Showing posts with label HEART DISEASE. Show all posts
Showing posts with label HEART DISEASE. Show all posts

Saturday, September 27, 2014

HHS SAYS $212 MILLION WILL BE GOING TO PREVENT CHRONIC DISEASES

FROM:  U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 
September 25, 2014

HHS announces nearly $212 million in grants to prevent chronic diseases
Funded in part by the Affordable Care Act, grants focus on preventing tobacco use, obesity, diabetes, heart disease, and stroke

Health and Human Services Secretary Sylvia M. Burwell today announced nearly $212 million in grant awards to all 50 states and the District of Columbia to support programs aimed at preventing chronic diseases such as heart disease, stroke and diabetes.  Funded in part by the Affordable Care Act, the awards will strengthen state and local programs aimed at fighting these chronic diseases, which are the leading causes of death and disability in the United States, and help lower our nation’s health care costs.

A total of 193 awards are being made  to states, large and small cities and counties, tribes and tribal organizations, and national and community organizations, with a special focus on populations hardest hit by chronic diseases. The Centers for Disease Control and Prevention will administer the grants.

“These grants will empower our partners to provide the tools that Americans need to help prevent chronic diseases like heart disease, stroke, and diabetes,” said Secretary Burwell. “Today’s news is important progress in our work to transition from a health care system focused on treating the sick to one that also helps keep people well throughout their lives.”

The goals of the grant funding are to reduce rates of death and disability due to tobacco use, reduce obesity prevalence, and reduce rates of death and disability due to diabetes, heart disease, and stroke.

“Tobacco use, high blood pressure, and obesity are leading preventable causes of death in the United States,” said CDC Director Tom Frieden, M.D., M.P.H. “These grants will enable state and local health departments, national and community organizations, and other partners from all sectors of society to help us prevent heart disease, cancer, stroke, and other leading chronic diseases, and help Americans to live longer, healthier, and more productive lives.”

This is one of many ways the Affordable Care Act is improving access to preventive care, and coverage for people with pre-existing conditions. Under the Affordable Care Act, 76 million Americans in private health insurance have gained access to preventive care services without cost-sharing and issuers can no longer deny coverage to anyone because of a pre-existing condition.

Chronic diseases are responsible for 7 of 10 deaths among Americans each year, and they account for more than 80 percent of the $2.7 trillion our nation spends annually on medical care.


Thursday, July 10, 2014

FDA APPROVES MEDTRONIC COREVALVE SYSTEM

FROM:  U.S. FOOD AND DRUG ADMINISTRATION 
Medtronic CoreValve System - P130021/S002

This is a brief overview of information related to FDA’s approval to market this product. See the links below to the Summary of Safety and Effectiveness Data (SSED) and product labeling for more complete information on this product, its indications for use, and the basis for FDA’s approval.

Product Name: Medtronic CoreValve System
PMA Applicant: Medtronic CoreValve LLC
Address: Medtronic CoreValve LLC, 3576 Unocal Place, Santa Rosa, CA 95403
Approval Date: June 12, 2014
Approval Letter: http://www.accessdata.fda.gov/ cdrh_docs/pdf13/P130021S002a.pdf

What is it? The Medtronic CoreValve System (often referred to as the CoreValve) consists of a catheter-based artificial aortic heart valve and accessories used to implant the valve without open-heart surgery. The valve is made of pig tissue attached to a flexible, self-expanding, nickel-titanium frame for support.

How does it work? The CoreValve is compressed and placed on the end of a tube-like device called a delivery catheter. It is then inserted through the femoral artery in the leg. If the femoral arteries are not suitable, the valve can also be inserted through other arteries or through the aorta. The catheter is pushed through the blood vessels until it reaches the diseased aortic valve. The valve is then released from the catheter, it expands on its own, and anchors to the diseased valve. The CoreValve functions the same as a normal valve, helping the blood flow properly by opening and closing like a door to force the blood to flow in the correct direction.

When is it used? The CoreValve is used in patients whose own aortic heart valve is diseased due to calcium build up, which causes the valve to narrow (aortic stenosis) and restricts blood flow through the valve. As the heart works harder to pump enough blood through the smaller opening, the heart eventually becomes weak. This can lead to symptoms and life-threatening heart problems such as fainting, chest pain, heart failure, irregular heart rhythms (arrhythmias), or cardiac arrest. Once symptoms of severe aortic stenosis occur, over half of the patients die within two years if the diseased valve is not replaced.

The CoreValve should only be used in patients who cannot undergo, or are at high risk for open heart surgery as determined by their heart team (a cardiologist and surgeon).

What will it accomplish? The CoreValve can help correct the blood flow problem associated with aortic stenosis in patients who need open-heart surgery to replace the diseased valve, but the surgical procedure is highly risky, or too risky. In the U.S. clinical trial, the CoreValve was shown to be reasonably safe and effective for those patients without the need for open-heart surgery. However, implanting the CoreValve also carries the risk of serious complications such as death, stroke, acute kidney injury, heart attack, bleeding, complications with the arteries used to insert the valve, and the need for a permanent pacemaker. For some patients with coexisting conditions or diseases, the risks may be especially high. Patients should discuss with their doctors the benefits and risks of this device.

When should it not be used? The CoreValve should not be used in patients who:

have an infection in the heart or elsewhere.
have an artificial (mechanical) aortic valve.
cannot tolerate blood thinning medicines.
have sensitivity to Nitinol (Titanium or Nickel) or to fluid used during the procedure to   see internal structures (contrast media).
Additional information: The Summary of Safety and Effectiveness Data and labeling are available online.

Tuesday, May 6, 2014

CDC REPORTS THAT DISABLED HAVE LESS ACTIVITY AND MORE CHRONIC DISEASE

FROM:  CENTERS FOR DISEASE CONTROL AND PREVENTION 

Inactivity Related to Chronic Disease in Adults with Disabilities
Half of adults with disability get no aerobic physical activity
Working age adults with disabilities who do not get any aerobic physical activity are 50 percent more likely than their active peers to have a chronic disease such as cancer, diabetes, stroke, or heart disease, according to a Vital Signs report released today by the Centers for Disease Control and Prevention (CDC).
Nearly half (47 percent) of adults with disabilities who are able to do aerobic physical activity do not get any. An additional 22 percent are not active enough. Yet only about 44 percent of adults with disabilities who saw a doctor in the past year got a recommendation for physical activity.

“Physical activity is the closest thing we have to a wonder drug,” said CDC Director Tom Frieden, M.D., M.P.H. “Unfortunately, many adults with disabilities don’t get regular physical activity.  That can change if doctors and other health care providers take a more active role helping their patients with disabilities develop a physical fitness plan that’s right for them.”

Most adults with disabilities are able to participate in some aerobic physical activity which has benefits for everyone by reducing the risk of serious chronic diseases. Some of the benefits from regular aerobic physical activity include increased heart and lung function; better performance in daily living activities; greater independence; decreased chances of developing chronic diseases; and improved mental health.

For this report, CDC analyzed data from the 2009-2012 National Health Interview Survey and focused on the relation between physical activity levels and chronic diseases among U.S. adults aged 18-64 years with disabilities, by disability status and type.  These are adults with serious difficulty walking or climbing stairs; hearing; seeing; or concentrating, remembering, or making decisions. Based on the 2010 data, the study also assessed the prevalence of receiving a health professional recommendation for physical activity and the association with the level of aerobic physical activity.

Key findings include:

Working age adults with disabilities are three times more likely to have heart disease, stroke, diabetes or cancer than adults without disabilities.
Nearly half of adults with disabilities get no aerobic physical activity, an important protective health behavior to help avoid these chronic diseases.
Inactive adults with disabilities were 50 percent more likely to report at least one chronic disease than were active adults with disabilities.
Adults with disabilities were 82 percent more likely to be physically active if their doctor recommended it.

The Physical Activity Guidelines for Americans recommend that all adults, including those with disabilities, get at least 150 minutes (2.5 hours) of moderate – intensity aerobic physical activity each week. If meeting these guidelines is not possible, adults with disabilities should start physical activity slowly based on their abilities and fitness level.

Doctors and other health professionals can recommend physical activity options that match the abilities of adults with disabilities and resources that can help overcome barriers to physical activity. These barriers include limited information about accessible facilities and programs; physical barriers in the built or natural environment; physical or emotional barriers to participating in fitness and recreation activities, and lack of training in accessibility and communication among fitness and recreation professionals.

“It is essential that we bring together adults with disabilities, health professionals and community leaders to address resource needs to increase physical activity for people with disabilities,” said Coleen Boyle, Ph.D., M.S. hyg., director of CDC’s National Center on Birth Defects and Developmental Disabilities.

CDC has set up a dedicated resource page for doctors and other health professionals with information to help them recommend physical activity to their adult patients with disabilities, www.cdc.gov/disabilities/PA.  

Through the Affordable Care Act, more Americans have access to health coverage and to no-cost preventive services. Most health insurance plans cannot deny, limit, or exclude coverage to anyone based on a pre-existing condition, including persons with disabilities. To learn more about the Affordable Care Act, visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325).

Vital Signs is a CDC report that appears on the first Tuesday of the month as part of the CDC journal Morbidity and Mortality Weekly Report, or MMWR. The report provides the latest data and information on key health indicators. These are cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care-associated infections, cardiovascular health, teen pregnancy, food safety and developmental disabilities.

Saturday, February 8, 2014

ENGINEER LOOKS AT DIABETES AND HEART DISEASE

FROM:  NATIONAL SCIENCE FOUNDATION 
Mechanical engineer studies flow of blood vessels related to diabetes and resulting heart disease
Research could lead to development of new drugs and tissue engineering applications

People with diabetes develop early and severe heart disease, specifically atherosclerosis, a condition in which plaque builds up inside the arteries. Alisa Clyne, a mechanical engineer by training, wants to better understand the biomechanics of this process.

"We know people with diabetes get these plaques but not why they are more severe with diabetes," says Clyne, an associate professor of mechanical engineering and mechanics at Drexel University. "Could there be a mechanical aspect to it?"

The National Science Foundation (NSF)-funded scientist specifically is studying the behavior of endothelial cells, which form the inner layer of blood vessels, and which "sense the mechanics of their environment and respond to it," she says. "They are exposed to a variety of mechanical forces, mostly from blood flow."

Moreover, blood flow, specifically shear stress--the force of flowing blood on the endothelial surfaces--cause the cells to react in multiple ways. "Atherosclerosis occurs in locations where there are disturbances in the blood flow," she says. "We want to know if the relationship between atherosclerotic plaque development and endothelial response to fluid flow is altered in diabetic conditions."

With normal flow, "your endothelial cells should not be dysfunctional, and you should not get plaque," she adds. "So the question for us is, if you change the endothelial cell environment to simulate a diabetic condition, such as high blood sugar, would there be a change in the way the cells are able to respond to fluid flow?"

Insights into the role of these cells in plaque development potentially could provide new ideas for drug development, as well as tissue engineering applications, such as designing new blood vessels.

"This information about how the cell mechanisms respond to blood flow is important," Clyne says. "For example, you could tissue engineer a better blood vessel for coronary artery bypass surgery by understanding how the endothelial cells respond to flow in a diabetic environment."

Clyne is conducting her research under an NSF Faculty Early Career Development (CAREER) award, which she received in 2009. The award supports junior faculty who exemplify the role of teacher-scholars through outstanding research, excellent education, and the integration of education and research within the context of the mission of their organization. NSF is funding her work with about $400,000 over five years.

Endothelial cells align and elongate in the direction of the shear stress, and change some of their functions as well. For example, in response to increased shear stress, endothelial cells produce more nitric oxide, a vasodilator which causes the blood vessels to expand. This physiological response decreases blood velocity and thereby reduces shear stress down to the original level. Nitric oxide also scavenges reactive oxygen species and reduces inflammation, both of which are factors that contribute to atherosclerotic plaque development. If endothelial cells do not produce nitric oxide in response to shear stress in a diabetic environment, this could contribute to atherosclerosis in people with diabetes.

In her experiments, Clyne cultures endothelial cells in a parallel plate flow chamber, which allows her to put "flow" over the cells to simulate the stresses they would experience in the human body. "We added high sugar levels to see how the cells would respond in normal flow," she says.

"One thing high sugars do is change the structure of proteins," she explains. "There are proteins underneath the endothelial cells, and the cells attach to them. The one we study in particular is collagen. As we age, or if you have high sugar levels, the collagen becomes glycated, meaning that sugar attaches to one of the collagen amino acids. When the cells are attached to glycated collagen, rather than normal collagen, it changes how they respond to fluid flow. "

The researchers measured the responses, including the release of nitric oxide, and found that the cells "don't align in the flow direction or release nitric oxide when they are on glycated collagen," she says. " The way in which cells adhere to the substrate proteins changes many signaling pathways in the cells. Our cells adhere to glycated collagen in a different way from native collagen, and this changes the way that they are able to respond to mechanical forces from fluid flow."

The researchers also looked at the effects of increasing sugar levels in the cultured cells and found that high sugar levels--and low sugar levels--also changed the way the cells respond to fluid flow. "So if you are at either extreme, you're in trouble," she says. "Sugar can either directly affect the cells or affect the proteins the cells adhere to, so it has two effects."

As part of the CAREER educational component, Clyne's lab is conducting an outreach program with the Girl Scouts, including a "Science Saturdays" program at Drexel, bringing in junior high school-age scouts for up to six Saturdays to teach them about different kinds of engineering, and how engineering applications can solve human health problems. The scouts are paired with mentors, who are Drexel engineering undergraduate students.

They engage in hands-on activities that relate to engineering. For example, they constructed robot cars (mechanical engineering), made lip gloss (chemical engineering) and participated in a water filtration project (civil engineering).

"Over the course of the program, they also worked on a design project related to biomedical engineering. One year, the girls created solutions that would help soldiers coming home from the war without a limb," she says. "One group made a gripper hand to help with eating, whereas another group made a device to improve balance using a prosthetic leg. The girls learned about how engineering contributes to helping others, which hopefully will encourage them to consider engineering careers."

-- Marlene Cimons, National Science Foundation
Investigators
Alisa Morss Clyne

Wednesday, January 8, 2014

CDC SAYS MOST HEALTH CARE PROVIDERS DON'T DISCUSS ALCOHOL USE

FROM:  CENTERS FOR DISEASE CONTROL AND PREVENTION

Most health care providers don’t talk about alcohol, even when patients drink too much.

Alcohol screening and counseling is an effective but underused health service
Only one in six adults -- and only one in four binge drinkers -- say a health professional has ever discussed alcohol use with them even though drinking too much is harmful to health, according to a new Vital Signs report from the Centers for Disease Control and Prevention.

Even among adults who binge drink 10 or more times a month, only one in three have ever had a health professional talk with them about alcohol use. Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men within 2-3 hours. Talking with a patient about their alcohol use is an important first step in screening and counseling, which has been proven effective in helping people who drink too much to drink less.

A drink is defined as five ounces of wine, 12 ounces of beer, or 1.5 ounces of 80-proof distilled spirits or liquor. At least 38 million adults in the United States drink too much. Most are not alcoholics. Drinking too much causes about 88,000 deaths in the United States each year, and was responsible for about $224 billion in economic costs in 2006. It can also lead to many health and social problems, including heart disease, breast cancer, sexually transmitted diseases, fetal alcohol spectrum disorders, motor-vehicle crashes, and violence.

Alcohol screening and brief counseling can reduce the amount of alcohol consumed on an occasion by 25 percent among those who drink too much. It is recommended for all adults, including pregnant women. As with blood pressure, cholesterol and breast cancer screening, and flu vaccination, it has also been shown to improve health and save money. Through the Affordable Care Act, alcohol screening and brief counseling can be covered by most health insurance plans without copay.

“Drinking too much alcohol has many more health risks than most people realize,” said CDC Director Tom Frieden, M.D., M.P.H. “Alcohol screening and brief counseling can help people set realistic goals for themselves and achieve those goals. Health care workers can provide this service to more patients and involve communities to help people avoid dangerous levels of drinking.”

Health professionals who conduct alcohol screening and brief counseling use a set of questions to screen all patients to determine how much they drink and assess problems associated with drinking. This allows them to counsel those who drink too much about the health dangers, and to refer those who need specialized treatment for alcohol dependence. CDC used 2011 Behavioral Risk Factor Surveillance System data to analyze self-reports of ever being “talked with by a health provider” about alcohol use among U.S. adults aged 18 and older from 44 states and the District of Columbia.

No state or district had more than one in four adults report that a health professional talked with them about their drinking, and only 17 percent of pregnant women reported this. Drinking during pregnancy can seriously harm the developing fetus.

Through the Affordable Care Act, more Americans will have access to health coverage and to no-cost preventive services like alcohol misuse screening and counseling. Visit Healthcare.gov to learn more. Open enrollment in the Marketplace began October 1 and ends March 31, 2014. For those enrolled by Dec. 15, 2013, coverage starts as early as Jan. 1, 2014.

Friday, September 6, 2013

CDC SAYS 200,000 HEART DISEASE, STROKE DEATHS COULD BE PREVENTED

FROM:  CENTERS FOR DISEASE CONTROL AND PREVENTION 
New CDC Vital Signs: CDC finds 200,000 heart disease and stroke deaths could be prevented

More than 200,000 preventable deaths from heart disease and stroke occurred in the United States in 2010, according to a new Vital Signs report from the Centers for Disease Control and Prevention.  More than half of these deaths happened to people younger than 65 years of age, and the overall rate of preventable deaths from heart disease and stroke went down nearly 30 percent between 2001 and 2010, with the declines varying by age.  Lack of access to preventive screenings and early treatment for high blood pressure and high cholesterol could explain the differences among age groups.

Age: Death rates in 2010 were highest among adults aged 65-74 years (401.5 per 100,000 population).  But preventable deaths have declined faster in those aged 65–74 years compared to those under age 65.

Race/ethnicity: Blacks are twice as likely—and Hispanics are slightly less likely—as whites to die from preventable heart disease and stroke.

Sex: Avoidable deaths from heart disease, stroke and high blood pressure were higher among males (83.7 per 100,000) than females (39.6 per 100,000). Black men have the highest risk. Hispanic men are twice as likely as Hispanic women to die from preventable heart disease and stroke.

Location: By state, avoidable deaths from cardiovascular disease ranged from a rate of 36.3 deaths per 100,000 population in Minnesota to 99.6 deaths per 100,000 in the District of Columbia. By county, the highest avoidable death rates in 2010 were concentrated primarily in the southern Appalachian region and much of Tennessee, Arkansas, Mississippi, Louisiana, and Oklahoma.  The lowest rates were in the West, Midwest, and Northeast regions.

To save more lives from these preventable deaths, doctors, nurses, and other health care providers can encourage healthy habits at every patient visit, including not smoking, increasing physical activity, eating a healthy diet, maintaining a healthy weight, and taking medicines as directed.  Communities and health departments can help by promoting healthier living spaces, including tobacco-free areas and safe walking areas. Local communities also can ensure access to healthy food options, including those with lower sodium. Health care systems can adopt and use electronic health records to identify patients who smoke or who have high blood pressure or high cholesterol and help providers follow and support patient progress

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