Dr. Yancy, who will deliver the Heart and Stroke Foundation of Canada Lecture at the opening ceremonies of the Canadian Cardiovascular Congress in Vancouver this Sunday, will tell delegates that people who follow seven simple steps to a healthy life can expect to live an additional 40 to 50 years after the age of 50.

“Achieving these seven simple lifestyle factors gives people a 90 per cent chance of living to the age of 90 or 100, free of not only heart disease and stroke but from a number of other chronic illnesses including cancer,” says Dr. Yancy, a professor of medicine and chief of cardiology at the Northwestern University’s Feinberg School of Medicine. He is also the past-president of the American Heart Association.

“By following these steps, we can compress life-threatening disease into the final stages of life and maintain quality of life for the longest possible time.” He predicts that, if we act now, we can reverse the tide by 2020.

According to the Heart and Stroke Foundation, every year in Canada about 250,000 potential years of life are lost due to heart disease and stroke, which are two of the three leading causes of death in Canada.

Canadians can achieve optimal health, says Dr. Yancy, by following these steps:

1. GET ACTIVE: Inactivity can shave almost four years off a person’s expected lifespan. People who are physically inactive are twice as likely to be at risk for heart disease or stroke.

2. KNOW AND CONTROL CHOLESTEROL LEVELS: Almost 40 per cent of Canadian adults have high blood cholesterol, which can lead to the build up of fatty deposits in your arteries − increasing your risk for heart disease and stroke.

3. FOLLOW A HEALTHY DIET: Healthy eating is one of the most important things you can do to improve your health – yet about half of Canadians don’t meet the healthy eating recommendations.

4. KNOW AND CONTROL BLOOD PRESSURE: High blood pressure − often called a ‘silent killer’ because it has no warning signs or symptoms − affects one in five Canadians. By knowing and controlling your blood pressure, you can cut your risk of stroke by up to 40 per cent and the risk of heart attack by up to 25 per cent.

5. ACHIEVE AND MAINTAIN A HEALTHY WEIGHT: Almost 60 per cent of Canadian adults are either overweight or obese − major risk factors for heart disease and stroke. Being obese can reduce your life span by almost four years.

6. MANAGE DIABETES: By 2016 an estimated 2.4 million Canadians will live with diabetes. Diabetes increases the risk of high blood pressure, atherosclerosis (narrowing of the arteries), coronary artery disease, and stroke, particularly if your blood sugar levels are poorly controlled.

7. BE TOBACCO FREE: More than 37,000 Canadians die prematurely each year due to tobacco use, and thousands of non-smokers die each year from exposure to second-hand smoke. As soon as you become smoke-free, your risk of heart disease and stroke begins to decrease. After 15 years ,your risk will be nearly that of a non-smoker.

A call for focused prevention strategies

While this goal of optimal health has been achieved by fewer than 10 per cent of the population, “it demonstrates the striking potential that prevention has if it is broadly embraced,” says Dr. Yancy. “We know how to prevent heart disease and stroke – we now need to build the tools to empower our citizens to manage their risk and prevent heart disease.”

Dr. Yancy calls on governments to invest in steady and focused prevention strategies. He says that necessary initiatives include a change in current sodium policies, continued progress in tobacco control initiatives, increased green space, and health education.

“Healthy living is key to preventing heart disease and stroke,” says Bobbe Wood, president of the Heart and Stroke Foundation of Canada. “The Foundation is committed to raising awareness about heart health and to promoting public policies that facilitate healthy lifestyles and communities.”

She says that the Foundation will continue to build on partnerships and policies that have led to a significant reduction of trans fats in the Canadian food supply; stronger tobacco control initiatives; healthy community design; and a continued reduction in the amount of salt in our food products, which has been achieved in part through Health Check™, the Foundation’s flagship food information program.

Dr. Yancy adds that improved access to health care that focuses on prevention and control of important risk factors including high blood pressure, high cholesterol and diabetes is also key.

Raising the alarm over looming costs of treating heart disease

Dr. Yancy will also raise the alarm over the looming cost of treating heart disease now and in the future. With predictions that the direct medical cost of treating heart disease in the U.S. alone could climb to $818 billion in 2030, he says there is a health and economic imperative for governments and societies around the world to embrace prevention strategies.

Heart disease and stroke cost the Canadian economy more than $20.9 billion every year in physician services, hospital costs, lost wages and decreased productivity.

“The opportunity for prevention is not an unrealistic expectation,” says Dr. Yancy. “Over the past 40 years the rates of heart disease and stroke have steadily declined.” The rate has declined in Canada by 70 per cent since the mid-1950s. In the last decade alone, the rate has declined by 25 per cent.

Unfortunately, says Dr. Yancy, these benefits may be short-lived if the burden of risk, specifically obesity and diabetes, continues to grow, especially in children. “We need to act now.”

Canadians can take a personalized My Heart&Stroke Risk Assessment™ to find out how their age, family history, and medical conditions affect their heart health at heartandstroke.ca/risk.

Fast response is critical for ST-segment elevation myocardial infarction (STEMI) patients. This severe heart attack is caused by a complete blockage of blood supply to the heart. More than 250,000 people suffer a STEMI each year.

But not all hospitals are equipped to perform artery-opening angioplasty – only about 25 percent in the United States. Facilities that can’t perform the procedure, also known as percutaneous coronary intervention, or PCI, typically refer and transfer patients to others that can.

“While we are making tremendous progress in PCI hospitals, delays are still occurring during the transfer process,” said Timothy D. Henry, M.D., the study’s senior author and director of research at the Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital in Minneapolis. “This is the first study that examines and identifies the specific reasons for delay of transfer patients.”

Researchers examined data from 2,034 STEMI patients transferred from 31 local non-PCI hospitals in Minnesota and Wisconsin to the Minneapolis Heart Institute from March 2003 to December 2009. Referring hospitals were up to 210 miles away from the Institute.

Despite long-distance transfers, 65.7 percent of patients were treated within120 minutes from the time of presentation at the initial referring hospitals.

However, 34.2 percent of patients experienced a delay in total treatment time, and the study found delays most frequently occurred at the referral hospital (64 percent), followed by the PCI center (15.7 percent) and during transport (12.6 percent).

Specifically, the 64 percent of delays at the referral hospital were caused by:

awaiting transportation ─ 26 percent;
emergency department delays ─ 14 percent;
diagnostic dilemma ─ 9 percent;
initial negative test for heart attack ─ 9 percent; and
cardiac arrest ─ 6 percent.
Delays related to cardiac arrest were the most likely to result in death, with an in-hospital mortality rate of 31 percent. In contrast, some delays, like an initially negative heart attack test, had no increased risk of death.

“All delays are not created equally,” Henry said. “By identifying where the delays are we can improve the systems for transferring patients to get them the care they need.”

He said it’s important to recognize that the higher risk patients are faring the worst, so the less successful outcomes may be related to their advanced disease states.

In 2007, the American Heart Association launched Mission: Lifeline to help improve systems of care for STEMI patients by reducing barriers from the time 9-1-1 is called until hospital discharge. That includes lack of timely access to a hospital capable of performing angioplasty, 24 hours a day, seven days a week.

The American Heart Association also offers Mission: Lifeline Accreditation by the Society for Chest Pain Centers for hospitals meeting specific criteria as either a STEMI-receiving hospital or a STEMI-referral hospital.

“A study recently published in Circulation – ‘Improvements in Door-to-Balloon Time in the United States, 2005 to 2010′ – found that more than twice as many people are getting treatment within 90 minutes of arriving at an angioplasty hospital than were five years ago, so we are making great progress,” said Chris Granger, M.D., chairman of the Mission: Lifeline steering committee and professor of medicine and director of the Cardiac Care Unit at Duke University Medical Center in Durham, N.C. “But Dr. Henry’s study shows us that many patients still have delays, and that certain types of delays are associated with worse outcomes. So there is an important opportunity to further improve care, especially for patients being transferred from hospitals not equipped to do angioplasty.”

“Our ultimate goal is to improve timely access to angioplasty in patients with STEMI,” Henry said. “We’ve been very successful doing this in hospitals that are equipped to provide the procedure. This study emphasizes that now our focus should be on regional systems which seek to incorporate those hospitals that require patient transfer in the process.”

Image shows a normal control lung blood vessel and heart (CTRL) compared with these structures affected by pulmonary hypertension (PH), at the advanced disease stage of right ventricle failure (RVF) and disease reversal with estrogen treatment (E2) and continued benefit even after estrogen treatment withdrawal (E2-W). Note the completely blocked blood vessel and enlarged right ventricle in advanced disease (RVF) and how the right ventricle (RV) shrinks and vessel clears during and after estrogen treatment (E2) and (E2-W). Credit: American Journal of Respiratory and Critical Care Medicine/UCLA

The condition causes a progressive increase in blood pressure in the main pulmonary artery, which originates in the heart’s right ventricle and delivers blood to the lungs. The rise in pressure impairs heart function by enlarging the right ventricle, potentially leading to heart failure.

Published in the Sept. 15 issue of the American Journal of Respiratory and Critical Care Medicine, the preclinical study shows that in rats, estrogen treatment can reverse the progression of pulmonary hypertension to heart failure and can restore lung and ventricle structure and function.

The disease progresses slowly, so most patients don’t seek treatment until major symptoms occur, such as shortness of breath, dizziness and fainting. According to researchers, current medication for pulmonary hypertension only temporarily reduces the disease’s severity. For advanced pulmonary hypertension, there are fewer options, and the condition often necessitates a lung transplant.

“Unfortunately, up until now, there hasn’t been an ideal pharmacological therapy to treat advanced pulmonary hypertension,” said senior study author Mansoureh Eghbali, Ph.D., an assistant professor of anesthesiology at the David Geffen School of Medicine at UCLA who has a strong background in studying the role of gender and estrogen in cardiovascular diseases. “We hope that this early study may offer insight into new therapies.”

The UCLA team found that by treating rats with severe pulmonary hypertension with low doses of estrogen, they were able to prevent the disease from progressing to right-ventricular heart failure; this did not happen in untreated rats.

Systolic blood pressure and ejection fraction — the volume of blood being pumped out of the heart’s right chamber with each heart beat — also improved. Tests showed that lung weight, which can increase with the disease and resulting heart-ventricle enlargement, was also corrected. After 10 days of estrogen treatment, function returned to an almost normal state.

The researchers stopped the estrogen therapy after 10 days but continued to observe some of the treated rats. They tracked the continued improvement and found almost full restoration of systolic blood pressure and ejection fraction to normal levels after an additional 12 days.

“We were surprised to find this continued benefit, even after we stopped the estrogen treatment,” said the study’s first author, Dr. Soban Umar, a UCLA Department of Anesthesiology researcher who has studied pulmonary hypertension and right-ventricular heart failure and is a key member of Eghbali’s laboratory team. “These findings suggest that even short-term estrogen therapy may suffice to reverse the disease.”

All rats with severe pulmonary hypertension that were treated with estrogen survived by the study’s end. Only 25 percent of the untreated rats survived.

The team also explored how estrogen could work in reversing the disease by studying several cellular and molecular mechanisms.

They found that the number of inflammatory cells in rats with pulmonary hypertension increased five-fold, compared with normal rats. In the animals treated with estrogen, this was reversed to normal. The team found that estrogen reduced regulation of a pro-inflammatory gene that also plays a key role in disease development caused by pulmonary hypertension. They also found that estrogen had an inhibitory effect on lung fibrosis.

In addition, the team observed that estrogen therapy restored blood vessels in the lungs and right ventricle whose loss is associated with the disease.

Further study identified that estrogen exerts its biological effects on pulmonary hypertension through a receptor called estrogen receptor beta, a protein that regulates estrogen’s activity in the body.

“Estrogen appears to work through an interplay of several factors, including suppression of lung inflammation and fibrosis, as well as reversal of ventricle enlargement,” Eghbali said. “We may be able to utilize estrogen receptor beta in the development of future therapies to stimulate estrogen activity to treat pulmonary hypertension.”

Researchers had also tested estrogen receptor alpha, the other receptor that controls estrogen activity, but found that it wasn’t as effective in treating pulmonary hypertension.

Eghbali added that estrogen receptor beta may prove to be a favorable therapeutic target, since this receptor may require only a short treatment duration and low dosage and has less pro-estrogenic effects on the breasts and uterus than estrogen receptor alpha.

Pulmonary hypertension affects mostly younger women, despite the fact that females in this age group should be under the protective benefits of natural estrogen produced by the body, Eghbali said.

“These patients may have a genetic mutation that is interfering in how estrogen receptor beta directs estrogen activity that is leading to pulmonary hypertension,” she said.

Her team’s next step is to explore these genetic questions. Currently, Umar and Eghbali are collaborating with UCLA pulmonary hypertension physicians to investigate gender-related issues and to define the role of estrogen in patients with this deadly disease.

Dingbo “Daniel” Lin, K-State research assistant professor of human nutrition, is studying wolfberries and their potential to improve damage to the retina. His findings show that the fruit can lower the oxidative stress that the eye undergoes as a result of type-2 diabetes.

Dingbo "Daniel" Lin is using dried wolfberries and examining their effects on the retina pigment epithelial cell layer. Credit: K-State media relations

“I would not say that wolfberries are a medicine, but they can be used as a dietary supplement to traditional treatments to improve vision,” Lin said. “Wolfberries have high antioxidant activity and are very beneficial to protect against oxidative stress caused by environmental stimuli and genetic mutations.”

Lin has experience in biochemistry and eye research, and he wanted to bridge his current work in nutrition with vision. In a conversation about the eye and phytochemicals Lin had with his father, a traditional medical doctor in China, Lin decided to explore the use of wolfberries for vision improvement.

“In our culture’s history, we have traditional medicine literature that describes things like the wolfberry and its functions,” Lin said.

Wolfberries are bright orange-red, oblong-shaped and grown in China. Lin said the fruit is known to help rebalance homeostasis, boost the immune system, nourish the liver and kidneys and improve vision. He wanted to understand the mechanisms of the wolfberry’s effects on vision and started the project in July 2008.

Lin and his colleagues have found that wolfberries have high levels of zeaxanthin, lutein, polysaccharides and polyphenolics, which have been shown to improve vision, including the prevention of age-related macular degeneration and diabetic retinopathy.

The researchers are using dried wolfberries and examining their effects on the retina pigment epithelial cell layer.

“It’s the only cell layer in the far back of the retina, and it provides a fundamental support to the whole retina, just like the base of a building,” Lin said. “All of the nutrients pass through that cell layer.”

By using type-2 diabetic mice, the researchers are studying the effects of wolfberries on oxidative stress, one of the factors that occurs in diabetic retinopathy, which is a common complication of diabetes and the leading cause of blindness in American adults.

“Oxidative stress is known as cell impairment of the production of reactive oxygen,” Lin said. “Cellular oxidative stress is involved in many human diseases, such as diabetes, vision impairment and blindness.”

The researchers also looked at the endoplasmic reticulum, which is where the folding process of proteins occurs in a cell. When the accumulation of unfolded protein aggregates occurs persistently, the endoplasmic reticulum is under stress. Prolonged stress will eventually cause cell deaths, Lin said.

The in vitro and in vivo studies have shown that the wolfberry’s phytochemicals protect the retinal pigment epithelial cells from hyperglycemia, or high glucose. The findings show that the fruit has local effects on oxidative stress, reactivates the enzyme AMPK and reduces endoplasmic reticulum stress.

“AMPK is a key enzyme in the balance of cell energy homeostasis,” Lin said. “The outcome of the current research will lead to the development of dietary regimens in prevention of an eye disease.”

The researchers are continuing to study wolfberries and their health benefits. Lin said wolfberries could be used as a dietary supplement, though the fruit isn’t likely to be found in traditional U.S. food stores. He said consumers might find them in a Chinese food store or on the Internet.

The research is part of a fast-moving field called nutrigenomics, which studies the effects of food on gene expression and disease. Nutrients have been shown to affect gene expression, and by understanding the roles of specific nutrients and how they might cause diseases, scientists could recommend specific foods for an individual based on his or her genetics.

At K-State, other researchers collaborated on the project: Denis Medeiros, professor and department head of human nutrition; Yu Jiang, research associate in human nutrition; Edlin Ortiz, junior in life sciences, Liberal; and Yunong Zhang, a former research assistant in human nutrition.

The research has been presented at the 2009 Experimental Biology conference and 2009 American Society of Cell Biology Conference. The project is funded by a grant from K-State’s Center of Biomedical Research Excellence.

via Kansas State University

One consolation for women is that many of them seem not to miss it. Men tend to marry younger women, die sooner and care more about sex, the study confirmed. Although 72 percent of men aged 75 to 85 have partners, fewer than 40 percent of women that age do. Only half of women 75 – 85 who remained sexually active rated their sex lives as “good,” and only 11 percent of all women that age report regularly thinking about or being interested in sex. Among those age 57 to 85 not living with a partner, 57 percent of men were interested in sex, compared to only 11 percent of women.

“Interest in sex, participation in sex and even the quality of sexual activity were higher for men than women, and this gender gap widened with age,” said lead author Stacy Tessler Lindau, MD, associate professor of obstetrics and gynecology at the University of Chicago. But the study also “affirms a positive association between later-life health, sexual partnership and sexual activity,” she said.

Lindau and co-author Natalia Gavrilova focused on two large surveys, the National Survey of Midlife Development, involving about 3,000 adults aged 25 to 74 and completed in 1996, and the National Social Life Health and Aging Project, involving another 3,000 adults aged 57 to 85, completed in 2006. Participants provided information about their relationship status and rated the quality of their sex lives and how often they had sex. They also rated the level of their general health as poor, fair, good, very good or excellent.

The results showed that men are more likely to be sexually active, report a good sex life and be interested in sex than women. This difference was most stark among the 75 to 85-year-old group, where almost 40 percent of men, compared to 17 percent of women, were sexually active.

The study also introduced a new health measure, “sexually active life expectancy,” or SALE, the average remaining years of sexually active life. For men, SALE was about ten years lower than total life expectance. For women it was 20 years lower.

Men at the age of 30, for example, have a sexually active life expectancy of nearly 35 years, but they can, on average, expect to remain alive for 45 years, including a sexless final decade. For 30-year-old women, SALE is almost 31 years but total life expectancy is more than 50. So men that age can anticipate remaining sexually active for 78 percent of their remaining lifespan, while women at 30 can expect to remain sexually active for only 61 percent of the remaining years.

The authors conclude that “sexually active life expectancy estimation is a new life expectancy tool than can be used for projecting public health and patient needs in the arena of sexual health,” and that “projecting the population patterns of later life sexual activity is useful for anticipating need for public health resources, expertise and medical services.”

In an accompanying editorial, Professor Patricia Goodson from Texas University says Lindau and Gavrilova’s research is both refreshing and hopeful. She says: “the study bears good news in the form of hope … the news that adults in the US can enjoy many years of sexual activity beyond age 55 is promising.”

Goodson adds that many unanswered questions remain in the field of older people and sexuality, such as problems with measurement and silence regarding the sexual health of aging homosexual, bisexual or intersexed people. “They stand as dim reminders of the limitations inherent in applying science to the study of complex human realities, and the cultural values shaping the topics we choose to study,” she concludes.

via University of Chicago Medical Center.

The study participants were assigned to a tai chi group or a control group. Both groups attended 60-minute classes twice a week for 12 weeks. The tai chi group learned and practiced Yang-style tai chi, modified slightly to eliminate excess stress on the knees. The control group received wellness education and did stretching exercises. Participants were also instructed to perform tai chi or stretching exercises between classes, and to continue this at-home activity after the classes were finished. The researchers used several measures to monitor the subjects at 12, 24, and 48 weeks.

Compared with the control group, tai chi patients had greater improvement in measures of pain, physical function, self-efficacy (belief in one’s own abilities), depression, and health-related quality of life. Although most differences between the two groups were statistically significant only at 12 weeks, the differences for self-efficacy and depression remained statistically significant at 24 and 48 weeks. No serious adverse events were reported.

The researchers recommend additional studies of biologic mechanisms and approaches of tai chi, so its benefits can be extended to a broader population.

Fruits and vegetables are a key part of calorie-restricted diets, which may increase longevity. Credit: Wikimedia Commons, Eric Hunt (High-resolution version)

Scientists searching for the secrets of how calorie-restricted diets increase longevity are reporting discovery of proteins in the fat cells of human volunteers that change as pounds drop off. The proteins could become markers for monitoring or boosting the effectiveness of calorie-restricted diets — the only scientifically proven way of extending life span in animals. Their study appears online in ACS’ Journal of Proteome Research: “The physiologic effects of calorie restriction are reflected in the in vivo adipocyte-enriched proteome of overweight/obese subjects.”

Edwin Mariman and colleagues note that scientists have long known that sharply restricting intake of calories while maintaining good nutrition makes animals live longer and stay healthier. Recent studies suggest that people may gain similar benefits. But scientists know little about how these diets work in humans, particularly their effects on cells that store fat.

The new study focused on proteins in abdominal subcutaneous fat cells from a group of overweight people before and after they went on a five-week-long calorie-restricted diet. The volunteers each lost an average of 21 pounds. Scientists identified changes in the levels of 6 proteins as the volunteers shed pounds, including proteins that tell the body to store fat. These proteins could serve as important markers for improving or tracking the effectiveness of therapies involving calorie-restricted diets, they say.

And retired players between the ages of 30 and 49 are 19 times more likely to struggle with memory problems than similarly aged men who never played professional football, the study found.

Read full story via HealthDay.

More than 80 percent of 40 Columbus-area stylists surveyed said that older clients often or always shared their problems during appointments.

Read full story via researchnews.osu.edu

The report, “Deaths: Preliminary Data for 2007,” was issued today by CDC’s National Center for Health Statistics. The data are based on nearly 90 percent of death certificates in the United States.

The 2007 increase in life expectancy – up from 77.7 in 2006 — represents a continuation of a trend. Over a decade, life expectancy has increased 1.4 years from 76.5 years in 1997 to 77.9 in 2007.

Other findings:

* Record high life expectancy was recorded for both males and females (75.3 years and 80.4 years, respectively). While the gap between male and female life expectancy has narrowed since the peak gap of 7.8 years in 1979, the 5.1 year difference in 2007 is the same as in 2006.

* For the first time, life expectancy for black males reached 70 years.

* The U.S. mortality rate fell for the eighth straight year to an all-time low of 760.3 deaths per 100,000 population in 2007 — 2.1 percent lower than the 2006 rate of 776.5. The 2007 mortality rate is half of what it was 60 years ago (1532 per 100,000 in 1947.)

* The preliminary number of deaths in the United States in 2007 was 2,423,995, a 2,269 decrease from the 2006 total.

* Heart disease and cancer, the two leading causes of death, accounted for nearly half (48.5 percent) of all deaths in 2007.

* Between 2006 and 2007, mortality rates declined significantly for eight of the 15 leading causes of death. Declines were observed for influenza and pneumonia (8.4 percent), homicide (6.5 percent), accidents (5 percent), heart disease (4.7 percent), stroke (4.6 percent), diabetes (3.9 percent), hypertension (2.7 percent), and cancer (1.8 percent).

* The death rate for the fourth leading cause of death, chronic lower respiratory diseases, increased by 1.7 percent. Preliminary death rates also increased for Parkinson’s disease, chronic liver disease and cirrhosis, and Alzheimer’s, but these gains are not statistically significant.

* There were an estimated 11,061 deaths from HIV/AIDS in 2007, and mortality rates from the disease declined 10 percent from 2006, the biggest one-year decline since 1998. HIV remains the sixth leading cause of death among 25-44 year-olds.

* The preliminary infant mortality rate for 2007 was 6.77 infant deaths per 1,000 live births, a 1.2 percent increase from the 2006 rate of 6.69, though not considered statistically significant. Birth defects were the leading cause of infant death in 2007, followed by disorders related to preterm birth and low birthweight. Sudden infant death syndrome (SIDS) was the third leading cause of infant death in the United States.

The full report is available at www.cdc.gov/nchs.

via CDC Newsroom Press Release August 19, 2009.