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As Disease Outbreaks Tied to ‘Anti-Vaxxers’ Rise, States Take Action

TUESDAY, Nov. 19, 2019 — Outbreaks of vaccine-preventable diseases are on the across rise in the United States, often fueled by “anti-vaxxer” parents reluctant to immunize their kids.

However, states are countering these trends with laws to boost childhood vaccination rates and safeguard children, a new study finds.

“Vaccines are our best public health tool for controlling many childhood diseases,” said lead author Neal Goldstein of Drexel University, in Philadelphia.

“Seeing an uptick in legislation aimed at cutting vaccine exemptions following disease outbreaks suggests that media coverage may raise public awareness and advocacy and response from legislators,” Goldstein said in a university news release.

“While it is unfortunate it took outbreaks of preventable disease to spawn legislative action, it further affirms the widespread support of this life-saving intervention,” he added. Goldstein is an assistant research professor of epidemiology and biostatistics in Drexel’s School of Public Health.

Recent outbreaks of illnesses such as measles or whooping cough in California (2015) and New York (2019) led lawmakers in those states to ban all non-medical vaccine exemptions.

To see if that trend was widespread, Goldstein’s team analyzed 2010 to 2016 state data on outbreaks of 12 childhood vaccine-preventable diseases, including hepatitis A and B, flu, measles and whooping cough.

The investigators also examined 2011 to 2017 data on state bills introduced the year after the start of an outbreak that would tighten or ease vaccination requirements for these diseases.

Each state reported an average of 25 vaccine-preventable diseases per 100,000 people per year, but there was significant year-to-year variation.

Of the 175 state vaccination-related bills proposed during 2011 to 2017, about 53% made it easier to get an exemption from vaccine requirements, while 47% made exemption more difficult.

While there were more anti-vaccine bills than pro-vaccine bills introduced overall, further analysis showed that increases in vaccine-preventable diseases were followed by increases in the number of proposed bills that restricted vaccine exemptions.

There was no association between decreases in vaccine-preventable diseases and proposed bills that made it easier to get vaccine exemptions, according to the study. The results were published Nov. 18 in JAMA Pediatrics.

Legislation to reduce vaccine exemptions is needed in the United States, the study authors said. Measles was declared eliminated in the United States in 2000, but there were 695 cases in 22 states in April 2019, according to the U.S. Centers for Disease Control and Prevention.

More information

The U.S. Centers for Disease Control and Prevention has more on vaccines.

© 2019 HealthDay. All rights reserved.

Posted: November 2019

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Fewer Teeth, Higher Risk of Heart Disease?

FRIDAY, Oct. 4, 2018 — Losing teeth may be associated with higher risk for heart disease, a new study suggests.

Researchers studied nearly 317,000 Americans between 40 and 79 years of age. They found that 28% of those who had lost all their teeth to gum disease also had heart problems, compared with 7% of those who kept all their teeth.

The researchers found that people with some missing teeth were more likely to develop heart disease, even when accounting for factors such as age, weight, race, tobacco and alcohol use, and dental visits.

“Our results support that there is a relationship between dental health and cardiovascular health,” said lead author Dr. Hamad Mohammed Qabha. He’s chief medical and surgical intern at Imam Muhammad Ibn Saud Islamic University in Riyadh, Saudi Arabia.

The findings were scheduled to be presented Thursday at a meeting of the American College of Cardiology, in Dubai, United Arab Emirates. The study only revealed an association rather than a cause-and-effect link.

“If a person’s teeth fall out, there may be other underlying health concerns,” Qabha said in a meeting news release. “Clinicians should be recommending that people in this age group receive adequate oral health care to prevent the diseases that lead to tooth loss in the first place and as potentially another way of reducing risk of future cardiovascular disease.”

Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

More information

For more about steps to prevent heart disease, visit the American Heart Association.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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Gum Disease Might Raise Your Blood Pressure

By Steven Reinberg
HealthDay Reporter

FRIDAY, Sept. 27, 2019 (HealthDay News) — Here’s a compelling reason to keep those dreaded appointments with your dentist: New research suggests that red, tender or bleeding gums could trigger high blood pressure.

In a review of 81 studies that included more than 250,000 people, U.K. scientists found that those who had moderate to severe gum disease (periodontitis) had a 22% increased risk for high blood pressure, and those with severe gum disease had a 49% higher risk.

Oral health is closely linked to general health,” explained researcher Dr. Francesco D’Aiuto, head of the periodontology unit at University College London’s Eastman Dental Institute.

“Looking after your teeth and gums is often neglected, but [it] should be as important as managing other general health risks,” he added.

Among people with periodontitis, systolic pressure (top number) was 4.5 mm Hg higher and diastolic pressure (bottom number) was 2 mm Hg higher, on average, than people without gum disease, the researchers found.

In five of the studies analyzed, researchers found that blood pressure dropped when periodontitis was treated. Blood pressure also dropped in patients treated for gum disease who didn’t have hypertension, they added.

But whether treating periodontitis really is the cause of a drop in blood pressure isn’t certain, D’Aiuto said, since the study did not prove a cause-and-effect link.

“Bad brushing and bacteria accumulation around teeth causes gum bleeding and disease, but also could raise body inflammation and cause blood vessel damage,” D’Aiuto said.

When the gums are infected, the disease can spread to other parts of the body causing systemic inflammation, which can harm blood, the researchers noted.

Some people may have a genetic susceptibility that might also play a part, along with other risk factors such as smoking and obesity, they added.

“Every dentist should inform their patients of the potential link and the risk of developing high blood pressure,” D’Aiuto said.

In addition to giving advice on good dental hygiene and treatment, dentists should advise patients to keep tabs on their blood pressure with their primary care doctor, he said.

Continued

“Future research should look at the effects of treating gum disease on blood pressure,” D’Aiuto said. “If the association is proven true, then patients could benefit from managing gum disease beyond the mouth.”

A growing body of evidence shows an association between periodontitis and hypertension, along with hardening of the arteries, said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles.

More than 50 studies have shown that periodontitis is associated with increased risk for heart disease and an association between tooth loss and stroke, cardiovascular death and death from any cause, he said.

“However, it remains unclear whether gum disease is a marker or mediator,” Fonarow said.

“If causal, these associations would be of great importance because of the potential that preventing or treating periodontal disease could reduce blood pressure levels, as well as reduce the risk of major adverse cardiovascular events,” he said.

More studies are needed to see if improving oral health can influence heart and vascular health, Fonarow added.

The report was published Sept. 24 in the journal Cardiovascular Research.

WebMD News from HealthDay

Sources

SOURCES: Francesco D’Aiuto, D.M.D., Ph.D., professor, head, periodontology unit, Eastman Dental Institute, University College London, England; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Sept. 24, 2019,Cardiovascular Research

Copyright © 2013-2018 HealthDay. All rights reserved.

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Cancer Overtakes Heart Disease as #1 Killer of Middle-Aged in Wealthy Nations

TUESDAY, Sept. 3, 2019 — Heart disease still claims the lives of more people globally, but in more affluent nations it has now ceded its place as the leading killer to cancer, a major new report finds.

Around the world, 40% of all deaths are caused by heart disease, making it the number one global killer. That means that of the estimated 55 million people who died around the world in 2017, approximately 17.7 million succumbed to heart disease.

Cancer was the second leading killer globally, accounting for 26% of all deaths, the study authors said.

However, when middle- and lower-income countries were taken out of the calculation, a different picture emerged, according to a report published online Sept. 3 in The Lancet.

For people living in “high-income” countries such as Canada, Sweden and Saudi Arabia, heart disease represented just 23% of deaths, while cancer was to blame for 55% of deaths, the researchers said.

The findings come from a global study of more than 162,500 middle-aged people living in four high-income countries, 12 countries considered middle-income, and five low-income countries. The study was led by Dr. Gilles Dagenais, emeritus professor at Laval University in Quebec, Canada.

Speaking in a journal news release, Dagenais said that the world is undergoing a “transition” in terms of causes of death, “with cardiovascular disease no longer the leading cause of death in high-income countries.”

But as better prevention and treatment of heart disease becomes more common, and cases of the disease “continue to fall, cancer could likely become the leading cause of death worldwide, within just a few decades,” Dagenais said.

Study principal investigator Dr. Salim Yusuf, a professor of medicine at McMaster University in Canada, agreed that “long-term cardiovascular disease prevention and management strategies have proved successful in reducing the burden in high-income countries.”

But poorer nations often lack either the resources or leadership to tackle high rates of heart disease, he added, so “governments in these countries need to start by investing a greater portion of their gross domestic product in preventing and managing non-communicable diseases, including cardiovascular disease, rather than focusing largely on infectious diseases.”

A second report focused on why people around the world continue to die in great numbers from heart disease. The same team of researchers used data on almost 156,000 middle-aged people to look at the role played by 14 heart disease risk factors.

The good news: 70% of the factors driving heart disease and heart disease death are “modifiable,” meaning changes to lifestyle and environment can greatly lessen people’s risk. Some of those factors include “metabolic” ones — overweight, diabetes and the like — or high blood pressure. In poorer countries, environmental factors, such as air pollution or poor diets, play a greater role.

The study was also presented Tuesday at the annual meeting of the European Society of Cardiology, in Paris.

More information

The American Heart Association has more on heart disease.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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Lifestyle May Matter More Than Your Genes in Early Heart Disease

MONDAY, Sept. 2, 2019 — An unhealthy lifestyle is a bigger contributor to heart disease than genetics for many younger adults, according to a new study.

The findings show that good health habits should be a key part of prevention efforts, even in people with a family history of early heart disease, researchers said.

The study included 1,075 people under age 50. Of those, 555 had coronary artery disease.

The investigators assessed five lifestyle factors linked to heart disease: physical inactivity, smoking, high blood pressure, diabetes and high cholesterol.

In all, 73% of patients had at least three of the risk factors compared to 31% of those without coronary artery disease (the control group).

In both groups, the odds of coronary artery disease increased with each additional risk factor. The risk was three times higher for those with a single risk factor and 24 times higher for those with three or more, the findings showed.

The researchers also found that the patients with coronary artery disease had a higher average genetic risk, based on 33 factors.

While their overall score on those 33 factors was an independent predictor for premature heart disease, the influence of genetics declined as the number of modifiable lifestyle factors increased, according to the study presented Monday at a meeting of the European Society of Cardiology (ESC), in Paris.

Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

“Genetics are an important contributor to premature heart disease but should not be used as an excuse to say it is inevitable,” study author Dr. Joao Sousa said in an ESC news release. Sousa is a cardiologist at Funchal Central Hospital in Portugal.

“In our clinical practice, we often hear young patients with premature heart disease ‘seek shelter’ and explanations in their genetics/family history,” he noted. “However, when we look at the data in our study, these young patients were frequently smokers, physically inactive, with high cholesterol levels and high blood pressure — all of which can be changed.”

Sousa said the study provides strong evidence that people with a family history of early heart disease should embrace a healthy lifestyle. “That means quit smoking, exercise regularly, eat a healthy diet, and get blood pressure and cholesterol levels checked,” he concluded.

More information

The U.S. Centers for Disease Control and Prevention has more on heart disease prevention.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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Obesity Harming Strides Made Against Heart Disease

By Steven Reinberg
HealthDay Reporter

TUESDAY, Aug. 27, 2019 (HealthDay News) — Rising obesity rates, coupled with an associated jump in diabetes and high blood pressure cases, appears to be undoing decades of gains made against heart disease, a new study finds.

After 2010, the rate of deaths from heart disease continued to drop, but more slowly. Deaths from stroke leveled off, and deaths from high blood pressure (“hypertension”) increased, researchers report.

“These findings are surprising and alarming, because despite medical and surgical advances and public policy initiatives around cholesterol and blood pressure awareness, we are losing ground in the battle against cardiovascular disease,” said lead researcher Dr. Sadiya Khan. She is an assistant professor of cardiology at Northwestern University Feinberg School of Medicine, in Chicago.

“The culprit may be the rise in obesity,” she added, though the study could not prove that definitively.

“One of the greatest success stories of the past century has been the marked reduction in cardiovascular disease death rates,” Khan said.

Despite this progress, heart disease continues to be the number one killer of American men and women. Moreover, the positive progress that was being made has slowed or stopped, Khan noted.

“The reversal of these trends is concerning,” she said. “Even more alarming is the fact that cardiovascular death rates for black Americans remain higher than those for white Americans.”

For the study, Khan and her colleagues used data from the U.S. Centers for Disease Control and Prevention on deaths from heart disease, stroke, diabetes and hypertension from 1999 through 2017.

The findings highlight the urgency to address the obesity epidemic and the increasing deaths from heart disease, Khan said. “We need to come up with better ways to fight cardiovascular disease, and quickly,” she explained.

Heart disease is largely preventable. “We know that prevention of risk factors and aggressive management beginning early in life is critical,” Khan added. People should talk with their doctor about their risk factors and how to live a heart-healthy lifestyle, she suggested.

Targeting people early in life and focusing on prevention even in childhood and young adulthood can go a long way to prevent heart disease later, she said.

Continued

“To support individual lifestyle changes, policymakers need prevention strategies to support Americans in eating a healthy diet, having safe places to exercise in the neighborhood, and access to health care and medications,” she said.

The report was published Aug. 27 in the Journal of the American Medical Association.

The findings really emphasize the need to focus on prevention, said Dr. Richard Becker, an American Heart Association expert and chair of medicine at the University of Cincinnati College of Medicine.

The increase in deaths from heart disease is a public health challenge that involves health care providers, national organizations and the health care industry, Becker said.

Prevention needs to start early, he stressed. “Without early identification and early intervention, we will not be able to reverse these alarming trends,” he added.

Curbing the obesity epidemic, with its probable effect of reducing the prevalence of diabetes and high blood pressure, is needed, Becker suggested.

“But in all likelihood, if we started today with some initiatives, it may take five to 10 years before you’re going to see the fruits of these labors,” Becker said. “So, we could start seeing an increase in cardiovascular deaths before they start to go down again.”

WebMD News from HealthDay

Sources

SOURCES: Sadiya Khan, M.D., assistant professor, cardiology, Northwestern University Feinberg School of Medicine, Chicago; Richard Becker, M.D., American Heart Association expert and chair and professor, medicine, University of Cincinnati College of Medicine; Aug. 27, 2019,Journal of the American Medical Association

Copyright © 2013-2018 HealthDay. All rights reserved.

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Lots of Gluten During Toddler Years Might Raise Odds for Celiac Disease

TUESDAY, Aug. 13, 2019 — Too much white bread and pasta fed to at-risk kids under age 5 could increase their odds of developing celiac disease, a new international study has concluded.

Every extra daily gram of gluten a young child eats increases their risk of celiac disease, if they are genetically predisposed to it, researchers found.

For example, eating an extra half-slice of white bread every day at age 2 can increase a kid’s risk of celiac disease at age 3 by 7%, according to findings published Aug. 13 in the Journal of the American Medical Association.

“The kids who went on to celiac disease were consuming more gluten in their diet in early childhood,” said study co-author Jill Norris, head of epidemiology at the University of Colorado’s School of Public Health.

However, Norris’ team warned it’s too soon to recommend eliminating gluten from the diets of young children, even those with a genetic risk for celiac disease.

“The worry is you would cut out healthy foods high in fiber and other nutrients simply to cut out gluten,” Norris said. “There are ways to remove gluten from the diet and maintain a healthy diet, but it’s actually quite difficult.”

Who’s at risk?

Celiac disease is an immune reaction in the small intestine to gluten, a protein found in some grains. It often causes diarrhea, fatigue, weight loss, bloating, abdominal pain and anemia, and can lead to serious complications.

A person with a parent, child or sibling who has celiac disease carries a 1-in-10 chance of developing the disorder, according to the Celiac Disease Foundation.

It often develops in early childhood, but it hasn’t been clear why some kids at risk for celiac disease wind up with it while others don’t, Norris said.

“Virtually everybody is exposed to gluten during their lifetime, and there are a number of people who we consider genetically at increased risk but they never get the disease,” Norris said. “We’re trying to figure out what’s different about the people who do end up getting the disease.”

For this study, researchers followed more than 6,600 children from birth through age 15 at six clinical research centers in Finland, Germany, Sweden and the United States. All had an inherited risk for celiac disease.

Their diets and gluten intake were tracked based on three-day food diaries taken at regular intervals throughout their lives.

About 18% of the kids developed autoimmune responses related to celiac disease and 7% developed full-blown celiac disease, with the onset of both conditions peaking at 2 to 3 years of age, researchers found.

Every 1-gram increase in daily gluten intake — about a half-slice of white bread — at age 2 was associated with an increased chance of celiac disease by age 3, they concluded.

“We can now confirm that besides certain genes, high intake of gluten also is an important risk factor for celiac disease,” said senior researcher Dr. Daniel Agardh, a pediatrician with the Diabetes and Celiac Disease Unit at Lund University in Sweden.

Tough to ‘micromanage’ diet

Still, more research is needed before doctors can offer parents solid advice about their young child’s diet, experts said.

Other possible factors in celiac disease still need to be considered, such as early childhood infections, changes in gut bacteria, and antibiotic exposure, noted Dr. Jacqueline Jossen. She’s a pediatric gastroenterologist at the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai Hospital in New York City.

“There’s a lot that was not specifically analyzed in this study, and there is previous literature to suggest those things may have a role as well,” said Jossen, who had no part in the research.

At this point, she wouldn’t recommend any dietary changes based off these findings.

“It’s such a small amount of gluten they’re talking about here. Even half a slice of bread can make a difference? Even on a practical level, it’s hard to micromanage something like that,” Jossen said.

Jossen speaks from experience. She has celiac disease and has a 3-year-old daughter with a genetic predisposition toward the condition.

“Even for me on a personal level, I wouldn’t change her diet based on this yet,” Jossen said of her daughter.

Is testing worth it?

And how do you even know for sure that you or your child is at risk?

Genetic tests for celiac disease risk are available, but often are not covered by insurance, said Dr. Maureen Leonard, clinical director of the Center for Celiac Research and Treatment at MassGeneral Hospital for Children in Boston.

“Online commercially available tests do not always assess all compatible genes for celiac disease,” said Leonard, who wrote an editorial published with the study. “Therefore, I would suggest parents speak with their physician about whether a genetic test may be appropriate for their child.”

Agardh doesn’t think genetic testing would be of much help, “since these genes are common in the general population.”

“In fact, the majority of individuals carrying these risk genes eating gluten will not develop celiac disease,” he said.

A second study this week in JAMA Pediatrics found that gluten also can boost children’s risk of developing type 1 diabetes.

Among children with a genetic susceptibility for type 1 diabetes, a high intake of gluten was associated with an increased risk of an immune response that can damage or destroy the body’s ability to produce insulin over time.

“Given that these cereals are eaten by most children daily and are important sources of many essential nutrients, further studies are warranted to confirm or rule out the findings,” said the authors led by Leena Hakola from Tampere University in Finland.

More information

The Celiac Disease Foundation has more about celiac disease.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

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Crowdsourcing to Fund Rare Disease Research

SOURCES:

Nicole Henwood, MD, president and CEO, NF2 BioSolutions, West Chester, PA.

UpToDate: “Neurofibromatosis type 2.”

National Institutes of Health: “Rare Disease Clinical Research Network.”

Lancet: “Spotlight on Rare Diseases.”

National Institutes of Health: “FAQs About Rare Diseases.”

University of California, Davis: “What is Translational Research?”

National Organization for Rare Disorders: “Member Snapshot.”

National Institutes of Health: “What is Gene Therapy?”

NF2 BioSolutions: “FAQs.”

Amber Salzman PhD, president and CEO, Ohana Biosciences, Merion Station, PA.

Gary Brenner, MD, PhD, director, Pain Medicine Fellowship, Massachusetts General Hospital; associate professor, Harvard Medical School.

Cancer Gene Therapy: “Schwannoma gene therapy by adeno-associated virus delivery of the pore-forming protein Gasdermin-D.”

University of California, Davis: “What is Translational Research?”

Chris Coburn, chief innovation officer, Partners HealthCare, Cambridge, MA.

Peg Brivanlou, PhD, partner, King & Spalding, New York.

Kaiser Health News: “The High Cost of Hope: When The Parallel Interests of Pharma and Families Collide.”

The Scientist: “The Challenges of Rare-Disease Research.”

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Heart Disease Is Lasting Threat to Breast Cancer Survivors

FRIDAY, June 21, 2019 — Postmenopausal women who survive breast cancer may have a higher risk for developing heart disease, a new study says.

Heart problems can appear more than five years after radiation treatment for breast cancer, and the added risk persists for as much as 30 years, according to Brazilian researchers.

Heart disease is the leading cause of death in older women.

“Heart disease appears more commonly in women treated for breast cancer because of the toxicities of chemotherapy, radiation therapy, and use of aromatase inhibitors, which lower estrogen. Heart-healthy lifestyle modifications will decrease both the risk of recurrent breast cancer and the risk of developing heart disease,” said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society (NAMS).

In this study, researchers led by Dr. Daniel de Araujo Brito Buttros, from Botucatu Medical School at Sao Paulo State University, compared and evaluated heart disease risk factors in 96 postmenopausal breast cancer survivors and 192 women without breast cancer.

The investigators found that cancer survivors were much more likely to have metabolic syndrome, diabetes, atherosclerosis, abdominal obesity and high triglyceride levels in their blood. All are major risk factors for heart disease.

The risk of heart-related death among breast cancer survivors was similar to the risk of death from breast cancer itself.

The study was recently published online in Menopause, the journal of NAMS. The findings suggest that women consider including a cardiologist in their cancer treatment decisions.

“Women should schedule a cardiology consultation when breast cancer is diagnosed and continue with ongoing follow-up after cancer treatments are completed,” Pinkerton advised in a journal news release.

More information

The nonprofit organization Susan G. Komen has more on later effects of breast cancer treatment.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

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How Your Marital Status Affects Your Odds of Dying From Heart Disease

FRIDAY, June 7, 2019 — Your gender and marital status hold telling clues about your risk of dying of heart disease, a large British study suggests.

It found that widowed and divorced men have significantly higher odds of death due to heart disease than women of the same marital status. But single men are more likely to survive heart failure than single women.

Compared to widows, men whose spouses die have an 11% higher risk of death after a heart attack. Widowers with heart failure are also 10% more likely to die; and widowers with atrial fibrillation or a-fib, an abnormal heart rhythm, are 13% more likely to die, the study found.

Similarly, divorced men with a-fib have a 14% higher risk of death than divorced women. Even among married people with a-fib, that risk was 6% higher for men.

But single men with heart failure actually had a 13% lower risk of death compared to single women.

“These findings suggest that widowed or divorced men, and single women, may be most in need of support in order to help minimize their individual risk of dying from these conditions,” Metin Avkiran, associate director of the British Heart Foundation, said in a foundation news release.

The findings come from an analysis of marital status and death rates of more than 1.8 million people treated for heart disease in Northern England between 2000 and 2014.

Lead author Dr. Rahul Potluri is a clinical lecturer in cardiology at Aston Medical School in Birmingham. He said when it comes to heart disease, focusing solely on a patient’s medical problem is not enough.

“It’s important we look into providing holistic care and explore other factors, such as their support network, which can also have a big impact on a person’s health,” Potluri said in the news release.

He and his colleagues discussed their findings Tuesday at a meeting of the British Cardiovascular Society, in Manchester. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

More information

The American Heart Association offers more details about heart disease.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

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ACA’s Medicaid Expansion May Have Lowered Heart Disease Deaths

WEDNESDAY, June 5, 2019 — New research supports the notion that Obamacare has improved the health of Americans: State expansions in Medicaid appear to have cut the number of deaths from heart disease.

Counties in states with expanded Medicaid experienced an average of four fewer deaths from heart disease per 100,000 people than states that didn’t accept the expansion under the Affordable Care Act.

In real terms, that’s about 2,000 fewer deaths a year among middle-aged adults.

“We believe these findings will be helpful for policymakers and health policy researchers in trying to tease out the impact of this most recent round of expansion,” said researcher Dr. Sameed Khatana, a cardiovascular medicine fellow at the University of Pennsylvania.

“We can’t necessarily say from our study that giving a person health insurance through Medicaid will save their life,” Khatana said in a university news release. The research only found an association rather than a cause-and-effect link.

“However, our study does show that at a population level, expanding Medicaid was associated with a reduction in deaths from cardiovascular disease. This was especially prominent in areas with a higher number of residents living in poverty and those areas that had greater increases in insurance coverage,” he said.

For the study, Khatana and his colleagues used data from the U.S. Centers for Disease Control and Prevention to look at county rates of heart disease deaths from 2010 to 2016 in 29 states with expanded Medicaid and 19 states without it.

They found that deaths from heart disease remained stable in states with expanded Medicaid. In states without added Medicaid, however, heart disease deaths climbed from 176 per 100,000 to nearly 181.

In addition, the largest increases in heart disease deaths were in counties with the smallest increases in insurance between 2010 and 2016.

The report was published online June 5 in the journal JAMA Cardiology.

More information

The American Heart Association offers more information on types of heart disease.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

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Could 2 Prostate Cancer Drugs Fight Disease in Earlier Stages?

SUNDAY, June 2, 2019 — Cutting-edge prostate cancer drugs that help extend life in the toughest cases might also be useful in fighting less aggressive tumors, two new clinical trials suggest.

Two drugs that interfere with cancer’s ability to use testosterone for fuel, apalutamide (Erleada) and enzalutamide (Xtandi), are already approved for use against more advanced prostate tumors that don’t respond to regular therapy.

But these trials show that the drugs also can improve survival and slow progression in prostate cancers that do respond to regular therapy, which typically involves medication that halts production of testosterone.

Both clinical trials involved patients with prostate cancer that had spread to other parts of their body but who still responded to androgen-deprivation therapy.

“We’re slowly starting to see a migration of drugs traditionally saved for advanced stages of disease, where we’re incorporating them into earlier stages of disease,” said Dr. Bobby Liaw, medical director of the Blavatnik Family Chelsea Medical Center at Mount Sinai, in New York City. He was not involved in the trials.

Apalutamide combined with androgen-deprivation therapy caused a 33% reduction in overall risk of death, compared against patients who received a placebo alongside their androgen-deprivation therapy, said the lead researcher of that clinical trial, Dr. Kim Chi.

Apalutamide also delayed progression of the cancer by 52%, and the length of time before patients required chemotherapy by 61%, said Chi, medical director of the Clinical Trials Unit at the BC Cancer Agency-Vancouver Prostate Center in Canada.

Adding the hormone blocker significantly improved patients’ outcomes with few side effects, Chi said.

“It’s well-tolerated, both from a side-effect profile and from a quality-of-life perspective,” Chi said, noting that side effects differ little from a placebo.

The second trial involved adding enzalutamide to androgen-deprivation therapy, and again positive results were found.

About 80% of men treated with enzalutamide were alive after three years, compared with 72% of men who received standard treatment, the researchers said.

Study co-chair Ian Davis is a professor at Monash University in Australia. “The actual result in patients starting hormonal therapy — noting patients had a 60% improvement in the time it takes to detect the cancer growing again along with a 33% increase chance of survival — was far higher than we expected,” he said in a news release.

In that trial, 1,125 men were randomly assigned to receive either enzalutamide or placebo, the study authors said.

The next step for researchers will be head-to-head comparisons that will help doctors decide which drugs would work best for specific patients, Liaw said.

“We don’t yet have any data to compare these drugs side-to-side. That’s where we’re going to start to see a bit of debate over which one is arguably the best drug to start with first,” Liaw said. “We’ve never had a lot of satisfying data to help us figure out what is the proper sequence, is there an optimal sequence, should we be combining certain drugs to get a better effect?”

Cost will also be an issue in using these new drugs to fight prostate cancer. “These are really expensive drugs,” Liaw said. “These are drugs that cost thousands for a month’s supply.”

Regardless, it is good for doctors to have more drugs on hand to help patients battle prostate cancer, he concluded.

“We’re certainly hoping to have their disease controlled, not just now but for the long haul, and that’s what these drugs are showing they have the capability of doing,” Liaw said.

Both trials were to be presented at the American Society for Clinical Oncology’s annual meeting, in Chicago, this weekend, and they will also be published in the New England Journal of Medicine.

More information

The American Cancer Society has more about treating prostate cancer.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

Drugs.com – Daily MedNews

Heavy Teen Boys May Face Higher Heart Disease Risk as Adults

MONDAY, May 20, 2019 — Just a few extra pounds during adolescence may translate into higher odds for heart disease in adulthood, a new study of young men suggests.

It included about 1.7 million Swedish men who began military service at ages 18 or 19 between 1969 and 2005. They were followed for up to 46 years.

During the follow-up, nearly 4,500 were diagnosed with cardiomyopathy, an uncommon heart muscle condition that can lead to heart failure. Average age at diagnosis was 45.5 years.

Men who were lean as teens (body mass index, or BMI, below 20) had a low risk of cardiomyopathy. But risk steadily rose with increased weight, even among men who were on the high end of normal BMI (22.5 to 25) as teens.

BMI is an estimate of body fat based on weight and height. A BMI of 30 or more is considered obese: For example, a 5-foot-10-inch man who weighs 209 pounds has a BMI of 30.

There are several types of cardiomyopathy. In dilated cardiomyopathy, the heart muscle becomes weak and can’t pump blood efficiently. In hypertrophic cardiomyopathy, it becomes stiff and the heart can’t fill with blood properly.

Men who had a BMI of 35 and over in their teens (someone 5-foot-10 who weighs 245 or more) were eight times more likely to develop dilated cardiomyopathy than those who were lean in their teens. Researchers weren’t able to estimate the increased risk for hypertrophic cardiomyopathy because there were too few cases.

The study was published May 20 in the journal Circulation.

The findings likely apply to men worldwide, including those in the United States, study co-author Dr. Annika Rosengren said in a journal news release. She is a cardiologist and professor of medicine at the University of Gothenburg in Sweden.

More study would be needed to learn if there are racial or ethnic differences in how weight affects cardiomyopathy risk, Rosengren said. The study only showed an association rather than a cause-and-effect link.

It’s also unclear if the findings apply to women, Rosengren said.

More information

The U.S. National Heart, Lung, and Blood Institute has more on cardiomyopathy.

© 2019 HealthDay. All rights reserved.

Posted: May 2019

Drugs.com – Daily MedNews

Pot Industry Proves Golden in Jenny Gold’s Fight Against Lyme Disease

High heels can get uncomfortable, but Jenny Gold misses the pain of walking around in them all day. The soreness was minuscule compared to her current agony, likely brought on by a tick while Gold was visiting Mexico over twenty years ago with college friends.

“You have to have a positive attitude with Lyme disease, because the people that don’t will not make it very long. There’s a lot of suicides because of the pain,” she explains. “Some people with heart problems don’t make it. So many different things can happen to your body with it.”

Gold didn’t come to Colorado in 2009 as a medical marijuana refugee. She’d already been diagnosed with Lyme disease a decade before, and the neurological problems she suffered grew worse in this state’s altitude, affecting Gold’s motor skills as well as draining her energy and finances. Traditional treatment wasn’t keeping up.

A marketer by trade, Gold had started taking on cannabis clients in 2014, and they began suggesting other treatment options. After she tried a THC-infused hard candy at a work event, her friends noticed a pep in her step, and she now uses them and CBD products for occasional relief. But cannabis edibles can’t cure Lyme disease: Gold eventually found herself using a walker and was forced to move into a new apartment after falling and landing in the emergency room last month.

“I ended up in the emergency room, and then they moved me into an area with people who’ve had strokes, broken pelvises and hip replacements. People like myself, who aren’t strong enough to live alone,” Gold says. “This is what happens with Lyme patients. It’s hard to live with, because you don’t feel like you’re living a normal life. Everything can change in a heartbeat.”

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The proud Michigan State Spartan and former real estate agent had wanted to move to California or Arizona this year, and she’d start showing homes in her heels again. After being forced to move into a more mobile-friendly home, though, she’s now stuck in Colorado for another year.

But Gold has friends — a lot of them. She just needed to ask for help.

Since starting a GoFundMe page seven months ago, Gold has raised almost $ 25,000 to help with health-care costs that have risen to over $ 94,000. She also began using her marketing talent and connections to organize dinners and auctions to raise more funds, and has secured around forty sponsors to donate money and resources at various events. The majority of them are in the cannabis industry.

“If you spread love and really believe in people, they’re going to give back to you. It sucks, because they’ve seen me go downhill over the years. When I put that GoFundMe up, I didn’t want to do it. But when I finally did, my friends just asked why I didn’t sooner,” she remembers. “My support system here is strong. That’s my canna-fam.”

Cannabis and hemp companies such as Incredibles, Veedverks, Evolab, Flora’s Mercantile, Steepfuze and Stashlogix, among dozens of others, have donated products for auctions and goodie bags, Gold says, while individuals in the cannabis community continue to offer aid through a variety of outlets. Gold’s friends are helping her host another fundraising dinner in June, with a silent auction and two different dinners — one infused with THC and one without.

“It’s really hard for me to ask for help, but it’s been made very clear that I do need some help. I’d love to help other people, but right now I need people just to come over and help me unpack in my new house,” Gold says. “I just want to be as active as I was. I want to show those 20,000-square-foot estates again in my heels, but it’s just not happening, and sometimes you have to learn to live with it.”

But living with Lyme doesn’t mean you have to let it define you, Gold adds. May is National Lyme Disease Awareness Month, and she’s not going to let her recent struggles stop her from spreading the word. Gold will appear on a podcast with Veedverks later this month to talk about a disease that scientists believe affects more than 300,000 people per year.

“My brain is so full of plaque, my doctors in Los Angeles say I shouldn’t be walking or talking at all,” she says. “But I can still talk. I’m a chatterer, actually.”


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