American College of Sports Medicine promotes sporting event for cardiac rehab patients

The American College of Sports Medicine will feature Olympic-style competition for cardiovascular rehabilitation patients at the World Heart Games, to be held May 14 and 15 in Decatur, Ga.

Events such as table tennis, golf and bocce ball will be designed to be challenging, but safe (and monitored) for those who are recovering cardiac patients or people with cardiovascular risk factors.

“Cardiac patients often see themselves in a diminished light, with concerns about how cardiac or pulmonary problems likely will permanently limit physical aspects of their lives and lead to more life-threatening events,” said Dr. F. Stuart Sanders, chair of the organizing committee for the event. “In contrast ... we have seen these games transform patients’ outlooks, generating excitement and confidence about how much they might achieve.”

Start walking to fight heart disease

Today--April 7--is National 'Start Walking' Day. Did you know that physical inactivity doubles your risk of heart disease? And that you can reduce your risk by adding regular activity to your day? And that something as simple as 30 minutes of walking can make a difference?

What difference can it make? Walking can lower your blood pressure, raise your good cholesterol and lower your bad cholesterol, help you lose weight, help you manage (or reduce your risk of) diabetes, improve your mood, and keep you strong and fit.

The American Council on Exercise will help you get started, by providing a free, personalized online walking plan. Looking for someplace that's great for a walk? Check out this collection of walking paths.

Bring sneakers to work and make it a point to get up and walk for a half hour every day. Set an example for colleagues, or, heck, bring them along! (Or, suggest a walking program to the person responsible for employee health programs.)

Heart disease affects gorillas, too

Cardiovascular disease is not just killing humans. Progressive heart ailments--aneurisms, valve disease, cardiomyopathy--are killing gorillas in American zoos. More than 40 percent of adult gorilla deaths are from heart disease, the Washington Post has reported.

It's not the same disease in both primates. Veterinarian Suzan Murray told United Press International that heart disease in gorillas is different from heart disease in humans. Gorillas develop a hardening of the heart muscle, called fibrosing cardiomyopathy, that has few symptoms.

"We've seen over the past 20, 30 years that as these big silverbacks get older, they have heart problems," Dr. Mark Stetter, director of animal health for Disney's Animal Programs, told the Orlando Sentinel in a story about research underway at Disney's Animal Kingdom.

Watch an ABC News report on heart disease in gorillas.

Read a Washington Post story.

Sweet news: Chocolate reduces blood pressure, risk for heart disease

Eating chocolate appears to lower the risk for cardiovascular disease by reducing blood pressure, German researchers have found. They're talking about a "moderate" consumption that replaces other high-density snacks in your diet.

The researchers analyzed diet and health habits for 19,357 people, from age 35 to 65, over 10 years. Those who ate the most chocolate (7.5 grams, or 0.3 ounces, per day) had lower blood pressure and were 39 percent less likely to suffer a heart attack than those who ate the least amount of chocolate (1.7 grams or .06 ounces, per day.)

"To put that in terms of absolute risk, if people in the group eating the least amount of chocolate increased their chocolate intake by 6 grams a day, 85 fewer heart attacks and strokes per 10,000 people could be expected to occur over a period of about 10 years," study leader Dr. Brian Buijsse, a nutritional epidemiologist at the German Institute of Human Nutrition, said in a news release from the European Heart Journal.

What gives chocolate its blood pressure-lowering powers?

Apparently, the high flavanol content of cocoa. Flavanols are a type of antioxidant, and chocolates with a higher percentage of cocoa, such as dark chocolate, contain more flavanols. Fruits and vegetables also contain flavanols.

"Flavanols appear to be the substances in cocoa that are responsible for improving the bioavailability of nitric oxide from the cells that line the inner wall of blood vessels," Buijsse told WebMD. "Nitric oxide is a gas that, once released, causes the smooth muscle cells of the blood vessels to relax and widen; this may contribute to lower blood pressure. Nitric oxide also improves platelet function, making the blood less sticky."

Read the HealthDay report.

Read the WebMD report.

Read the abstract in the European Heart Journal.

How to travel (safely!) to high altitudes if you have heart disease

So you want to climb Mount Kilimanjaro. Will your heart hold up?

Doctors are hearing variations of this question more frequently as people (including those with previous heart problems) make travel plans that involve altitude. Giving an accurate answer depends on elevation, rate of ascent and acclimitazation and exercise intensity--along with a patient's age, genetics and physical conditioning.

Altitude travel can tax the cardiopulmonary system, with significant changes typically beginning at about 8,200 feet, say researchers writing for the American Heart Journal. The heart has to work harder, in an environment of reduced oxygen, with the body releasing more epinephrine and an increased pulmonary artery pressure.

The researchers are from Lyndon B. Johnson General Hospital and Memorial Hermann Sports Medicine Institute at the University of Texas Medical School at Houston. They recommend:

* Limiting your workload or exercise time to about 80 to 90 percent of what you can do comfortably at sea level.

* Raising your sleeping altitude gradually, especially if a prolonged trek is planned.

* A moderate degree of physical conditioning at sea level before exercise at altitude.

* Alcohol consumption should be minimized and proper hydration should be maintained to keep blood viscosity and volume within normal parameters.

They say doctors should consider an exercise treadmill test for any men or women over age 40. They say people with recent unstable cadiovascular conditions should refrain from high altitudes, but people who exercise at sea level without symptoms can make plans for a trip at altitude "as long as they are vigilant regarding their heart rate and blood pressure and they decrease the total intensity and duration of their exercise (at altitude.)"

Read the abstract for "Altitude and the Heart: Is Going High Safe for Your Cardiac Patient?"

Healthy Eats: Lentil Tortillas

The Heart-Smart Diabetes Kitchen shares this "Lentil Tortillas" recipe for those of us who like salsa, cilantro and jalapeno.

Ingredients
3/4 cup (4 ounces) dried brown lentils

2 cups water

1/2 cup salsa verde, divided

2 tablespoons canola oil, divided

1/2 teaspoon ground cumin

canola oil cooking spray

8 corn tortillas, warmed

1 medium jalapeno, seeded and finely chopped

1/4 cup chopped fresh cilantro leaves

1/2 cup (2 ounces) shredded reduced fat Mexican blend cheese or mozzarella

2 cups loosely packed shredded lettuce

1/2 cup fat-free sour cream

Preparation
1. Bring lentils and water to a boil in a medium saucepan over high heat; reduce heat, cover tightly and simmer 25 to 30 minutes or until tender. Drain in a fine-mesh strainer, place in a small bowl and add 1/4 cup salsa verde, 1 tablespoon canola oil and cumin. In a separate bowl, mix the remaining 1/4 cup salsa verde and 1 tablespoon canola oil.

2. Preheat oven to 350 degrees. Coat a nonstick baking sheet with cooking spray. Arrange tortillas on the baking sheet and spoon equal amounts of lentil mixtures on tortillas. Using the back of a spoon, spread mixture to edges of tortillas. Top with jalapeno, cilantro and cheese. Bake 3 to 5 minutes or until cheese melts.

3. Place on four dinner plates and top with lettuce, sour cream and remaining salsa verde.

Cheers! More studies confirm moderate drinking is good for the heart

Drinking moderate amounts of alcohol is better for your heart health than abstaining altogether, report two major studies in the Journal of the American College of Cardiology.

The studies confirm previous work showing that alcohol, in moderation, can be good for the heart. They do not change the medical consensus that heavy drinking is bad for health in general. American Heart Association guidelines say that if you do drink alcohol, do so in moderation.

"This would not change our current guidelines, which provide an upper limit and not a lower limit, no more than two drinks a day for men and no more than one drink a day for women," Dr. Kenneth J. Mukamal, an associate professor of medicine at Harvard Medical School and an internist at Beth Israel Deaconess Medical Center, told HealthDay.

His study found a lower rate of deaths from cardiovascular conditions such as heart attack and stroke among light and moderate drinkers than among people who never drank or quit. Whether they drank beer, wine or liquor did not matter. "Indeed, the lowest rate of cardiovascular mortality was among those who drink moderately," Mukamal told HealthDay. "That benefit is clearly eliminated in people who drank above that level."

The second report in the journal comes out of Italy, where researchers compared alcohol consuption and death rates among drinkers and nondrinkers who had cardiovascular disease. They, too, found that moderate alcohol intake had a protective effect. "Moderate" meant 5 to 10 grams of alcohol per day. A typical drink contains about 13.7 grams of alcohol.

Mukamal's study in the Journal of the American College of Cardiology.

Read the HealthDay story.

Risk of muscle injury warning is issued for Zocor cholesterol medicine

If you take Zocor (simvastatin) to lower your cholesterol, be aware that the FDA is warning patients and healthcare providers of the potential risk for muscle injury.

Although muscle injury--called myopathy--is a known side effect with all statins, the warning for Zocor highlights the greater risk of developing muscle injury, including rhabdomyolysis, the most serious form of myopathy which can also lead to severe kidney damage, kidney failure, and sometimes death.

Simvastatin is the generic medication for Zocor. It is also sold in combination with ezetimibe as Vytorin, and in combination with niacin as Simcor.

The FDA safety announcement from March 19, 2010.

The FDA alert from August 2008.

New York Times articles about Zocor.

The risks of statins, from the Mayo Clinic.

Heart disease (not cancer recurrence) a greater risk for cancer survivors

Cancer survival rates are so high that many cancer survivors now have a higher risk of cardiovascular disease than of cancer recurrence.

Cardiac diseases in cancer patients--including heart failure, ischemia, thromboembolism, conduction abnormalities, and low blood pressure--do not develop the same way they do in people without cancer. And the presence of the cancer often limits treatment options for the cardiac diseases.

"Preventing cardiovascular disease in patients with cancer and cardiac complications of cancer therapy might have dual benefits, allowing cancer patients to be treated more effectively with potentially life-saving cancer therapies, and preventing long-term cardiovascular morbidity and mortality in these individuals long after cancer therapy is complete," Dr. Aarif Khakoo, of the University of Texas M. D. Anderson Cancer Center in Houston, writes in the Journal of the American Medical Association.

His article, "Cancer Therapy Can be Hard on the Heart," explains that although most oncologists realize that chemotherapy, radiation, and even newer targeted cancer therapies can inflict collateral damage on the heart, little is known about the extent of that damage or the mechanisms behind it. He specifically addresses congestive heart failure and cardiomyopathy, as well as myocardial ischemia and myocardial infarction.

In a previous article, for the Journal of Clinical Investigation, Khakoo explains how a growth factor that is a common target of cancer drugs also plays an important role in the heart's response to stress. Targeting this platelet-derived growth factor receptor(PDGFR)slows the growth of cancer, but it also slows angiogenesis, the growth of new blood vessels.

The article on cardiotoxicity in the Journal of the American Medical Association.

The JAMA article on cardiotoxicity on Medscape.

The article about how cancer drugs slow the growth of new blood vessels in the Journal of Clinical Investigation.

Implanting LVAD may help obese patients awaiting heart transplant to lose weight

For people awaiting heart transplant, Left Vetricular Assist Devices (LVADs) can mean the difference between life and death. They help a person's own weakened heart continue pumping until a donor heart becomes available.

Physician scientists from the Cedars-Sinai Heart Institute say that in addition, LVADs can help obese transplant patients lose weight. That's important because, just as obesity is a risk factor for heart failure, it's also associated with poor outcomes after a heart transplant.

Among 19 obese patients who received an LVAD while awaiting a transplant, researchers noted a loss of about 12 percent of body weight--nearly double the amount of weight lost by patients who were not obese. Researchers say a combination of factors may be at work. The device possibly caused more calories to be consumed while simultaneously also resulting in decreased caloric intake. In addition, the LVAD allowed the patients to become more active, improve their overall conditioning and expend more calories.

“LVADs could prove to be helpful in improving obese patients’ outcomes,” said Dr. Ernst Schwarz, director of Multidisciplinary Heart Failure Research at the institute.

Job stress means police, firefighters more likely to suffer heart attack, NY study says

Police officers and firefighters are up to four times more likely than the general public to suffer heart attack or sudden cardiac death on the job, and research presented this week at the American College of Cardiology's 59th annual scientic session points to the stress of their work as the reason.

Already, cardiac arrests are the most frequent cause of on-the-job death for police officers and firefighters. This new data suggests that's more likely due to the "tremendous physical and emotional stress they face in fulfilling their jobs," and not due to additional coronary blockages, says the lead author of the study, Dr. Zubair Jafar, director of the Cardiac Cath Lab and the Cardiac Research Program, Hudson Valley Heart Center, N.Y.

Jafar and his team used calcium scoring, a type of CT scan that shows plaque in the coronary arteries. They offered a screening program free to New York State firefighters and police officers and got scores for 717 men. They compared those nubmers with those from age-matched men from the general population. Scores were similar in both groups.

But, says Jafar, sudden spikes in stress levels-—which are common when police and firefighters respond to emergencies—-may cause plaque to rupture and result in a heart attack.

"It’s critical that we understand what causes these cardiac events because the approaches to prevention might be very different. We are talking about a high-risk population that needs to be treated differently and more aggressively," he says.

Dr. Zubair Jafar was involved in another study looking at heart attack risk for World Trade Center rescuers from Sept. 11, 2001.

Healthy Eats: Garlic White Bean Soup with Smoked Sausage

The Heart-Smart Diabetes Kitchen cookbook says this is perfect for a cold, rainy day. See what you think:

Ingredients
1 1/2 tablespoons canola oil, divided
1 1/2 cups (6 ounces) smoked turkey sausage, diced
1 1/2 cup chopped onions
1 cup matchstick carrots
4 medium cloves garlic, minced
1 can (15 ounces) no-salt-added navy beans, rinsed and drained
1 can (14 ounces)reduced-sodium chicken broth
1 cup water
1 teaspoon dried oregano leaves, crumbled
1/2 teaspoon dried thyme leaves, crumbled
1 teaspoon Worcestershire sauce
3/4 teaspoon black pepper
1 tablespoon liquid smoke

Preparation
Heat 1 1/2 teaspoons canola oil in Dutch oven over medium-high heat. Add sausage and cook until browned, about 2 minutes. Remove sausage from Dutch oven; set aside on a separate plate.

Add remaining 1 tablespoon canola oil and reduce to medium heat. Add onions and carrots; cook 3 minutes or until onions are translucent, stirring frequently. Add garlic; cook 15 seconds. Add remaining ingredients, except liquid smoke and sausage. Bring to a boil over high heat, reduce heat, cover, and simmer 20 minutes or until onions are tender.

Remove from heat and add liquid smoke and sausage. Cook and let stand 10 minutes. To serve, spoon equal amounts of soup into four shallow bowls.

Nutritional information:
Calories, 265; Total fat, 10 grams; fiber, 8 grams.

New baseball gear protects kids' hearts from line drives

The advertisements are honest by saying how very rare it is that a blow to the chest (say, by a line drive) could send a child into a potentially fatal heart rhythm called commotio cordis.

It's rare, but 200 cases have been reported to the U.S. Commotion Cordis Registry. Most victims have been boys between ages 10 and 18, and most died following a "seemingly inconsequential, nonpenetrating blow to the chest," says Medscape's eMedicine Web site. It also says more than half of victims were participating in organized sports, most commonly baseball, softball or hockey. "In most instances (58 percent), the person was struck by a projectile, which was most commonly a pitched, thrown, or batted baseball or softball estimated to be traveling 30 to 50 mph at most," the article says.

A protective solution: the Markwort Heart-Gard shirt, containing a high density polyethylene dome that covers the heart area. Its makers say "if your kid is an infielder, especially a pitcher with such a close proximity to swinging batters, a heart guard makes more than perfect sense."

It's something to consider. Dick's Sporting Goods sells the Heart-Gard shirt for $39.99. It also sells a Heart-Gard chest protector held in place with straps for $19.99.

Are doctors too quick to order angiograms?

A study in the New England Journal of Medicine calls into question something that has become standard practice--that of sending patients with chest pain to have a cardiac catheterization or angiogram. In the study, slightly more than a third of patients were found to have obstructive coronary disease.

"What this says is that we need to re-evaluate how we work these patients up from start to finish," Dr. Manesh Patel told HealthDay. Patel, assistant professor of medicine at Duke University, is lead author of the report in the March 11 issue.

He and his team included 398,978 patients from 663 hospitals between 2004 and 2008. Of those who underwent the testing--in which a long, thin, flexible catheter is inserted into a blood vessel in your arm, groin or neck and threaded into your heart--obstructions were found in 37 percent of patients. Thirty-nine percent were found not to have obstructive disease.

Patel writes in his conclusion that "better strategies for risk stratification are needed to inform decisions and to increase the diagnostic yield of cardiac catheterization in routine clinical practice."

Read the HealthDay story.

Read the NPR story.

Thanks, AHA, for helping keep our hearts healthier over the years

Here are six reminders of just how far we've come in fighting heart disease, courtesy of Mary Kate Hartmann of the American Heart Association's Syracuse Metro & Greater Mohawk Valley Region.

Sometimes, even as we're moving forward, it's beneficial to stop and admire our accomplishments.

Consider:

* 50 years ago, there was no CPR.

* 35 years ago, there was no angioplasty.

* 30 years ago, there were no effective anti-rejection drugs for heart transplants. (Read my story about Syracuse's first heart transplant patient and the 25th anniversary of his donor heart being implanted.)

* 20 years ago, there were no medications to reduce disability from stroke.

* 15 years ago, there were no defibrillators on airplanes.

* 10 years ago, there were no drug-eluting stents.

"These are tangible ways that the citizens of our community have benefited from the American Heart Assocation's work," says Hartmann.

Don't forget to sign up for this year's Heart Walk, taking place April 17 at Longbranch Park in Liverpool, near Syracuse.

The cardiac benefits of banning salt

Restaurants throughout New York State would be forbidden to use salt in the preparation of food if New York Assemblyman Felix Ortiz has his way. He introduced a bill Tuesday, citing a World Health Organization report that says at least three-quarters of the sodium Americans consume comes from restaurant foods.

"Studies have also proven that lowering the amount of salt people eat, even by small amounts, could reduce cases of heart disease, stroke, and heart attacks as much as reductions in smoking, obesity, and cholesterol levels," Ortiz told Nation's Restaurant News.

That's true. (Check out the recent Time magazine story on that subject.) But civil libertarians might quibble with whether that means we should be creating laws that prevent restaurants from cooking with salt.

Aside from the health benefits of lower salt intake, a study in this month's Annals of Internal Medicine says reducing dietary sodium levels would save $32 billion in medical costs and avert almost one million heart attacks and strokes over the lifetime of adults ages 45 to 85.

In the study, researchers considered two approaches for reducing a population's sodium intake--governments getting food manufacturers to voluntarily reduce salt in processed foods, and governments placing a sodium tax on food, reports HeartWire. Though they projected financial savings and health improvements, researchers admitted that "efforts to reduce population sodium intake could result in other dietary changes that are difficult to predict."

We Americans like our salt, after all-- and generally ingest way more than we need. It's not that way everywhere. Check out that World Health Organization report that Ortiz referenced and you'll read how some cultures grapple with iodine deficiency from too little sodium.

Meanwhile: Some advice for cooking flavorfully with less salt.

Got heart disease? You're at greater risk for kidney disease

If you have a heart disease diagnosis, it's important to also consider another pair of organs--your kidneys. That's because heart disease and high blood pressure are risk factors for kidney disease, and you could be affected without even knowing it.

That's sort of the basis of World Kidney Day, which takes place Thursday, March 11. The National Kidney Foundation sponsors free screenings through its Kidney Early Evaluation Program. Find one near you.

Healthy Eats: Spring Vegetables With Shallot Butter

I can vouch for this recipe being not only tasty, but easy, too. (And, asparagus is on sale this week, to boot.)

It's a recipe I found in Woman's Day magazine. Here goes:

Ingredients
2 tablespoons unsalted butter
1/2 cup chopped shallots
2 teaspoons grated lemon zest
1/4 teaspoon each salt and pepper
1 pound asparagus, ends trimmed, cut into 2-inch lengths
8 ounces sugar snap peas, ends trimmed
2 cups frozen peas, thawed

Preparation
Bring a pot of lightly salted water to a boil.

Meanwhile, melt butter in a large nonstick skillet. Add shallots and cook, stirring often, 5 minutes or until tender. Stir in lemon zest, salt and pepper and remove from heat.

Add asparagus and sugar snap peas to boiling water; cook 2 to 3 minutes or until crisp-tender. Add peas, remove from heat and drain.

Add vegetables to skillet with shallot butter. Gently toss over medium heat until hot and coated with the shallot butter. Tansfer to a serving bowl.

What's so great about asparagus? It's high in vitamin C. It's a great source of folate. And, it contains the antioxidant glutathione.

Healthy Eats: Rocco's Fettuccine Alfredo

I love the "Athlete's Palate" recipes in Runner's World, and this one from Rocco Disprito promises to be another winner.

It replaces the heavy cream, butter and cheese of typical fettucines with Greek yogurt (which is generally lower in sugar and higher in protein than other yogurts) and chicken broth.

Ingredients
8 ounces whole-wheat fettucine
1 tablespoon butter
3 garlic cloves, minced
2 teaspoons cornstarch
pinch of ground nutmeg
3/4 cup low-fat, low-sodium chicken broth
3/4 cup grated Parmigiano-Reggiano cheese
3/4 cup 5 percent Greek yogurt
salt and freshly ground black pepper, to taste

Preparation
Bring a pot of salted water to a boil. Add fettuccine; cook according to package directions.

While pasta cooks, melt butter in a large nonstick saute pan over medium heat. Add garlic and cook two minutes. Combine cornstarch and nutmeg in a small bowl; whisk in chicken broth until smooth. Pour into saute pan, raise the heat, and bring sauce to a simmer, whisking occasionally. Whisk in 1/2 cup of the cheese until melted. Remove pan from heat. Whisk in yogurt until smooth. Toss fettuccine with Alfredo sauce. Season with salt and pepper. Top pasta with remaining cheese.

Serves four.

Calories per serving: 336. Fat: 10 grams.

Processed meats are tied to higher rates of heart disease and diabetes

Combing through 20 relevant studies, involving 1.2 million adults in 10 countries, researchers discovered that unprocessed red meat isn't so bad for our hearts. It's processed meats that are actually linked to a higher incidence of coronary heart disease and diabetes.

"To lower risk of heart attacks and diabetes, people should avoid eating too much processed meats -- for example, hot dogs, bacon, sausage or processed deli meats," lead researcher Renata Micha, a research fellow at the Harvard School of Public Health, told the Palm Beach Post. "Based on our findings, eating up to one serving per week would be associated with relatively small risk."

Researchers found that:

• higher consumption of unprocessed red meat was not significantly associated with risk of either coronary heart disease or diabetes.

• higher consumption of processed meat was associated with risk: each daily 50-gram serving was associated with 42 percent higher risk of coronary heart disease and 19 percent higher risk of diabetes.

Unprocessed red meat included beef, hamburgers, lamb or pork.

Processed meat was any meat preserved by smoking, curing or salting, or with the addition of chemical preservatives, including bacon, salami, sausages, hot dogs, or processed deli or luncheon meats.

The processed meats contained, on average, four times higher sodium and 50 percent higher levels of nitrate/nitrite preservatives than unprocessed red meats. In contrast, saturated fat levels were similar and cholesterol levels were higher in unprocessed red meats versus processed meats. Researchers said this suggests that salt and other preservatives, rather than fats, could account for the higher risk seen with processed meats.

Their work was presented this week at an American Heart Association conference in San Francisco.