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From the FDA

FDA Approves Computer-Assisted Heart Scan

The Food and Drug Administration recently approved the first ever computer assisted heart scan, which can be used by physicians to detect heart murmurs. The product, called Cardioscan, enables physicians to analyze sounds made by the heart to listen for potential symptoms of heart disease. Cardioscan was developed by biomedical scientists from Siemens and Zargis over the past seven years.

Cardioscan is non-invasive, portable, and takes minutes to perform. Cardioscan acquires processes and analyzes heart sounds, then provides easily interpretable graphical and textual results to physicians. Using Cardioscan to identify suspected murmurs through the assessment of patients' heart sounds, physicians will have an added tool available to them in identifying the presence of murmurs that will assist them in their determination of whether further testing or specialized attention from a cardiologist is warranted. In addition, Cardioscan will provide an electronic and printable record of a patient's heart sounds, giving the physician a baseline and an additional means by which to detect and track changes over time.

According to research, it is estimated that approximately 30% of the adult population, and up to 80% of children are affected by heart murmurs. Although only a small percentage of these murmurs result from heart disease, and even fewer are life threatening, the American Heart Association states that valvular heart disease affects more than 20 million people in the United States, while another 1 million Americans are living with congenital cardiovascular defects. Moreover, according to the same report, mortality for diseases of the heart that may be related to a murmur is in excess of 49,000 per year.

prnewswire.com

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Anticoagulation News

Gender Affects Clotting Risk

A new study found that men are more likely than women to experience recurring blood clots in the legs. Although the genders are equally likely to develop a first clot, men are at greater risks for second clots. The reason behind this difference is unclear to researchers from the University of Vienna who conducted the study.

They looked at 826 patients for an average of three years after an initial episode of deep-vein thrombosis, as these blood clots are called. Twenty percent of the men developed a second clot, compared with just 6 percent of the women. After adjusting for age and other factors, the risk of another episode was more than triple for men.

Deep vein thrombosis (DVT) refers to the formation of a thrombus (blood clot) within a deep vein, commonly in the thigh or calf. This can have two serious consequences:

1. If the thrombus partially or completely blocks the flow of blood through the vein, blood begins to pool and build-up below the site. Chronic swelling and pain may develop. The valves in the blood vessels may be damaged, leading to venous hypertension. A person's ability to live a full, active life may be impaired.
   
2. If the thrombus breaks free and travels through the veins, it can reach the lungs, where it is called a pulmonary embolism (PE). A pulmonary embolism is a potentially fatal condition that can kill within hours.

Both DVT and PE may be present without symptoms and difficult to detect. Physicians focus on preventing their development by using mechanical or drug therapies. Without this preventive treatment, as many as 80 percent of orthopedic surgical patients would develop DVT, and 10 percent to 20 percent would develop PE. Even with these preventative therapies, DVT and subsequent PE remain the most common cause for emergency readmission and death following joint replacement.

reutershealth.com

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Readers Comments

Prostate Cancer Test Missing Cases

Q: On several occasions I've questioned my test results at my doctor's office. Are lab tests always correct? Can the results be inaccurate?

A new study found that the standard screening test for prostate cancer misses 15 percent of older men's tumors, including some aggressive ones, when interpreted under existing guidelines. The findings have sparked debate among doctors on how to interpret the PSA test and how vigorously to treat screened men who show no symptoms. Some doctors feel the test's threshold should be lowered, while others believe this would only cause unnecessary operations.

Sixteen percent of American men can expect to be diagnosed with prostate cancer at some point in their lives. Yet most such tumors grow slowly, with the death risk at just 3 percent. Existing screening methods cannot always establish whether cancer is present and dangerous, so some cases are missed and others are over treated with surgery or radiation.
The study focuses on the standard screening test for prostate cancer: the prostate-specific antigen test, or PSA count. The blood test has been used on millions of men since the late 1980s to screen those with no symptoms. It is suggested that men start screening at age 50. Ask your doctor today what test is best for you.

From: New England Journal of Medicine, May 27, 2004

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New Treatment

New Recommendations Released for Chest Pain

The American Heart Association (AHA) together with the American College of Cardiology (ACC) has issued new recommendations for responding to chest pain. Any person who experiences chest pain for more than five minutes is urged to call 911, especially if they feel short of breath, light-headed, or weak. While individuals are likely to contact 911 for others, they are less likely to seek emergency medical treatment for their own pain. The AHA's new recommendations represent an effort to help people stay better attuned to their own symptoms and corresponding treatment needs.

Other symptoms of a heart attack include chest pain radiating into the arms, back, neck, jaw or stomach, and excessive sweating. The faster patients receive medical treatment, the better their long-term cardiovascular outcomes. Approximately 500,000 Americans have a heart attack called an ST elevation myocardial infarction, or STEMI, every year. This type of heart attack generally occurs when one of the blood vessels feeding the heart becomes completely blocked.

It is particularly important to treat this type of heart attack quickly because patients can develop permanent damage within 20 minutes. More heart function is lost with every extra minute that patients remain untreated. The new guidelines are available at the AHA and ACC websites.

Circulation: Journal of the American Heart Association, June 15, 2004.

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Life Style

Marriage Improves Blood Pressure

People who are married exercise better control of their hypertension than people who are single, widowed, divorced, or separated, according to results from a recent study. Social isolation appears to contribute negatively to high blood pressure treatment and control. People most at risk for intensive high blood pressure include those experience low social support and low socioeconomic status.

These circumstances are associated with lack of awareness of blood pressure treatment options and lack of access to treatment. Results from the study found that difficulty controlling high blood pressure was most common among those separated (14%), divorced (13.3%) and widowed (12.8%).

High blood pressure has been associated with a variety of significant health risks, including an increased risk of heart disease. It is also common in persons with obstructive sleep apnea. The findings were reported at the American Heart Association's Fifth Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

From: Heart Center Online, May 20, 2004

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Advocate Talk

Group Advocates for Fat Ban

A consumer advocacy group is urging the government to issue a ban on partially hydrogenated vegetable oil in food sold by restaurants and food manufacturers. This fat contributes to clogged arteries and can be found in foods such as pastries, cookies, crackers, and deep-fried foods. It is the main source in Americans' diets of trans fat, which raises the "bad" cholesterol, LDL, and increases the risk of heart disease.

Removing partially hydrogenated vegetable oil from the food supply could save between 11,000 and 30,000 lives each year, the consumer group Center for Science in the Public Interest said in a petition to the Food and Drug Administration. Partially hydrogenated oil is used to make shortening and some types of margarine, and is found in thousands of processed foods. Other trans fats occur naturally in beef and dairy products.

Health officials advise Americans to consume as little trans fat as possible. CSPI said it was starting a campaign to encourage more companies to replace trans fat in their products. People do not need to avoid fully hydrogenated oils, which contain little or no trans fat.

http://www.forbes.com/healthcare/

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Fitness Watch

Study Shows Chocolate Helps Heart

A new study shows moderate chocolate consumption can benefit cardiovascular health. In the study, people who ate a dark-chocolate candy bar with a substantial level of naturally occurring compounds known as flavonols had healthier blood vessels than people who ate chocolate bars with fewer of the compounds.

Flavonoids have antioxidant properties. Antioxidants have been shown to help lower levels of bad cholesterol and reduce the risk of blood clots, which can lead to heart attack and stroke. The test subjects ate the bars daily for two weeks.

Previous research suggests that flavanols may have positive effects on vascular function, but the mechanisms through which these effects take place remain unknown. The hypothesis that the consumption of a flavanol-rich cocoa product will improve endothelial function, and that this improvement is related to an increase in circulating nitric oxide concentrations.

The candy bar used in the experiment at the University of California-San Francisco, the 1.6-ounce Dove dark chocolate bar, contains 259 milligrams of cocoa flavonols. A good indicator of a chocolate bar's healthful powers is the percent of cocoa it contains. Widely marketed milk chocolate bars have 15 percent to 20 percent cocoa. Along with flavonols, chocolate contains antioxidant vitamins C and E and phytosterols, a group of plant-derived compounds that have been proven to lower cholesterol.

Researchers sought to examine the effects of polyphenol-rich chocolate on blood pressure in participants with mild hypertension. Older adults, aged 55-64 years, with newly diagnosed mild hypertension were divided into two groups as part of a randomized trial. Each group was assigned to consume daily doses of either 100 grams of dark, polyphenol-rich chocolate bars or 90 grams of white, polyphenol-free chocolate for 14 days. After a washout phase of seven days, the participants were crossed over to the other group. Blood pressure was monitored daily and participants were instructed to incorporate the chocolate into their diet by substituting the chocolate for foods of similar calorie and macronutrient content. Participants consuming polyphenols-rich chocolate experienced a significant decrease in systolic and diastolic blood pressure within ten days of treatment, an effect which was not observed in the polyphenols-free group. At the end of the 14-day intervention, the average systolic and diastolic blood pressure had decreased by 5.1 (2.4) mmHg and 1.8 (2.0) mmHg, respectively. Researchers concluded that including polyphenol-rich chocolate in a calorie-balanced diet appeared to beneficially affect blood pressure in mildly hypertensive people. The results of these new studies support earlier research findings, which suggest that certain chocolates and cocoas, when consumed as part of a healthy diet, may offer a number of cardiovascular benefits.

http://www.jointogether.org

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Product of the Month

Digital Pedometer with Calorie Counter

July is Fitness Awareness Month. Its summer time and exercise is a vital part of health and fitness. Here are two easy to use home testing products to help you achieve your personal goals and take charge of your health.

Track your exercise program progress with our digital pedometer and make it easy to set and reach your exercise goals. Simply set the time, your weight and stride length - and start moving!

• 1 year warranty
• Displays time and distance
• Shows aerobic steps and calculates calories and fat grams burned
• Step counter adjustment
• Light
• 7 day memory
• EASY TO USE

Omron® Automatic Inflation Blood Pressure Monitor

• Cuff inflates and deflates with the push of a button
• Large LCD digital panel displays blood pressure and pulse
• Easy-to-apply cuff
• Memory stores last reading
• Uses 4 AA batteries (not included); compatible with AC adapter
• 2-year warranty

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Copyright ©2003 QAS, Inc. All rights reserved. The information provided in this Newsletter and on the Hometestmed site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions.