensives in the country, says Dr. Norm Campbell, of Blood Pressure Canada.

“The individual can only do so much and now more food companies have to step up,” says Dr. Kevin Willis, director of the Canadian Stroke Network. “If we discovered that a food additive was causing 30 per cent of all cancers, something would be done right away. The same action is needed with sodium to prevent stroke, heart disease and other vascular illnesses.”

Federal Health Minister Tony Clement Thursday announced the creation of a sodium working group to look at ways to cut sodium additives in foods.

Most Canadians consume more than twice the healthy level of dietary sodium, Senator Wilbert Keon told an Ottawa news conference, “the bulk of which is in products like breads, cereals, soups, processed foods and fast foods.”

“The result is an epidemic of high blood pressure that leads to strokes, heart disease, kidney disease and other chronic conditions.”

And it’s not just adults who have to worry, experts say. Recent evidence shows sodium is harmful to children, causing high blood pressure and damage to blood vessels.

“In my own work as a heart surgeon I’ve seen the impact of a poor diet on diseased and damaged hearts,” Keon said.

The coalition of 17 health groups, which includes the Canadian Stroke Network, Heart and Stroke Foundation of Canada and the Canadian Medical Association, is urging the federal government to set graduated targets for sodium levels and to track and report on progress by 2012 and 2016.

They also want Canadians educated on the health risks of high dietary sodium and how to reduce consumption by reading labels, choosing fresh food over processed food and keeping the salt shaker off the kitchen table.

Source: Canada.com

An increasing evidence shows a link between gum disease and heart disease.

A French study, reported just last month at the Congress of the European Society of Cardiology, has shown that the more severe the periodontal (gum) disease, the more widespread the damage to the arteries.

It’s not yet known how gum disease might trigger heart disease, but there’s a suggestion that bacteria released from infected gums may enter the bloodstream where they activate the immune system causing inflammation and narrowing of the blood vessels.

Bacteria also cause tooth decay. They collect on and between the teeth as dental plaque, and react with sugars in our diet to destroy the tooth enamel. The result: is inflammation, cavities, root canal infection and gum disease.

The role of fluoride in preventing tooth decay is well established - whether that fluoride comes from fluoridated water or from pastes, mouthwashes or gels. Dental fluorosis, mottling or marks on the teeth from excessive fluoride intake, is rare but occasionally occurs in children at the time of the formation of tooth enamel if the children swallow too much fluoride from either pastes or supplementation.

So parents should clean their infants’ teeth with just a soft brush - no toothpaste; and for older children, up to the age of six years, the tooth pastes specially formulated for children (containing a low concentration of fluoride) should be used.

For a truly adult experience at cleaning teeth you can’t go past the power brushing technology provided by the pulsating, vibrating, rotating, oscillating brush heads at the end of an electric or battery operated toothbrush such as the Oral B. They’re proven to be more effective at reducing and removing plaque.

Gum disease is very common. Generally it can be managed by reasonable attention to oral hygiene; but recurrent or ongoing gum disease may be indicative of a serious underlying cause.

Gingivitis is the name given to inflammation of the gums. Periodontitis is a more severe form of gingivitis when the connective tissue around the teeth is progressively destroyed. Apart from lack of attention to tooth and gum care, other factors which might frequently cause or worsen these conditions are common mouth infections, such as oral thrush, more serious infections (such as HIV) where the immune system is compromised, poorly controlled diabetes, smoking and certain medicines, notably: phenytoin, cyclosporin and the calcium channel blocker blood pressure medicines.

Medicines are also a major, possibly the most common, cause of dry mouth known medically as xerostomia.

As we get older, all our body secretions are reduced in both quantity and quality. We get dry skin, dry eye and we’re more likely to have dry mouth. When taking a few medicines as well, then dry mouth becomes a strong probability.

Antidepressants are among those most commonly implicated, but the list of possible offenders also includes some non-prescription medicines such as antihistamines (particularly the older, more sedating antihistamines) and the so-called anticholinergic medicines used for stomach cramp. The high dose codeine-containing pain relievers might also be a problem for some people.

There are a number of useful products for the treatment of dry mouth - mouth sprays, mouthwashes, gels and toothpastes. Pharmaceutical Society’s Self Care health information program has a fact card titled Dry Mouth which offers suggestions on how to avoid this condition.

The Mouth Ulcers card is another useful fact card. It explains the likely causes and the possible `cures’. Local trauma is often the reason for a mouth ulcer - maybe from a hard bristle toothbrush, dentures or some other form of orthodontic appliance.

Use of the chlorhexidine mouthwashes, the analgesic/local anaesthetic gels (with lignocaine or choline salicylate) or the anti-inflammatory gels, sprays or solutions containing benzydamine (Difflam) are all quite useful. Kenalog in Orabase contains a corticosteroid in a protective paste and may produce more rapid healing - it’s a pharmacist-only product, so if recurrent mouth ulcers are a problem ask your pharmacist for advice.

Source: Toronto Daily News

It is well known that physical activity can improve cardiovascular health. But it’s the impact exercise has on specific known risk factors that accounts for about 60 percent of that improvement, researchers reported in Circulation: Journal of the American Heart Association.

In a major study of over 27,000 women in the Women’s Health Study, researchers assessed a variety of risk factors and different levels of exercise in women who were followed for 11 years for new diagnosis of heart attack and stroke.

“Regular physical activity is enormously beneficial in preventing heart attack and stroke,” said Samia Mora, M.D., lead author of the study and instructor of medicine at Harvard Medical School in the divisions of preventive and cardiovascular medicine at Brigham and Women’s Hospital, Boston Mass. “We found that even modest changes in risk factors for heart disease and stroke, especially those related to inflammation / hemostasis and blood pressure, can have a profound impact on preventing clinical events. This study is the first to examine the importance of a variety of known risk factors in explaining how physical activity prevents heart disease and stroke.”

The women ranged from 45 to 90 years old (average age 55) and were assessed for a full range of risk factors and different levels of exercise. There was a 40 percent reduction in heart attack and stroke between the highest and lowest exercise groups. The women self-reported physical activity, weight, height, hypertension and diabetes.

The long-term benefits of exercise start at a relatively low level, 600 kilocalories per week, equivalent to about two hours of physical activity per week, Mora said.

The study measured levels of a variety of traditional and novel risk factors to help understand the mechanisms that reduce risk for heart attack and stroke. Novel risk factors are emerging clinical, biochemical, and genetic markers that researchers have studied in order to better understand the development of a disease, to improve disease risk prediction, and to identify new targets for treatment.

Inflammatory and hemostatic biomarkers — fibrinogen, C-reactive protein and intracellular adhesion molecule-1 — together made the largest contribution to lower risk, 33 percent.

Blood pressure was the next major contributor to lower risk, 27 percent, followed by lipids, body mass index, glucose abnormalities, with minimal contribution from measures of renal function or homocysteine.

Inflammatory and hemostatic biomarkers are novel risk factors that relate to blood vessel function and inflammation of the arteries.

“Inflammatory and hemostatic factors as a group have overlapping functions and roles and, in our study, had the biggest effect in mediating exercise-related cardioprotection, more so than blood pressure or body weight,” Mora said. The study population was divided into four groups by levels of exercise:

* The highest level expended greater than or equal to 1,500 kilocalories per week (kcal/week) representing greater than five hours of moderately intense physical activity (such as brisk walking) per week.
* The next group expended from 600 to 1,499 kcal/week which reflected about two to five hours of physical activity per week.
* A third group represented an expenditure of 200 to 599 kcal/week, which is about one to two hours of physical activity per week.
* The reference group had less than 200 kcal per week (less than one hr per week).

The risk of cardiovascular disease events decreased with higher levels of physical activity. Compared to the reference group, relative risk reductions were associated with — 1,500, 600 to 1,499, 200 to 599 kcal/wk of 41 percent, 32 percent and 27 percent, respectively.

The American Heart Association does not recognize the inclusion of inflammatory and hemostatic biomarkers as risk factors in assessing cardiovascular disease because they have yet to be clinically proven.

Source: Science Daily

ONE of the biggest risk factors with heart problems is ageing, but lifestyle factors such as smoking or stress also result in many people in their early 40s succumbing to fatal heart attacks.

Director of the Baker Heart Research Institute Garry Jennings said death rates increased strongly with age but it was not unusual to see people in their early 40s die from heart attack.

“This is not so uncommon and about half the people who get heart disease die suddenly,” Professor Jennings said.

“The rates increase with age so it’s uncommon to see people in their 20s, but we see quite a few people in their 30s and 40s just start to get into the coronary-prone age group.”

About one in five Australians with cardiovascular disease are aged 35 to 44, he said.

While John Ilhan was described as being a fit 42-year-old, he was a former smoker and was believed to have only given up in recent months. Smoking was a key factor in the early onset of heart problems.

“The one that really stands out when people come along in their 20s, 30s and early 40s is smoking, particularly with fatal heart attacks,” Professor Jennings said. “Having given up smoking reduces your risk considerably and that risk disappears fairly quickly, but it doesn’t go immediately and it doesn’t go back all the way of someone who has never smoked.”

Life stresses are a factor as well in that they may influence unhealthy behaviour.

“They also seem to be more important in turning a small heart attack into a big heart attack or a fatal one,” he said.

Australian death rates from heart disease, stroke and vascular conditions are 250 a year per 100,000 people, Professor Jennings said. They kill more Australians than any other disease, with high blood pressure and cholesterol the other major factors in the disease.

For 35 to 44-year-olds death rates are 80 per 100,000 and that increases slightly to 83 deaths per 100,000 for 45 to 54-year-olds, he said. Death rates jump for the 55 to 64-year-old bracket to 226 deaths per 100,000 and then to 718 deaths per 100,000 for the 65 to 74-year-old bracket.

Associate professor Bronwyn Kingwell, an expert at the Baker in heart problems and exercise, warned that taking up vigorous exercise was another risk factor.

“You shouldn’t start an exercise program unless you’re used to regular exercise, particularly as you get older,” she said.

“You should visit a doctor and make sure all your risk factors are under control for heart disease, and that includes your blood pressure and cholesterol.”

When starting a new exercise program it was important to start slowly, she said.

The risk of heart attack during exercise was related to the intensity of the exercise. “How much you’re sweating, how much you’re puffing, so to reduce that risk you want to keep the intensity of that exercise down.”

Despite those risks it was unusual for heart failure to occur during exercise. “It shouldn’t dissuade people from undertaking regular exercise as it does actually reduce your risk of heart disease,” she said.

Source: The Age

Eating whole grain cereals has already shown promise for lowering blood pressure and warding off heart attacks, but it may also significantly reduce the risk of heart failure, U.S. researchers said on Monday.

They found that men who ate a bowl a day of whole grain cereal had a 28 percent lower risk of developing heart failure over a 20-year study.

“Eating half a cup to a cup of whole grain breakfast cereal may help lower your blood pressure. It may help lower your risk of diabetes and heart disease,” said Dr. Luc Djousse of Brigham and Women’s Hospital and Harvard Medical School in Boston.

“This study adds another piece to the puzzle. It may also lower your risk of heart failure,” Djousse, whose study appears in the Archives of Internal Medicine, said in a telephone interview.

Around 5 million people in the United States have heart failure, and about 550,000 new cases of the chronic heart condition are diagnosed each year, according to the U.S. Centers for Disease Control and Prevention. Each year 287,000 people die with heart failure, the CDC says.

Djousse and colleagues studied the breakfast habits of more than 21,000 male doctors with an average age of 53.7 years for nearly 20 years.

A bowl a day
Men in the study tracked their cold cereal intake with questionnaires, and the researchers also tracked new cases of heart failure on an annual basis. Cereals with at least 25 percent whole grain or bran by weight were classified as whole grain.

Over the course of the study, 1,018 of the men had heart failure. Most new cases were in the men who ate no whole grain cereals — 362 cases of heart failure out of nearly 7,000 participants.

Those who ate at least one bowl a day of whole grain cereal had the lowest incidence of heart failure, with 189 cases out of more than 4,000.

Source: MSNBC

Amid the welter of often-conflicting diet and health advice, it can be difficult to figure out what constitutes a healthful diet and lifestyle — especially when it comes to preventing heart disease. Should one go low-fat or avoid alcohol while doubling up on soy foods? How much exercise is enough, and should it be aerobic or strength training? A new report in the Archives of Internal Medicine (Akesson, A, et al., Combined effect of low-risk dietary and lifestyle behaviors in primary prevention of myocardial infarction in women. Arch Intern Med. 2007; 167:2122-2127) goes a long way towards clarifying some of the answers, and along the way supports what mainstream science has been telling us for years.

Akesson and colleagues at the Swedish Karolinska Institute used data provided by over 24,000 post-menopausal Swedish women (mean age was approximately 59) to ascertain their dietary patterns, activity levels, and other lifestyle factors (e.g., smoking, alcohol consumption). At the start of the study, all were free of cardiovascular disease and diabetes, and had not been diagnosed with cancer. The women’s health status was followed for a little over six years.

Participants were divided into five groups, depending on the extent to which their diets and lifestyles approximated a “healthy dietary pattern” score. Those in the highest group (i.e, with the best dietary and lifestyle score) typically were the least likely to smoke, walked for more than forty minutes per day and exercised at least one hour per week, and on average drank about six grams of alcohol per day (for comparison, a standard drink of 5 oz. of wine, 12 oz. of beer, or 1.5 oz. of 80-proof distilled spirits contains 14 grams of alcohol). Compared to the other groups, these women ate twice as many vegetables, more fruits and slightly more red meat and whole grains. They also consumed more fiber, folate, vitamins C and E (a consequence of their high intake of vegetables, no doubt) than women in the other groups.

As one might expect, the risk of heart attacks in the group following the healthiest lifestyle compared to the group least compliant with these attributes was much lower — by an astonishing 92%. Even when the most compliant group was compared with all the other groups combined, they still had a 78% lower risk of heart attacks.

Impressive as these results are, it’s important to note that only about 5% of the women in the study actually had been adhering consistently to the lowest-risk lifestyle. The authors suggested that increasing the prevalence of such a lifestyle could substantially decrease the occurrence of heart attacks — at least in post-menopausal women.

Source: SCSH

Cigarette makers tried to undermine evidence that secondhand smoke causes cardiovascular disease, according to a review by a UC Davis physician of scores of once-secret tobacco industry documents.

The report published Monday in the American Heart Association journal Circulation discredits research paid for by the tobacco industry as attempts to put corporate viability above public health and to downplay scientific findings on the role of secondhand smoke in heart disease.

The report – by Eliza Tong of UC Davis and Stanton Glantz, a longtime tobacco researcher at UC San Francisco – also discusses how the industry used questionable research to promote what are allegedly less harmful cigarettes.

“This special report exposes the deceitful practices of the tobacco industry in its attempts to fight smoke-free regulations and serves as an eye-opener for the public health community and the federal government as the ‘reduced harm product’ debate picks up steam,” M. Cass Wheeler, CEO of the American Heart Association, said in a prepared statement.

David Sutton, a spokesman for Phillip Morris USA, said he couldn’t comment specifically about the report, but he acknowledged that public health officials have linked secondhand smoke with disease.

“We believe the public should be guided by the conclusion of public health officials regarding the effect of secondhand smoke in deciding whether to be in places where it is present,” Sutton said, “or, if they are smokers, when and where they should smoke around others.”

Sutton stressed that Phillip Morris continues to research ways to reduce the health risks from smoking, creating a $350 million center for research and technology in Richmond, Va.

The scientific consensus is that frequent exposure to secondhand smoke increases the risk of cardiovascular disease by 30 percent.

Health concerns have driven efforts nationwide to ban smoking in many public places, including restaurants, bars and other workplaces.

California has some of the most stringent anti-smoking laws in the country and boasts some of the nation’s lowest rates of smoking and smoking-related diseases. Gov. Arnold Schwarzenegger last week signed legislation to ban smoking in vehicles carrying children.

The review in Circulation represents the first time researchers have have looked at how tobacco companies funded and used scientific studies that tied environmental tobacco smoke to heart and artery disease.

The review of nearly 5,000 internal tobacco industry documents – made public during legal proceedings in recent years – found 47 that specifically took up the subject of heart disease.

Glantz said that while most people associate secondhand smoke with cancer risk, heart disease is far more prevalent among those exposed to tobacco smoke.

“The effects on blood and the heart and vascular system occur very, very quickly” he said, “and you get big drops in heart attacks immediately when you put smoke-free policies in place.”

Glantz and Tong said the tobacco industry suppressed research with negative findings about environmental exposure to tobacco smoke.

A 1995 industry-funded study, for example, in which people were subjected to seven hours of secondhand smoke found significant adverse effects.

Study participants experienced decreased lung function, and increased levels of bad cholesterol and lower levels of good cholesterol. Blood tests also revealed inflammatory markers, which are used to identify people at high risk for cardiovascular problems.

Those findings, however, were not published completely, and industry scientists attributed all of the significant adverse effects to stress related to the tobacco smoke odor and not to the toxicity of the tobacco smoke itself.

In another case, when an industry-paid researcher found that secondhand smoke contributes to clogged arteries, an industry executive later criticized the work in a major medical journal and the industry discontinued funding for it.

The researchers found other examples in which tobacco-funded studies labeled certain study subjects as nonsmokers when they actually were “passive smokers” because they were being exposed to secondhand smoke.

Glantz and Tong said the misclassification skewed the study results against finding a link between exposure to secondhand smoke and heart disease risk.

The researchers suggest the tobacco industry has an established pattern of countering legitimate scientific data on the dangers of tobacco smoke exposure and promoting less damning results when it suits their corporate interests.

“I think they are still trying to frame the issue to minimize the risks,” said Tong. “Secondhand smoke does cause cardiovascular disease, and any research by tobacco industry should be treated with skepticism.”

Source: Sacbee

While aspirin has been found to reduce the risk of heart attack by a quarter, recent research has found that women are less likely to benefit from the drug than men.

The protective effect of aspirin (acetylsalicylic acid) against myocardial infarction (heart attack) has been found to vary wildly from clinical trial to clinical trial, with the reduction in risk of heart attack ranging from 0 to 50 per cent.

New research from the University of British Columbia’s (UBC) James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research in Canada has found that a considerable proportion (27 per cent) of this dramatic variation can be accounted for by considering the genders of those participating in the studies.

The study, published in the journal BMC Medicine, found that women were less likely to benefit from taking the drug to prevent heart attack.

“Trials that recruited predominantly men demonstrated the largest risk reduction in non-fatal heart attacks,” said Dr Don Sin, associate professor at UBC and one of the authors of the study.

“The trials that contained predominately women failed to demonstrate a significant risk reduction in these non-fatal events. We found that a lot of the variability in these trials seems to be due to the gender ratios, supporting the theory that women may be less responsive to aspirin than men for heart protection.”

Aspirin irreversibly inhibits the COX-1 enzyme while modifying the activity of COX-2 to produce anti-inflammatory lipoxins rather than the pro-inflammatory prostanoids.

In addition, low-dose, long term aspirin use has been shown to irreversibly block the formation of thromboxane A2, inhibiting platelet aggregation and reducing the risk of heart attacks.

The researchers note that no clear mechanism has yet been found to explain why women demonstrate higher levels of resistance to the heart attack reducing properties of the drug than men.

However, they do suggest that major structural and physiological differences in the coronary vasculature of men and women could play a role in the differing responses.

Women have smaller coronary vessels than men that are also stiffer due to increased deposition of fibrotic tissue of the vessel walls.

In addition, women are more likely to demonstrate impaired responses to vascular dilators such as acetylcholine.

“From our findings we would caution clinicians on the prescribing aspirin to women, especially for primary prevention of heart attacks,” says Dr Sin.

“Whether or not other pharmaceutical products would be more effective for women is unclear; more sex-specific studies should now be conducted.”

Whether gender could play a role in the efficacy of other drugs is, as yet, unknown.

However, these results raise the question as to whether gender specific drugs could play a part in the personalisation of medicine.

Source: Drug Researcher