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Nov 9, 2015 by traciklein · View  

Genetic Risk Information for Coronary Heart Disease Leads to Lower Bad Cholesterol

ORLANDO, Fla. – A group of researchers led by Mayo Clinic has discovered that disclosing genetic risk for coronary heart disease (CHD) results in lower low-density lipoprotein cholesterol (LDL), also known as bad cholesterol. The findings of the Myocardial Infarction Genes (MI-GENES) Study were presented today at the annual American Heart Association Scientific Sessions 2015 as a late-breaking clinical trial.

LDL bad cholesterol word signIn this study, the investigators tested the hypothesis that incorporating genetic risk information into CHD risk estimates would lead to lowering of LDL levels. Participants were randomized to receive a CHD risk estimate that included genetic risk information versus an estimate based on conventional risk factors alone. Conventional risk factors include high blood pressure, diabetes, physical inactivity and a history of smoking. Six months after risk disclosure, the LDL levels were nearly 10 milligrams per deciliter of blood lower in those randomized to receive genetic risk information. The lower LDL levels resulted from a greater proportion of individuals in this group being started on statin medication.

“This study demonstrates for the first time that disclosing genetic risk information for a common disease such as CHD can result in changes in a relevant health outcome, in this case, LDL levels,” says Iftikhar Kullo, M.D., Mayo Clinic cardiologist and lead author. “The study also demonstrates the feasibility of placing genetic risk information into the electronic health record to empower patients and physicians to make decisions related to initiation of a statin medication. This is an important advance in the area of precision medicine for cardiovascular diseases.”

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, Klein.traci@mayo.edu

Journalists: Sound bites with Dr. Kullo are available in the downloads.

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Nov 9, 2015 by traciklein · View  

Mayo Clinic study: One energy drink may increase heart disease risk in young adults

soda pop, energy drink cans

ORLANDO, Fla. — New research shows that drinking one 16-ounce energy drink can increase blood pressure and stress hormone responses significantly. This raises the concern that these response changes could increase the risk of cardiovascular events, according to a study presented today at the American Heart Association’s Scientific Sessions 2015. The findings also are published in the Journal of the American Medical Association.

“In previous research, we found that energy drink consumption increased blood pressure in healthy young adults,” says Anna Svatikova, M.D., Ph.D., a Mayo Clinic cardiology fellow and the first author. “We now show that the increases in blood pressure are accompanied by increases in norepinephrine, a stress hormone chemical, and this could predispose an increased risk of cardiac events – even in healthy people.”

Mayo Clinic researchers conducted a randomized, double-blind, placebo-controlled pilot study on 25 healthy volunteers with an average age of 29. Each participant consumed a 16-ounce energy drink and placebo drink within five minutes, in random order, on two separate days, with a maximum of two weeks apart. The placebo drink was similar in taste, texture and color, but lacked caffeine and other stimulants of the energy drink, such as taurine, guarana and ginseng.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, Klein.traci@mayo.edu

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Nov 8, 2015 by traciklein · View  

Common medication for heart failure patients does not increase activity level

ORLANDO, Fla. — Heart failure patients with preserved ejection fraction (HFpEF) — where the heart becomes stiff and cannot relax or fill properly — did not have increased exercise tolerance after taking isosorbide mononitrate, compared to a placebo, according to a study presented today at the American Heart Association’s Scientific Sessions 2015. The findings come from the National Heart, Lung, and Blood Institute’s Heart Failure Clinical Research Network and are also published in the New England Journal of Medicine.
illustration of man having heart failure

Importantly, the HFpEF patients’ daily activity level was assessed with accelerometers, devices patients wore to measure movement throughout the study. Daily activity progressively and significantly decreased as the dose of the nitrate increased, says Margaret Redfield, M.D., first author and cardiologist at Mayo Clinic’s Rochester, Minnesota, campus.

“It is important to relieve symptoms in heart failure, so patients can be more active. Inactivity perpetuates deconditioning and frailty in heart failure,” Dr. Redfield says. “While nitrates are commonly prescribed for symptom relief in HFpEF, the effects of nitrates in patients with HFpEF have not been studied.”

In a multicenter, randomized, double-blind, two-period, 12-week crossover study called the Nitrate’s Effect on Activity Tolerance in Heart Failure with Preserved Ejection Fraction (NEAT-HFpEF) Trial, 110 patients with HFpEF at 20 sites were studied. Patients were randomized into one of two treatment groups:

  1. Six weeks of placebo first, followed by six weeks of isosorbide mononitrate
  2. Six weeks of isosorbide mononitrate, followed by six weeks of placebo

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-990-1182, Klein.traci@mayo.edu

Journalists: Sound bites with Dr. Redfield are available in the downloads.

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Mar 23, 2015 by traciklein · View  

Mayo Clinic Study First to Identify Spontaneous Coronary Artery Disease as Inherited


EMBARGO: Monday, March 23, at (11 am ET), JAMA Internal Medicine

A Mayo Clinic study has identified a familial association in spontaneous coronary artery dissection, a type of heart attack that most commonly affects younger women, suggesting a genetic predisposition to the condition, researchers say. The results are published in the March 23 issue of JAMA Internal Medicine.

Researchers used the Mayo Clinic SCAD Registry of 412 enrollees to identify five familial cases of SCAD, comprised of three pairs of first-degree relatives (mother-daughter, identical twin sisters, sisters) and two pairs of second-degree relatives (aunt and niece, and first cousins). Researchers believe this is the first study to identify SCAD as an inherited disorder.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-284-5005, email: newsbureau@mayo.edu

Journalists: Sound bites with Dr. Hayes and SCAD animation are available in the downloads.

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Mar 13, 2015 by traciklein · View  

Energy Drinks Raise Resting Blood Pressure, Dramatic In Those Not Used To Caffeine

Image of heart wrapped in blood pressure monitorSAN DIEGO — Healthy young adults who don’t consume caffeine regularly experienced greater rise in resting blood pressure after consumption of a commercially available energy drink — compared to a placebo drink — thus raising the concern that energy drinks may increase the risk of cardiac events, Mayo Clinic researchers found.

Results of the study will be presented Saturday, March 14, at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.

In this study, researchers alternately gave a can of a commercially available energy drink or a placebo drink to 25 healthy young adults, age 19 to 40, and assessed changes in heart rate and blood pressure. Blood pressure and heart rate were recorded before and 30 minutes after energy drink/placebo drink consumption, and were also compared between caffeine-naïve participants (those consuming less than 160 mg of caffeine per day,  the amount frequently found in a cup of coffee) and regular caffeine users (those consuming more than 160 mg of caffeine per day).

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Mar 13, 2015 by traciklein · View  

Prolonged Shortened Sleep Increases Blood Pressure at Night

SAN DIEGO — People exposed to prolonged periods of shortened sleep have significant increases in blood pressure during nighttime hours, Mayo Clinic researchers report in a small study of eight participants.illustration describing how to measure blood pressure

Results of the study will be presented Sunday, March 15, at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.

In this study, eight healthy, normal weight participants, ages 19 to 36, participated in a 16-day inpatient protocol, consisting of a four-day acclimation period followed by nine days of either sleep restriction (four hours of sleep per night) or normal sleep (nine hours of sleep per night), and three days of recovery. Twenty-four blood pressure monitoring at regular intervals was measured at each study phase.

During the nighttime, in the sleep restriction phase compared to the normal sleep phase, systolic (top number) and diastolic (bottom number) blood pressure  averaged 115/64 millimeters of mercury (mm Hg) versus 105/57 mm Hg, respectively, researchers found. Furthermore, the expected fall in blood pressure during the night was suppressed when subjects had inadequate sleep. They also found that nighttime heart rate was higher with sleep restriction than in normal sleep.

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Mar 12, 2015 by traciklein · View  

New Book “Caring for the Heart” Outlines History of Medical Specialization

Caring for the Heart bookROCHESTER, Minn. — Mayo Clinic announced today the release of a new book, “Caring for the Heart: Mayo Clinic and the Rise of Specialization.” This historical book weaves together three important themes: major developments in the diagnosis and treatment of heart disease in the 20th Century, how Mayo Clinic evolved from a family practice in Minnesota into one of the world's leading medical centers, and how the invention of new technologies and procedures promoted specialization among physicians and surgeons.

“Caring for the Heart” (Oxford, Hardcover Original, 704 Pages, $39.95, ISBN: 9780199982356) is written for general readers as well as health care professionals, historians and policy analysts. Unlike traditional institutional or disease-focused histories, this book places individuals and events in national and international contexts that emphasize the interplay of medical, scientific, technological, social, political, and economic forces that have resulted in contemporary heart care. Patient stories and media perspectives are included throughout to help general readers understand the medical and technological developments that are described.

The book is written so that readers may pick and choose the chapters of most interest to them. Another feature of the book is that readers may follow the stories without looking at the notes. Those who are interested in delving deeper into the main topics will find references that offer greater detail and additional perspectives. The descriptions and interpretations that fill the book benefit from the fact that the author has been a practicing cardiologist and medical historian for almost four decades.

MEDIA CONTACT: Traci Klein, Mayo Clinic Public Affairs, 507-284-5005, email: newsbureau@mayo.edu [...]

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Mar 10, 2015 by traciklein · View  

JAMA: One-Year Data for Transcatheter Aortic Valve Replacement in U.S. Patients

ROCHESTER, MINN — Study results of one-year data for more than 12,000 patients who had transcatheter aortic valve replacement (TAVR) in the United States show an overall one-year death rate of 23.7 percent and a stroke rate of 4.1 percent, according to a study published in the March 10 issue of JAMA.

“Transcatheter aortic valve replacement has become transformational for patients who need a new valve and are at high-risk for surgery or inoperable. aortic valve stenosis TAVR illustrationBut we have been lacking long-term data for this group of patients who are considering this procedure,” says study lead author David R. Holmes, Jr., M.D., a Mayo Clinic interventional cardiologist. “Before this study, we only had 30-day information. This is a milestone and will help us better guide patients and learn as physicians.”

For the study, researchers used the Transcatheter Valve Therapies Registry, developed by the Society of Thoracic Surgeons and the American College of Cardiology, combining 12,182 TAVR patient procedures performed from November 2011 through June 2013 and linking to Centers for Medicare and Medicaid Services administrative claims for one-year data using direct Medicare patient identifiers (name and social security numbers).

Other important results from the study are: [...]

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Feb 11, 2015 by traciklein · View  

Mayo Researcher Receives Woman's Day Red Dress Award

Virginia Miller, Ph.D.Dr. Virginia Miller, Director, Women’s Health Research Center, Mayo Clinic, director of the Women’s Health Research Center at Mayo Clinic, has spent her career researching how heart disease differs in women and men. On Feb. 10, she was honored for that work with a Woman’s Day Red Dress Award in New York City.

She received the award along with others who have made contributions in the fight against heart disease, the No. 1 killer of women today. Other award winners are: Andie MacDowell, actress and Go Red For Women spokesperson; CVS Health, the first national pharmacy chain to end tobacco sales; Margaret Hamburg, M.D., Former Commissioner of Food and Drugs, U.S. Food and Drug Administration; and Jennifer Donelan, WJLA TV ABC 7 reporter in Washington, D.C., and a heart attack survivor.

Dr. Miller’s research focuses on how sex hormones, such as estrogen and testosterone, affect the blood vessels and heart in women and men, as well as the role of other gender differences in cardiovascular health.

An important part of her research is to advocate for research that is sex-specific, meaning that research studies include both men and women, and that the results are analyzed separately by sex. Historically, and today even, that has not always happened, but it is so important, Dr. Miller says. “It is poor science to study one sex and apply the results to the other,” she says. “In the end, that does not help health care providers treat patients the best they can. With heart disease still as the No. 1 cause of death in women and men, we need to continue to research in the best ways possible in order to treat heart disease.”Red dress awards with Dr. Sharonne Hayes and Dr. Virginia Miller

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Nov 16, 2014 by traciklein · View  

Patients with active asthma at higher risk for heart attack, Mayo Clinic research shows

CHICAGO — Patients with active asthma  — such as any use of asthma medications, and unscheduled office or emergency visits for asthma — are at a twofold risk of having a heart attack, according to Mayo Clinic research presented at the American Heart Association’s Scientific Sessions 2014.

Heart with stethoscopeResearchers compared 543 patients who had heart attacks with 543 non-heart attack patients of the same age and gender. These patients were treated at health care facilities in Rochester, Minnesota, between 2002 and 2006. The average age of patients was 67 years old, and 44 percent were women. Within the heart attack patient group, 81 patients had asthma, 44 of those with active asthma.

After controlling for traditional heart attack risk factors such as age, obesity, high blood pressure, smoking, diabetes and high cholesterol, a history of coronary heart disease, and conditions such as chronic obstructive pulmonary disease, results showed that patients with inactive asthma were not at an increased risk of heart attack, but those with active asthma were at a 70 percent risk, says Young Juhn, M.D., senior author and Mayo Clinic pediatric and adolescent physician and clinical epidemiologist. [...]

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Aug 15, 2014 by traciklein · View  

Mayo Clinic Task Force Challenges Some Recommendations in Updated Cholesterol Treatment Guideline

A Mayo Clinic task force challenges some recommendations in the updated guideline for cholesterol treatment unveiled by the American College of Cardiology (ACC) and American Heart Association (AHA) in 2013. The task force concludes, based on current evidence, that not all patients encouraged to take cholesterol-lowering medications, such as statins, may benefit from them and that the guideline missed some important conditions that might benefit from medication.

Furthermore, the task force believes an emphasis needs to be placed on an individualized treatment approach with each patient and exercising shared decision-making.

heart stethoscopeRecommendations of the task force, made up of Mayo Clinic experts in cardiology, endocrinology and preventive medicine, with no conflicts of interest or links to the drug industry, will be published Aug. 14 in Mayo Clinic Proceedings. An editorial will accompany the paper. Mayo Clinic physicians are adopting the task force’s guideline.

“The ACC/AHA cholesterol guideline was last updated in 2001, so it needed to be updated. We agree with many points of the guideline, but there are some key areas where we do not completely agree or we wanted to expand and provide more guidance,” says Francisco Lopez-Jimenez, M.D., task force chairman and director of preventive cardiology at Mayo Clinic in Rochester, Minnesota.

Journalists: Sound bites with Dr. Kullo and Dr. Lopez-Jimenez are available in the downloads, as well as animations of statins' effects in the bloodstream and carotid artery plaque formation

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Jun 24, 2014 by traciklein · View  

BMI measurement may be missing 25 percent of children who could be considered obese, Mayo Clinic research says

heart stethoscopeROCHESTER, Minn. — Physicians using body mass index (BMI) to diagnose children as obese may be missing 25 percent of kids who have excess body fat despite a normal BMI, which can be a serious concern for long-term health, according to a Mayo Clinic study published online today in Pediatric Obesity.

The researchers found that BMI has high specificity in identifying pediatric obesity, meaning BMI accurately identifies children who are obese, but has a moderate sensitivity, meaning the BMI tool misses children who actually should be considered obese, according to the percent of fat in their bodies.

“If we are using BMI to find out which children are obese, it works if the BMI is high, but what about the children who have a normal BMI but do have excess fat? Those parents may get a false sense of reassurance that they do not need to focus on a better weight for their children,” says Francisco Lopez-Jimenez, M.D., senior study author and director of preventive cardiology at Mayo Clinic, Rochester, Minn.

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Mar 29, 2014 by traciklein · View  

Mayo Research Shows Cardiac Rehab Patients Who Use Smartphone App Recover Better

American College of Cardiology

Washington — March 29, 2014 — Patients who attended cardiac rehabilitation and used a smartphone-based app to record daily measurements such as weight and blood pressure had greater improvements in those cardiovascular risk factors; they also were less likely to be readmitted to the hospital within 90 days of discharge, compared with patients who only attended cardiac rehabilitation, Mayo Clinic researchers found.

Journalists: Soundbites and b-roll with Dr. Widmer are available in the downloads.

Only 20 percent of the patients who attended cardiac rehab and used the app were readmitted to the hospital or visited the emergency department within 90 days, compared with 60 percent of those in the control group, researchers discovered.

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Feb 6, 2014 by traciklein · View  

Surprising Trends in Cause of Long-Term Death for Heart Patients

ROCHESTER, Minn. — Feb. 6, 2014 — More people who have known coronary heart disease die from other causes — such as cancer, and lung and neurological diseases — than heart disease, compared with 20 years ago, according to a Mayo Clinic study published online Feb. 10 in Circulation, an American Heart Association journal.

Journalists: Sound bites with Dr. Gulati and b-roll of a cath lab are available in the downloads.

The researchers evaluated the trends in cause-specific, long-term mortality from 1991 to 2008 in patients at Mayo Clinic in Rochester who underwent percutaneous coronary intervention (PCI), a procedure used to open clogged heart arteries. They broke the study population into three eras: 1991 to 1996, 1997 to 2002, and 2003 to 2008. Cardiac deaths predominated in the first era and were about equal with non-cardiac deaths in the middle era. In the final era — the modern-era (2003 to 2008) — non-cardiac deaths dominated.
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Jan 21, 2014 by traciklein · View  

Emergency Treatment Longer for Heart Attack Victims Arriving at Hospital During Off-Hours

ROCHESTER, Minn. — Jan. 21, 2014 — More people die and emergency hospital treatment takes longer for heart attack victims who arrive at the hospital during off-hours (nights and weekends), compared with patients who arrive during regular daily hours, according to a Mayo Clinic study published online in the British Medical Journal on Jan. 21.

Journalists: Sound bites with Dr. Sorita are available in the downloads.

Mayo Clinic researchers analyzed results of 48 studies published between 2001 and 2013 involving 1.8 million patients in the United States, Europe and Canada to assess the effect of off-hour hospital arrival for heart attack patients.

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Nov 18, 2013 by traciklein · View  

Mayo Clinic-led Study: Two Drugs do not Improve Kidney Function in Acute Heart Failure Patients

Low-dose dopamine or low-dose nesiritide tested in hospitalized heart failure patients

DALLAS — Two drugs tested in a larger trial did not improve kidney function in acute heart failure patients, contrary to results of smaller studies. The results were presented today at the American Heart Association's Scientific Sessions 2013 in Dallas and simultaneously published in the Journal of the American Medical Association. Previous smaller studies showed that low-dose dopamine or low-dose nesiritide could improve kidney function and reduce fluid overload that is often present in hospitalized acute heart failure patients by increasing urine production.

MULTIMEDIA ALERT: Video of Dr. Horng Chen will be available for download on the Mayo Clinic News Network.

In the Renal Optimization Strategies Evaluation in Acute Heart Failure (ROSE-AHF) randomized 26-site trial in the U.S. and Canada, researchers analyzed data on 360 hospitalized acute heart failure patients with kidney dysfunction from September 2010 to March 2013. Compared to placebo, researchers found that neither dopamine nor nesiritide, when also used with diuretic (water pills) therapy, was better at increasing urine volume or improving levels of serum cystatin-C, an indicator of kidney function, at the end of a 72-hour treatment.

"Kidney-enhancing therapies in acute heart failure continue to elude us," says Horng Chen, M.B., B.Ch., lead author and Mayo Clinic cardiologist. "In the past five years, all the major acute heart failure therapeutic clinical trials have not demonstrated beneficial effects of the therapies tested. This could be partly because the definition of acute heart failure is broad, and hence it includes a diverse group of patients."

Therefore, one take-away from the results of ROSE-AHF is that future studies in acute heart failure may need to target specific subgroups of these patients. For example, some patients have preserved ejection fraction, where the heart's lower chambers are stiff and cannot relax enough to fill fully between beats, and others may have reduced ejection fraction, where the heart is weak, Dr. Chen says.

Heart failure occurs when the heart doesn't pump blood as well as it should. Acute heart failure — when heart failure patients require hospitalization — is the most common cause of hospitalization in patients 65 years and older in the U.S., according to the American Heart Association.

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Sep 30, 2013 by traciklein · View  

Total Hospital Cost of Robotic or Conventional Open-Chest Mitral Valve Repair Surgery is Similar

Mayo Clinic study examines costs following operating room and recovery improvement efforts

ROCHESTER, Minn. —  Sept. 30, 2013  — The total hospital cost of mitral valve repair surgery — from the time a patient is admitted to the hospital until release — is similar, whether performed through small port incisions using robotic equipment or via the conventional open-chest method, a Mayo Clinic study of 370 patients found. Importantly, robotic surgeries were just as safe as conventional open procedures, but patients who underwent robotic mitral valve repair recovered more rapidly and returned home earlier than patients who had open-chest surgery, the study found. The results of the study also reflect systems innovation efforts designed to reduce the cost of high-technology cardiac care. The findings will be published online Oct. 1 in Mayo Clinic Proceedings.

MULTIMEDIA ALERT: Video of Dr. Rakesh Suri will be available for download on the Mayo Clinic News Network.

"These results reflect an important opportunity to decrease cost and improve quality of U.S. health care when technologically complex procedures are performed by well-trained, high-volume teams capable of leveraging the potential of less invasive approaches for patient benefit," says lead author Rakesh Suri, M.D., D.Phil., a cardiovascular surgeon at Mayo Clinic in Rochester. [...]

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Sep 5, 2013 by traciklein · View  

Critically Ill Patients at Mayo Clinic Health System Receive Additional Level of Care

Physicians, nurses at Mayo Clinic in Minnesota also monitor patients by computerized system

ROCHESTER, Minn. — Sept. 5, 2013 — Critically ill patients are benefiting from a new program designed to improve care and shorten hospital stays. Mayo Clinic's Enhanced Critical Care program offers 24/7 remote monitoring of the sickest patients at six Mayo Clinic Health System hospitals.

MULTIMEDIA ALERT: Click here to retrieve video and photography from the Mayo Clinic News Network.

Patients will continue to receive care from the local care team, but physicians and nurses in an operations center in Rochester will monitor patients' vital signs and other health data on a computerized system able to detect subtle changes in a patient's condition. High definition video cameras and computer screens will allow operations center staff to communicate with patients, their families and the care team. [...]

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Aug 8, 2013 by traciklein · View  

Early Surgery Better Than Watchful Waiting for Patients with Severe Mitral Valve Regurgitation

ROCHESTER, Minn. — Aug. 8, 2013 — Patients with severe mitral valve regurgitation who are otherwise healthy should have mitral valve repair surgery sooner rather than later, even if they feel no symptoms, a Mayo Clinic-led study by U.S. and European researchers found. The results challenge the long-held belief that it is safer to "watch and wait" until a patient has symptoms, such as shortness of breath. This is the largest study to show that patients who undergo surgery early after diagnosis have improved long-term survival and lower risk of heart failure.

MULTIMEDIA ALERT: Video of Drs. Rakesh Suri and Maurice Enriquez-Sarano will be available for download on the Mayo Clinic News Network.

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Aug 27, 2012 by traciklein · View  

People of Normal Weight With Belly Fat at Highest Death Risk, Mayo Clinic Study Finds

ROCHESTER, Minn. — August 27, 2012.  People who are of normal weight but have fat concentrated in their bellies have a higher death risk than those who are obese, according to Mayo Clinic research presented today at the European Society of Cardiology Congress in Munich. Those studied who had a normal body mass index but central obesity — a high waist-to-hip ratio — had the highest cardiovascular death risk and the highest death risk from all causes, the analysis found.

Man with obese stomach being measured

"We knew from previous research that central obesity is bad, but what is new in this research is that the distribution of the fat is very important even in people with a normal weight," says senior author Francisco Lopez-Jimenez, M.D., a cardiologist at Mayo Clinic in Rochester. "This group has the highest death rate, even higher than those who are considered obese based on body mass index. From a public health perspective, this is a significant finding."

The study included 12,785 people 18 and older from the Third National Health and Nutrition Examination Survey, a representative sample of the U.S. population. The survey recorded body measurements such as height, weight, waist circumference and hip circumference, as well as socioeconomic status, comorbidities, and physiological and laboratory measurements. Baseline data were matched to the National Death Index to assess deaths at follow-up.

Those studied were divided by body mass index into three categories (normal: 18.5–24.9 kg/m2; overweight: 25.0–29.9 kg/m2; and obese: >30 kg/m2) and two categories of waist-to-hip ratio (normal:

The mean age was 44; 47.4 percent were men. The median follow-up period was 14.3 years. There were 2,562 deaths, of which 1,138 were cardiovascular related.

The risk of cardiovascular death was 2.75 times higher, and the risk of death from all causes was 2.08 times higher, in people of normal weight with central obesity, compared with those with a normal body mass index and waist-to-hip ratio.

"The high risk of death may be related to a higher visceral fat accumulation in this group, which is associated with insulin resistance and other risk factors, the limited amount of fat located on the hips and legs, which is fat with presumed protective effects, and to the relatively limited amount of muscle mass," says Karine Sahakyan, M.D., Ph.D., a cardiovascular research fellow at Mayo Clinic in Rochester.

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