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Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
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Diabetes Study Ends Early With a Surprising Result

Diabetes Study Ends Early With a Surprising Result | Heart and Vascular Health | Scoop.it
Diet and weight loss did not prevent heart attacks and strokes in overweight and obese people with Type 2 diabetes.

A large federal study of whether diet and weight loss can prevent heart attacks and strokes in overweight and obese people with Type 2 diabetes has ended two years ahead of schedule because the intensive program did not help.  Many have assumed diet and exercise would help, in part because short-term studies had found that those strategies lowered blood sugar levels, blood pressure and cholesterol levels. Still, medical experts said there were many benefits to diet and exercise even if they did not reduce cardiovascular disease in people with diabetes.

About 25 million Americans have Type 2 diabetes. Many are overweight or obese. On average, the disease increases heart disease risk by 2 to 2 ½ times.  Study randomly assigned 5,145 overweight or obese people with Type 2 diabetes to either a rigorous diet and exercise regimen or to sessions in which they got general health information. The diet involved 1,200 to 1,500 calories a day for those weighing less than 250 pounds and 1,500 to 1,800 calories a day for those weighing more. The exercise program was at least 175 minutes a week of moderate exercise.

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Get Up. Get Out. Don't Sit.

Get Up. Get Out. Don't Sit. | Heart and Vascular Health | Scoop.it

Two new studies make a convincing case that sitting too much will shorten your life.

The research adds to a growing scientific consensus that the more time someone spends sitting, especially in front of the television, the shorter and less robust his or her life may be.

Thankfully, excessive sitting is theoretically easy to combat. First, cut TV time. “The evidence indicates that four hours per day is in the ‘risky’ category,”  “while less than two hours per day is in the lower-risk group.”

Then look to the rest of your day. When group of volunteers were asked recently to reduce their daily sitting time by an hour, “they came up with lots of ideas,”  including “putting the garbage bin on the other side of the office, standing during coffee breaks and telephone calls, having standing meetings, standing on the bus.”

“There is absolutely no doubt that exercise is beneficial for health,”  It just may not, by itself, be sufficient for health. If you exercise for 30 minutes a day, she says, “take time to reflect on your activity levels for the remaining 23.5 hours,” and aim to “be active, sit less.”

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Laura Richards's curator insight, March 25, 2015 8:00 PM

'4 hours sitting puts you in the 'at risk category' - just sitting at my desk blows that one off the radar yet alone in front of a television screen....

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Multivitamins Modestly Lower Cancer Risk

Multivitamins Modestly Lower Cancer Risk | Heart and Vascular Health | Scoop.it

Daily use of a common multivitamin modestly reduced the risk for cancer in a long-term study of nearly 15,000 men.

Researchers cautioned the reduction in risk in the new study was small and that the mainstay prevention strategies against the disease remained quitting smoking, avoiding obesity, eating a healthy diet and keeping physically active.

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School Nutrition Changes in Massachusetts - Andover's Effort

School Nutrition Changes in Massachusetts - Andover's Effort | Heart and Vascular Health | Scoop.it

As a part of the effort to improve children’s health in Massachusetts, the State Legislature asked the Massachusetts Departments of Public Health and the Department of Elementary and Secondary Education to develop nutrition standards for our public schools. The new standards refer to the nutritional content of food and were developed by health and education experts using guidelines from the Institute of Medicine.
These nutrition standards apply to “competitive” foods and drinks provided in public schools during the school day, including thirty minutes before and thirty minutes after the school day ends. Competitive foods and drinks do not apply to school breakfast/lunch programs as they are regulated by the United States Department of Agriculture (USDA). These standards do, however, apply to classrooms, hallways, school grounds, school stores, snack bars, vending machines, concession stands, booster sales and fundraisers, school sponsored or related events, classroom parties, student councils and club activities that occur during the school day.  See the “At-A-Glance” summary of the nutrition standards. 

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Darby Whitehair's curator insight, December 20, 2013 7:54 PM

This is a quick glance at the snack food allowed in Andover Schools in Mass. I find this extremely interesting. I know that when I was in elementary school our teachers were allowed to bring in candy, food whatever they want and give it to us. Then near fifth grade they were told that anything they brought had to be prepackaged. One of our substitutes was told she was no longer allowed to bring in jolly ranchers her staple item of substitituing. I can understand why the school system wants to make sure students are getting proper nutrition. However, I find it extremely interesting that this just involves snacks because the school lunch and breakfast is approved by the USDA. I didn't know that, I thought each school system made their own decison. It makes me wonder if every kid in America is eating the same variation of a lunch.

 

 

 

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CDC Report = Deaths: Preliminary Data for 2011

Death rates dropped significantly last year for five out of the 15 leading causes of death in US. But the average American’s life expectancy remained the same at 78.7 years from 2010 to 2011.

Top 10 Causes of Death (% change from 2010 to 2011):

Heart disease (-3%) Cancer (-2.4%) Chronic lower respiratory diseases, including chronic obstructive pulmonary disease, emphysema, and bronchitis (+1.2%) Stroke (-3.1%) Accidents or unintentional injuries (unchanged) Alzheimer’s disease (-2%) Diabetes (+3.4%) Influenza and pneumonia (+4%) Kidney-related diseases, including nephritis, nephrotic syndrome, and nephrosis (-12.4%) Suicide (-0.8%)

see also Medscapes review: http://www.webmd.com/healthy-aging/news/20121010/death-rates-drop-5-top-causes-death

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Can You Do Too Much to Prevent a Stroke?

Can You Do Too Much to Prevent a Stroke? | Heart and Vascular Health | Scoop.it
Too many people who are free of symptoms associated with stroke are undergoing surgery to clear carotid arteries, or are having stents inserted, than is justified by available evidence, experts say.

Stroke is the fourth leading cause of death among Americans, and a much larger contributor to chronic disability and health care costs than this ranking suggests. There’s no question that preventing strokes is important. But a big question is how best to do so and in whom.

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New Push to Tailor Treatment for High Blood Pressure

New Push to Tailor Treatment for High Blood Pressure | Heart and Vascular Health | Scoop.it

Blood Pressure Myths and Facts

MYTH: High blood pressure is hereditary.

FACT: While heredity increases the risk of developing high blood pressure, many people with no family history also develop it.

MYTH: The only way to control high blood pressure is with medications.

FACT:: About half of adults with high blood pressure can control it with lifestyle changes including weight loss, exercise, avoiding tobacco and limiting intake of salt, alcohol and caffeine.

MYTH: I don't use table salt, so my blood pressure isn't affected.

FACT: Most sodium consumption comes from processed foods like tomato sauce, soups, condiments, canned foods and prepared mixes. Look for 'soda' and 'sodium' and the symbol 'Na' on labels, which show sodium compounds are present. Using kosher or sea salt doesn't make a difference; chemically they are the same as table salt.

MYTH: I feel fine. I don't have to worry about high blood pressure.

FACT: A third of American adults have high blood pressure—and many of them don't know it or don't experience typical symptoms. If uncontrolled, high blood pressure can lead to severe health problems, and is the No. 1 cause of stroke.

MYTH: My doctor checks my blood pressure so I don't have to do it at home.

FACT: Blood pressure can fluctuate so home monitoring can help your doctors determine whether you really have it and, if you do, whether your treatment plan is working.

MYTH: People with high blood pressure have symptoms such as nervousness, sweating, difficulty sleeping and facial flushing. If I don't have symptoms I don't have high blood pressure.

FACT: High blood pressure is often called 'the silent killer' because it has no symptoms, so patients may not be aware that it is damaging arteries, heart and other organs.

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Who's responsible when social media violates patient privacy?

Who's responsible when social media violates patient privacy? | Heart and Vascular Health | Scoop.it

Despite a hospital's best efforts to protect patient privacy, sometimes it only takes one person with a smartphone to take a video and upload it to YouTube. Then all bets are off.

We recently stumbled upon footage of an intoxicated man in our trauma center that was videotaped by another patient. The good news is the video put our staff members in an incredibly positive light, being caring and compassionate. The bad news is the patient's privacy was violated.

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Candy at the Cash Register — Obesity & Chronic Disease Risk Factor

Candy at the Cash Register — Obesity & Chronic Disease Risk Factor | Heart and Vascular Health | Scoop.it

A basic misconception has stymied our response to the obesity epidemic: the belief that food-related decisions are consciously and deliberately made. Our reluctance to interfere with or regulate the food environment is a direct consequence of the belief that people's food choices reflect their true desires. However, given the large proportion of people who claim that they want to lose weight and the small proportion who are actually able to do so, we must concede that human behavior doesn't always conform with professed goals. The reality is that food choices are often automatic and made without full conscious awareness. Placement of foods in prominent locations increases the rate at which they're purchased; purchase leads to consumption; and consumption of foods high in sugar, fat, and salt increases the risks of chronic diseases.  Although placement is a factor that is right in front of our noses, we should consider treating it as a hidden risk factor, like carcinogens in water, because placement influences our food choices in a way that is largely automatic and out of our conscious control and that subsequently affects our risk of diet-related chronic diseases.

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BCHS- Alyssa Snyder's curator insight, February 26, 2013 4:04 PM

Many people believe it is their choice conciously of what they will buy and eat that night for their dinner. Sometimes it isnt, it could possibly be a subconcious decision made when we go to a store and look at the candy surrounding a cash register. Due to the placing of the sweet and sugar-rich foods, we are chosing them more than the nutrisous foods past generations would chose. Many things effect our eating ehaviour though, such as commercials, placings of food, whic many people would not think of as a major thing for chosing food, and also what our parents usually buy. We can prevent this by avoiding those aisles that have suh=gary foods or foods that are attractive to us located in them.

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Risk of coronary heart disease is associated with triglycerides and high-density lipoprotein cholesterol in women

Risk of coronary heart disease is associated with triglycerides and high-density lipoprotein cholesterol in women | Heart and Vascular Health | Scoop.it

The graded risk for patients is well shown in these charts.  The cut point for the HDL for women is less than 50 and for men les than 40. The triglyceride cutpoint is 150 for both men and women.

The bars are very steep for women (on the left).  Blue is the patients with both good level of HDL & triglyceride.  The purple bar is for patients with both levels in an undesitrable range.  For women the incidence is 2.4 for every 1000 person years in the best group and 13.4 in the worst group.

These parameters diffentiate risk for men less well (low rate of 13.1 and high rate of 22.1)

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Tomatoes for Stroke Prevention?

Tomatoes for Stroke Prevention? | Heart and Vascular Health | Scoop.it

My comment:  Another data point adding to the recommendation for 5 fruits and vegetables daily.  DON'T take some nutritional supplement - eat your veggies!

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Lycopene, which is found in high concentrations in tomatoes and tomato-based products, may lower stroke risk in men, researchers found. "Foods such as tomatoes, guava, watermelon, and grapefruit are good sources of lycopene,"  "When a tomato is cooked, the heat processing actually increases the levels of cis-lycopene, which is easily absorbed by the body."

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Pepsi and Coke to Post Calories of Drinks Sold in Vending Machines

Pepsi and Coke to Post Calories of Drinks Sold in Vending Machines | Heart and Vascular Health | Scoop.it

The two big soda companies, often criticized for producing drinks that are too sugary, will post the figures first in San Antonio and Chicago and later nationwide.  The program, which will add calorie counts and more low-calorie and no-calorie drinks to vending machines, will first appear in municipal buildings in Chicago and San Antonio early next year. It represents the latest effort by the industry to head off mounting criticism of its products as one of the chief villains responsible for the nation’s obesity crisis.

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Steve Kingsley's curator insight, May 29, 2013 10:26 PM

High time they did!

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The Ups and Downs of Electronic Medical Records - The Digital Doctor

The Ups and Downs of Electronic Medical Records - The Digital Doctor | Heart and Vascular Health | Scoop.it

Electronic record systems can make health care more efficient and less expensive, but their potential for mistakes and confusion can be frustrating, costly and even dangerous.

The government has given $6.5 billion in incentives, and hospitals and doctors have spent billions more.  “The current information tools are still difficult to set up. They are hard to use. They fit only parts of what doctors do, and not the rest.”  Mayo Clinic, which treats more than a million patients a year, has serious unresolved problems after working for years to get its three major electronic records systems to talk to one another.

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5 Common workout mistakes

5 Common workout mistakes | Heart and Vascular Health | Scoop.it

For most people, unless you continually educate yourself on how to properly train for your goals, it can be hard to know if what you’re doing is correct or effective. Here are five common errors that a lot of people make in the gym and suggestions on how to rectify them:

1. Not having a plan

2. Limiting your tools

3. Sticking to the same routine:

4. Disregarding proper form:

5. Neglecting mobility and flexibility:

 

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delia thompson's curator insight, October 20, 2014 8:00 PM

Are you working out effectively?

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5 Foods That Fight Heart Disease

5 Foods That Fight Heart Disease | Heart and Vascular Health | Scoop.it

While losing excess weight, reducing saturated fat in the diet, and partaking in daily physical activity are all key to lowering your risk of heart disease, adding heart-healthy foods to your diet can also help.

Here are 5 foods that are deliciously good for your heart: Beans, Oats, Nuts, Fish, Whole Grains.

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U.S. Ties Hospital Payments to Making Patients Happy

U.S. Ties Hospital Payments to Making Patients Happy | Heart and Vascular Health | Scoop.it

My commnet:  CMS will punish hospitals for readmissions and low patient satisfaction.  Hospitals with patient populations that are underserved (poor, minorites) will bear the brunt  and be put in jeopardy.

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Hospitals are making changes to improve patient satisfaction in response to a shift in how the federal government pays hospitals for treating people on Medicare.

At Grady Memorial Hospital here, doctors are being taught to stop interrupting patients while they are speaking. Nurses recently got hand-held phones so patients can reach them instantly. New bedside comforts include cable sports channel ESPN and a menu featuring wild salmon.

Grady is making these changes in response to a shift in how the federal government pays hospitals for treating people on Medicare, the federal health-care program for seniors. Dr. Michael Frankel, director of Grady's stroke center Nearly $1 billion in payments to hospitals over the next year will be based in part on patient satisfaction, determined by a 27-question government survey administered to patients. Hospitals with high scores will get a bonus payment. Those with low ones will lose money. 

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Avoid Unnecessary Procedures

Avoid Unnecessary Procedures | Heart and Vascular Health | Scoop.it

The test results are in: You probably need fewer tests. For example, in May the US Preventive Services Task Force, an independent group of experts, declared that the PSA blood test to screen for prostate cancer should no longer be done: It doesn’t lower death rates, and treatment can have nasty side effects. “The health care field really promoted screening and prevention,” USPSTF chair Virginia Moyer says. “And it caught on without people recognizing that there are downsides.” So do you do whatever the group says? Or do you seek out a second opinion? The answer depends on who you are..

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Open Season on Salt: What the Science on Hypertension Really Shows

Open Season on Salt: What the Science on Hypertension Really Shows | Heart and Vascular Health | Scoop.it

My comment:  This article does a good job explaing that the short term risk of high salt intake is being exaggerated in kids. BUT as an adult cardiologist I can attest to many patients who strugle with this in their mid life.  By acquiring a taste (and compulsion) for salty foods may patients suffer lasting and difficult consequences on the  cardiovascular system including congrestive heart failure and kidney disease.  Changing their taste buds is often a major challenge for disease management becasue of what has been learned early in life

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The latest news reports about salt are enough to make a parent ponder a household ban on pizza and cold cuts. A study published last week in Pediatrics found that children eat, on average, 3.4 grams of sodium daily—more than twice the amount recommended for adults by the Institute of Medicine.

 

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Ideal Cardiovascular Health & Mortality - we are not ideal

Ideal Cardiovascular Health & Mortality - we are not ideal | Heart and Vascular Health | Scoop.it

Mycomment: We continue to do poorly in these seven ideal cardiovascular strategies.  

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Using the AHA definition of ideal cardiovascular health, Mayo investigators classified the level of each cardiovascular health metric at baseline as ideal, intermediate, or poor

The seven parameters are: 

Smoking
Body mass index
Physical activity
Healthy diet 
Total cholesterol
Blood pressure, mm Hg SBP ≥140 or DBP ≥90
Fasting plasma glucose, mg/dL ≥126

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Chocolate Consumption, Cognitive Function & Nobel Laureates

Chocolate Consumption, Cognitive Function & Nobel Laureates | Heart and Vascular Health | Scoop.it

My comment:  It has been known for sometime that Chocolate makes your clothes shrink, but this interesting relationship between chocolate consumption and Nobel laureates helps us remember to be cautious in attributing causal relationships between observed factors.  What would be most interesting is if the Nobel winners themselves ate chocolate.

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There was a close, significant linear correlation (r=0.791, P<0.0001) between chocolate consumption per capita and the number of Nobel laureates per 10 million persons in a total of 23 countries. When recalculated with the exclusion of Sweden, the correlation coefficient increased to 0.862. Switzerland was the top performer in terms of both the number of Nobel laureates and chocolate consumption. The slope of the regression line allows us to estimate that it would take about 0.4 kg of chocolate per capita per year to increase the number of Nobel laureates in a given country by 1. For the United States, that would amount to 125 million kg per year. The minimally effective chocolate dose seems to hover around 2 kg per year, and the dose–response curve reveals no apparent ceiling on the number of Nobel laureates at the highest chocolate-dose level of 11 kg per year.

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Elizabeth Avilés Lobera's curator insight, November 4, 2014 2:25 PM

El chocolate es delicioso!

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Why are Massachusetts hospitals doing fewer angioplasties on heart attack patients?

Why are Massachusetts hospitals doing fewer angioplasties on heart attack patients? | Heart and Vascular Health | Scoop.it

My comment: This is one of the unintended consequences of public reporting.  If a patient has a high risk of death in the setting of a heart attack, avoiding the procedure to prevent institutional or individual operator mortality statistics might be chosen.  Being risk averse in elective procedures is wise; A small potentail benefit in a critically ill patient however might warrant intervention.

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Seven years ago, Massachusetts mandated that hospitals report on a public database how often they perform minimally invasive heart procedures to open blocked arteries -- like angioplasty and stenting -- and their death rates from these procedures. That was meant to reduce unnecessary procedures and to lower death rates, but new research from the Harvard School of Public Health and two Boston hospitals indicates that the public reporting system might also be leading to fewer angioplasties in patients who need them the most: those in the throes of a heart attack.

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Are You Likely to Respond to Exercise?

Are You Likely to Respond to Exercise? | Heart and Vascular Health | Scoop.it
Research has confirmed that people's physiological responses to exercise vary wildly. Now a new genetic test promises to tell you whether you are likely to benefit aerobically from exercise.
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Mining the Internet for Speedier Safety Alerts on Drugs

Mining the Internet for Speedier Safety Alerts on Drugs | Heart and Vascular Health | Scoop.it

My comment: Big Data and Crowd sourcing are popular terms with great potential.  If our ability to find real problems with new therapies was improved with monitoring & catloguing of social media we would have a significant step forward.  

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Scientists are sifting through massive quantities of freely available data scattered across the Internet, aiming to catch potentially deadly problems with prescription drugs more quickly—even ahead of federal regulators.

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Live-tweeting at academic conferences: 10 rules of thumb

Live-tweeting at academic conferences: 10 rules of thumb | Heart and Vascular Health | Scoop.it

Ernesto Priego explores the ethics of live-tweeting academic events and provides 10 points to bear in mind when navigating this emerging social media minefield...  Recommendations for both event oragnizers and tweeters.

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Hypertension or Hammertoe? To the Computer, It’s Just ‘HT’

Hypertension or Hammertoe? To the Computer, It’s Just ‘HT’ | Heart and Vascular Health | Scoop.it
Lesser versions of the electronic medical record leave many doctors scrambling, as the transition from paper to computer is not always a smooth one.

Multiple computer systems are still running simultaneously. Some always talk to one another, some never do, and some have periodic, inexplicable fallings-out, during which valuable information becomes unavailable save by the old standbys: Call the lab, or head down there on foot.

Even in its most primitive form, the strengths of the electronic record are clear. Not for nothing has it been dubbed by some cynics the “electronic cash register”: Aggressive billing to wring all possible cash from each clinical encounter becomes breathtakingly easy.

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