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Tag: risk factors

Higher Risk Factors for Women

Fewer women who suffer a heart attack each year in the UK would die if they were simply given the same treatments as men, according to new research.

Scientists at the University of Leeds and the Karolinska Institute in Sweden used data from Sweden’s extensive online cardiac registry, SWEDEHEART, to analyze the outcomes of 180,368 patients who suffered a heart attack over a 10 year period to December 2013.

After accounting for the expected number of deaths seen in the average population, the researchers found that women had an excess mortality up to three times higher than men’s in the year after having a heart attack.

While the analysis uses Swedish data, the researchers believe that the situation for women in the UK is likely to be worse than in Sweden, which has one of the lowest mortality rates from heart attacks anywhere in the world. The study, published yesterday in the Journal of the American Heart Association, was co-funded by the British Heart Foundation.

Professor Chris Gale, Professor of Cardiovascular Medicine at the University of Leeds, who co-authored the study, said: “We need to work harder to shift the perception that heart attacks only affect a certain type of person. Typically, when we think of a heart attack patient, we see a middle-aged man who is overweight, has diabetes and smokes. This is not always the case: heart attacks affect the wider spectrum of the population, including women. Sweden is a leader in healthcare, with one of the lowest mortality rates from heart attacks, yet we still see this disparity in treatment and outcomes between men and women. In all likelihood, the situation for women in the UK may be worse.”

Analysis of the Swedish data found that women who had a heart attack resulting from a blockage in the coronary artery were 34 per cent less likely than men to receive procedures which clear blocked arteries and restore blood flow to the heart, including bypass surgery and stents.

The paper reported that women were also 24 per cent less likely to be prescribed statins, which help to prevent a second heart attack, and 16 per cent less likely to be given aspirin, which helps to prevent blood clots. Critically, when women received all of the treatments recommended for patients who have suffered a heart attack, the gap in excess mortality between the sexes decreased dramatically.

Professor Gale, from the Leeds Institute of Cardiovascular and Metabolic Medicine, added: “The findings from this study suggest that there are clear and simple ways to improve the outcomes for women who have a heart attack – we must ensure equal provision of evidence-based treatments for women.”

Previous British Heart Foundation research has shown that women are 50 percent more likely than men to receive the wrong initial diagnosis and are less likely to get a pre-hospital Electrocardiogram (ECG) which is essential for swift diagnosis and treatment.

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: “Heart attacks are often seen as a male health issue, but more women die from coronary heart disease than breast cancer in the UK. The findings from this research are concerning – women are dying because they are not receiving proven treatments to save lives after a heart attack.”

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Early Baldness: Higher Risk Factor Than Obesity?

Male pattern baldness and premature greying are more of a risk factor for heart disease than obesity in men under 40, new research suggests. A study of more than 2,000 young men in India showed more who had coronary artery disease were prematurely bald or grey than men with a full head of hair.

Dr Mike Knapton, associate medical director at the British Heart Foundation, told the BBC: “This study suggests that identifying men with premature hair loss and greying may help identify those with an increased risk of developing heart disease. However, this isn’t something that people can change, whereas you can modify your lifestyle and risk factors such as high cholesterol and blood pressure. These are far more important things to consider.”

The research, to be presented at the CSI’s 69th annual conference in Kolkata, studied 790 men under 40 who had coronary artery disease and 1,270 healthy men of a similar age, who acted as a control group.

A clinical history was taken of all the participants, who were then marked on their levels of male pattern baldness – the common type of hair loss that develops in most men at some stage – and hair whitening. The researchers correlated the findings with the severity of heart disease symptoms, and discovered that the men with the heart condition were more likely to have gone prematurely grey – 50% compared with 30% of the healthy group – more than five times the risk of the control group.

The heart condition group were also more likely to have male pattern baldness – 49% against 27% of those in the healthy group – a 5.6 times greater risk. Yet obesity was associated with only a fourfold increased risk of the disease.

Dr Kamal Sharma, the principal investigator on the study, said: “The possible reason could be the process of biological aging, which may be faster in certain patients and may be reflected in hair changes.”

Prof Alun Hughes, professor of cardiovascular physiology and pharmacology at University College London, said similar correlations had been made before. “People have speculated that it may be an indicator of DNA damage associated with aging,” he said. “Also, since hair follicles are a target for androgens – for example testosterone – it has been suggested that early male pattern baldness could reflect differences in responses to androgens that might influence the risk of heart disease.”

A study of nearly 37,000 people in Japan in 2013 said balding men were 32% more likely to have coronary heart disease. Prof Hughes said a study of 10,885 Danish people in 2014 reported that grey hair predicted future heart disease, but said it could be explained by taking account of other cardiovascular risk factors.

Lead study author Dr Dhammdeep Humane, of the UN Mehta Institute of Cardiology and Research Centre in Ahmedabad, said men with male pattern balding or premature greying “should receive extra monitoring for coronary artery disease and advice on lifestyle changes, such as healthy diet, exercise, and stress management.”

Another study author, Dr Sachin Patil, said there was an increase in coronary disease in young men which could not be explained by traditional risk factors and added that the hair conditions were “plausible risk factors”.

Prof Marco Roffi, head of the Interventional Cardiology Unit at Geneva University Hospital, said: “Assessment of risk factors is critical in the prevention and management of cardiovascular disease. “Classical risk factors, such as diabetes, family history of coronary disease, smoking, sedentary lifestyle, high cholesterol levels and high blood pressure, are responsible for the vast majority of cardiovascular disease. “It remains to be determined whether potential new risk factors, like the ones described, may improve cardiovascular risk assessment.”

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Heart Disease Among Chinese Americans: Frequently Overlooked

A new study published by the Centers for Disease Control and Prevention indicates that risk factors for heart disease among Chinese Americans are often overlooked, as the standard generally utilized to determine a healthy weight is commonly not adjusted for Asian populations.

The study, “Obesity and Modifiable Cardiovascular Disease Risk Factors Among Chinese Americans in New York City, 2009—2012” examined the relationship between body mass index (BMI) and risk factors for cardiovascular disease among New York City’s Chinese Americans.

Simona Kwon, lead investigator of the study and director of New York University’s Center for the Study of Asian Health, reported that Asian Americans are often left out of health research analysis, “Because it looks like we’re not experiencing health disparities in cardiovascular disease.”

Kwan reports that there is a well established link between high rates of diabetes and South Asian communities, yet there is a ‘model minority’ of East Asians having less risk of cardiovascular disease. While the World Health Organization defines a ‘normal’ BMI as between 18.5 to 24.9, ‘overweight’ as 25 to 29.9, and ‘obese’ as 30 or higher, people of Asian descent tend to have higher body fat percentages—so BMI measurements must be adjusted.

Measured against standard BMI values, the authors found a low prevalence of Chinese Americans who were overweight and obese, yet when they used the BMI cut points adjusted or the Asian population, the numbers went up. Researchers state that Chinese Americans are disproportionately affected by cardiovascular disease risk factors that are preventable and treatable, like diabetes and high blood pressure.

Because physicians decide whether or not to screen patients for diabetes based on BMI, authors of the article suggest that patients of Asian descent should use lower BMI cut points; traditional cutoffs would miss Chinese Americans at risk of diabetes.

“There’s a need to disaggregate data on Asian Americans and focus on subgroups because when you look at Asian Americans as a whole, a lot of differences get masked,” says Kwan.

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