Cardiovascular - November 2015 Archives

Do you know what health conditions run in your family? Take advantage of upcoming holiday gatherings to find out. Having access to this vital ...

Watch today's Mayo Clinic Minute In today's Mayo Clinic Minute, we look at cranberries – they're not just for Thanksgiving! Research shows drinking ...

https://www.youtube.com/watch?v=POskT8R_3t4&feature=youtu.be In her down time, Laura Floeckhler, 45, enjoyed visiting the theme parks in her hometown of Orlando, Fla. But last year she started getting ...

November is Pulmonary Hypertension Awareness Month. About 20,000 people in the United States are being treated for pulmonary hypertension (PH). Mayo Clinic in ...

In a viewpoint released today in The Journal of the American Medical Association Cardiovascular Special Issue, Mayo Clinic endocrinologists and researchers are warning against the “premature and widespread adoption” of a new type of drug that reduces cholesterol, PCSK-9 inhibitors. They argue that little is known about their long-term safety and efficacy on outcomes that matter to patients. Given the long track record of efficacy and safety and the low cost of statins, they think that it is premature to adopt PCSK-9 inhibitors as alternatives to statins. The Food and Drug Administration has recently approved the new class of drugs for patients with high LDL-cholesterol who also have familial hypercholesterolemia or with clinical cardiovascular disease who are seeking secondary prevention or cannot tolerate statins. The Mayo experts are predicting four situations that will fuel abandoning statins in favor of the PCSK-9 inhibitors: Patients who have muscle problems or other symptoms suggestive of statin intolerance. Patients who have a heart attack or a stroke while using a statin. Patients who may not to be taking statins every day. Patients who have cholesterol levels that remain high despite statins. Media Contact: Bob Nellis, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu https://youtu.be/uUOG2fIhlDI Journalists: Sound bites with Drs. Montori and Rodriguez-Gutierrez are available in the downloads.

Rheumatoid arthritis patients are twice as likely as the average person to develop heart disease, but a new study shows that efforts to prevent heart problems and diagnose and treat heart disease early may be paying off. Despite the heightened danger, deaths from cardiovascular disease among people with rheumatoid arthritis are declining, the research found. The study was among Mayo Clinic research being presented at the American College of Rheumatology’s annual meeting in San Francisco. Other Mayo studies discussed at the conference chronicled a significant increase in gout; examined rare intestinal microbes in rheumatoid arthritis patients; and discovered that people with rheumatoid arthritis use opioid painkillers at a higher rate than the general public, but that it isn’t related to disease severity. In the study on rheumatoid arthritis and heart disease, researchers looked at heart disease deaths within 10 years of rheumatoid arthritis diagnosis among two groups of people: 315 patients diagnosed with rheumatoid arthritis from 2000 to 2007 and 498 patients diagnosed with rheumatoid arthritis in the 1980s and 1990s. They also looked at heart disease deaths among 813 people without the rheumatic disease. Roughly two-thirds of patients studied were women, and the average age was 60. They found a significantly lower rate of deaths from heart disease in the more recently diagnosed rheumatoid arthritis patients than in those diagnosed earlier: 2.8 percent and 7.9 percent, respectively. Media contact: Sharon Theimer in Mayo Clinic Public Affairs, 507-284-5005 or newsbureau@mayo.edu.

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. In 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. https://www.youtube.com/watch?v=DHcGI91HJqA

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

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. 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: Six weeks of placebo first, followed by six weeks of isosorbide mononitrate 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. https://www.youtube.com/watch?v=fJTkB2Gy2Hc

DEAR MAYO CLINIC: I regularly have heartburn and my doctor is recommending I try a proton pump inhibitor. Can you tell me more about this medication? Are there any risks to taking it? ANSWER: Proton pump inhibitors (PPIs) are the most effective medications for the treatment of chronic acid reflux (gastroesophageal reflux disease, or GERD) and peptic ulcer. They work by blocking the production of stomach acid — too much of which can cause a burning sensation in your chest or throat (heartburn) — and by giving damaged tissue in your esophagus time to heal. Proton pump inhibitors come in prescription and nonprescription strengths. These medications are most commonly taken as a pill once a day, usually about an hour before breakfast. Proton pump inhibitors are generally safe when you use them as directed. But as with any medications, there are potential risks with taking them. Long-term use of proton pump inhibitors has been associated with a greater risk of infections such as pneumonia and a form of antibiotic-associated diarrhea caused by the bacteria Clostridium difficile (C. difficile). However, whether proton pump inhibitors are directly responsible hasn’t been proved.