Your life in your hands

By ANUSHIA KANDASIVAM

MEDICAL science is constantly evolving and improving through research and study by medical professionals and other scientists.

Heart disease being the No.1 killer of men and women around the world, there are numerous studies on its causes and risk factors, preventative measures and cures, and processes of rehabilitation and recovery.

Here are just a few of the numerous studies that have led to breakthroughs that will improve the lives of people living with heart disease and help prevent more people from developing it.

Drug that reduces risk of heart failure

A study recently published online by the New England Journal of Medicine reports that a new drug could possibly be one of the biggest advances in combating heart failure in more than a decade.

The study involved about 8,500 people in 47 countries, the largest experiment that has ever been conducted on heart failure. It was designed and paid for by a Swiss pharmaceutical company.

The drug, which is as yet unnamed, was compared to the current standard drug. The study was stopped by independent monitors seven months early – after a 27-month study – according to pre-specified rules, when the boundary for an overwhelming benefit for the new drug had been crossed.

The people in the study were already taking three to five different drugs to control their risk of heart failure. One of these drugs, an ACE inhibitor (a pharmaceutical drug used to treat hypertension and congestive heart failure), was tested against the new drug in this study.

The new drug is a combination of two medicines used to block the effects of substances that harm the heart while preserving the ones that help protect it.

It is taken twice a day in pill form.

The study found that the new drug reduced the chances of dying of heart-related causes by 20% and for any other reason by 16% compared to the older drug, and reduced the chances of being hospitalised for heart failure by 21%.

According to the study, the new drug also seems relatively safe. There were more cases of too-low blood pressure and nonserious swelling beneath the skin with the new drug, but more cases of kidney problems, excess potassium in the blood and cough with the older drug.

The pharmaceutical company will seek approval for the drug by the end of this year in the United States and early next year in Europe.

Dairy good for the heart

New research by international scientists suggests that there is a correlation between the consumption of dairy and heart disease.

At the recent 12th Euro Fed Lipid Congress in Montpellier, France, researchers from Wageningen University in the Netherlands explained that as total dairy, low-fat dairy and milk (a little more than two cups a day) consumption increased, the risk for high blood pressure decreased, which relates to a reduced risk of cardiovascular disease.

The study also reveals that the association between coronary heart disease, stroke or total mortality and the intake of milk was not statistically significant.

The research results are based on nine studies with 57,256 individuals and 15,367 cases of hypertension.

A clinical trial published in the American Journal of Clinical Nutrition in May this year reveals supporting results.

It shows that the addition of four servings of non-fat dairy per day to a person’s usual diet lowered blood pressure in middleaged and older adults.

A similar study published online in July this year by the Journal of the American College of Nutrition states that a small serving of dairy food daily may reduce the risk of heart disease or stroke even in communities where such food are not traditionally part of the diet.

This study involved about 4,000 Taiwanese people who, living in a dominantly Chinese food culture, were unaccustomed to dairy foods. It was found that even in these communities, consuming dairy foods up to seven times a week does not increase mortality.

The optimal rate of consumption is about five servings per week, with one serving being equivalent to 8g of protein – one cup of milk or 45g of cheese.

The study also found that such quantities rarely cause trouble even for people considered to be lactose intolerant.

Good background checks could save more lives

In a joint statement released earlier this month, the American Heart Association and the American College of Cardiology recommended that health care professionals include 14 key elements that can be used as a checklist for screening young people aged 12 to 25 for congenital and genetic heart disease. If any of the elements are positive, further testing may be needed.

Screenings using electrocardiograms (ECG) to detect underlying genetic and congenital heart disease in this age group prior to employing this checklist has not been shown to save lives.

ECGs record the heart’s electrical activity and may detect some cases of congenital heart disease that can lead to sudden cardiac death. The 14-element questionnaire should be part of history taking and used together with an ECG or other tests and physical examination.

The questionnaire is actually an expansion of a 12-item checklist that was recommended in 2007. Since then, two questions were added.

Included in the 14-element checklist are questions relating to: unexplained fainting chest pain upon exertion excessive shortness of breath or fatigue during exercise

family history of premature death or disability due to heart disease or known cardiac conditions involving the heart muscle or heart rhythm before age 50

if the individual has been restricted from participation in sports in the past

if the individual has had prior testing for the heart, ordered by a health care provider

Although media coverage has brought sudden cardiac arrest and death in young people, especially athletes, to the attention of the wider public, the authors of the statement point out that there is no evidence that sudden cardiac arrest is more common in athletes than in the general population of young people.

The statement also notes that broader availability of automatic external defibrillators (AEDs) in public gathering places such as schools and sports arenas can be highly effective in saving young lives on the sports field and elsewhere when cardiac arrest occurs. www.malaysianheart.org, www.yjm.org.my www.world-heart-federation.org