JAMA – Nonobstructive Coronary Artery Disease and Risk of Myocardial Infarction

JAMA Network | JAMA | Nonobstructive Coronary Artery Disease and Risk of Myocardial Infarction.

Conclusions and Relevance  In this cohort of patients undergoing elective coronary angiography, nonobstructive CAD, compared with no apparent CAD, was associated with a significantly greater 1-year risk of MI and all-cause mortality. These findings suggest clinical importance of nonobstructive CAD and warrant further investigation of interventions to improve outcomes among these patients.

 

Let’s Stop the Unnecessary Treatment of Heart Disease

Let’s Stop the Unnecessary Treatment of Heart Disease.

recent population-based prospective studyof Swedish men suggested almost four of five MIs in men could be preventable.[1](That’s not a typo.) Researchers from the Institute of Environmental Medicine in Stockholm, Sweden, followed 20 721 men from 1997 to 2009. They specifically asked about five modifiable lifestyle behaviors: a healthy diet, moderate alcohol consumption, no smoking, being physically active, and having no abdominal fat (waist circumference.) There were 1361 cases of MI in the 11-year follow-up period.

heartwire journalist Michael O’Riordan recaps the details of the study here. The short story was that each of the five low-risk behaviors independently reduced the chance of having a heart attack. Not smoking was the strongest risk reducer. Men who combined all five behaviors were 86% less likely than those who had zero behaviors to have a heart attack.

What’s Your CRF? – Johns Hopkins Health Alerts

What’s Your CRF?: Johns Hopkins Health Alerts.

Johns Hopkins Health Alert

What’s Your CRF?

Engaging in regular physical activity has long been recognized as a key ingredient to a healthy heart. That’s because aerobic activities such as jogging, walking and bike riding can help improve blood circulation, insulin sensitivity and blood pressure, as well as assist in quitting smoking, maintaining a healthy weight, managing stress and warding off depression. Unfortunately, many people aren’t getting up and moving for their health.

The Centers for Disease Control and Prevention reports that only about 22 percent of adults participate in regular, sustained activity (defined as the recommended five times a week for a minimum of 30 minutes), and about 25 percent of adults admit to engaging in no physical activity in their downtime.

Complicating matters is that many people may be overestimating how active they really are. In one study, British researchers report that almost half of participants deemed “inactive” inaccurately labeled themselves as “active,” making it more difficult to target these individuals for lifestyle interventions.

Putting older adults at a further disadvantage, cardiorespiratory fitness (CRF) levels — essentially a measurement of your body’s ability to supply the necessary oxygen during physical activity — also tend to decrease as we age. And while CRF levels haven’t received as much attention as risk factors such as high blood pressure and high cholesterol, many experts say low CRF levels are a separate, serious risk factor for cardiovascular disease.

The numbers behind CRF. Preliminary results from the Kuopio Ischemic Heart Disease Risk Factor Study, which looked at more than 2,600 Finnish men between the ages of 42 and 60, spell out the consequences: Those people whose CRF levels decreased more than 15 percent over a decade increased their risk of heart attack by 88 percent and faced a 122 percent increased risk of dying of any cause. Previous research found significant increases in risk as well.

So how do people know if they’re “heart fit”? In a clinical setting, CRF can be measured with simple exercise stress tests. These tests are performed with the subject either walking or running on a treadmill or pedaling a special stationary bike equipped to measure exercise output. The results are expressed in METs, or metabolic equivalents.

A study published in the New England Journal of Medicine found that the minimum output needed to preserve overall heart health was 7.9 METs. Relating to real life, that’s a 50-year-old man being able to walk continuously at a speed of 4 miles per hour during the test, and 3 miles per hour for a woman.

Posted in Heart Health on October 31, 2014


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer