January 30, 2009

Top 10 Heart-Stroke Advances for 2008

FRIDAY, Jan. 30 (HealthDay News) -- Studies on smoking bans, acute care of heart attack and stroke patients, diabetes control and childhood obesity were among the top 10 major advances in heart disease and stroke research in 2008, according to the American Heart Association.

"It's always difficult to choose from among such a broad array of new discoveries," AHA President Dr. Timothy Gardner said in an AHA news release. "This year, we included not only novel work in fundamental or basic science, but also important clinical studies that we believe will influence medical care in the future. In addition, we have chosen a number of studies that demonstrate the effectiveness of science applied in the real world, from hospitals to schools to whole communities. These implementation studies are of increasing importance as we try to determine how best to translate basic and clinical science for the benefit of the public."

The top 10 for 2008 were:

• A Scottish study found hospital admissions for acute coronary syndrome decreased by 17 percent after smoking was banned in all enclosed places. Sixty-seven percent of the decrease occurred among never-smokers, while former and current smokers accounted for the remainder of the decrease.
• Two studies concluded that participation in quality improvement programs substantially improved hospitals' acute care of heart attack and stroke patients. The studies examined the stroke and coronary disease modules of the AHA's Get With the Guidelines program, designed to ensure that heart attack and stroke patients received appropriate therapy.
• A 10-year follow-up study of drug-based intensive glucose control in patients with type 2 diabetes found a significant reduction in heart attacks and deaths from any cause. This reinforces the importance of good glucose control. The study also concluded that continuous blood pressure control plays an important role in risk reduction.
• A U.S. study found that a school-based intervention program that included nutrition education, nutrition policy, social marketing and parent outreach led to a 50 percent reduction in the incidence of overweight among students in grades 4-6 in 10 urban schools. The results suggest this type of multi-component approach could help fight the childhood obesity epidemic in the United States.
• A position statement from European experts that transcatheter valve implementation is beginning to offer a reasonable alternative to conventional surgery for high-risk patients with aortic stenosis.
• A study found that both percutaneous coronary interventions (PCI) and medical therapy improve health and quality of life in patients with stable angina. The findings should lead to more aggressive medical treatments of patients with stable coronary disease and more thoughtful use of PCI.
• A study concluded that treatment with the drug rosuvastatin reduced the risk of nonfatal heart attack, nonfatal stroke and cardiovascular death in people who wouldn't normally be prescribed a cholesterol-lowering statin, because their levels of low density lipoprotein ("bad") cholesterol were below 130. The findings triggered discussion about expanding the use of statins.
• U.S. researchers advanced efforts to grow new hearts for patients dying from heart failure. They showed it's possible to create a functioning bioartificial heart "using a matrix from which cells had been removed as a platform in which new immuno-compatible cardiac cells could survive and function."
• Another research team demonstrated that cells needed to grow a new heart could be derived from human embryonic stem cells.
• A study offered evidence that treatment of high blood pressure in people 80 years and older reduces their risk of cardiovascular events such as stroke and heart failure. There have been questions about blood pressure control in the very elderly, but these findings prove the value of hypertension prevention in this group of patients.

More information

The U.S. Centers for Disease Control and Prevention outlines heart disease risk factors.

-- Robert Preidt
SOURCE: American Heart Association, news release, Jan. 21, 2009
id=623527