Trouble sleeping? Insomnia symptoms linked to increased risk of stroke, heart attack

People who have trouble sleeping may be more likely to have a stroke, heart attack or other cerebrovascular or cardiovascular diseases, according to a study published in the November 6, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“These results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it’s possible that we could reduce the number of cases of stroke, heart attack and other diseases later down the line,” said study author Liming Li, MD, of Peking University in Beijing, China.

The study involved 487,200 people in China with an average age of 51. Participants had no history of stroke or heart disease at the beginning of the study.

Participants were asked if they had any of three symptoms of insomnia at least three days per week: trouble falling asleep or staying asleep; waking up too early in the morning; or trouble staying focused during the day due to poor sleep. A total of 11 percent of the people had difficulty falling asleep or staying asleep; 10 percent reported waking up too early; and 2 percent had trouble staying focused during the day due to poor sleep. The researchers did not determine if the people met the full definition of insomnia.

Full story at Science Daily

Not all hypertension drugs are created equal, reports big-data study

For those with extremely high blood pressure, or hypertension, there are many initial medication options — so many that it can be hard to know which one to use. Now, a Yale-coauthored paper in Lancet provides more information about the relative safety and effectiveness of different hypertension drugs in order to inform this critical treatment decision. The study reveals that angiotensin converting enzyme (ACE) inhibitors may not be the best choice for initial treatment.

Unprecedented in scale, the Lancet study pulled together the data of 4.9 million patients from nine institutional databases across four countries. The researchers used that data to compare the safety and effectiveness of the five classes of first-line hypertension medications, including the popular ACE inhibitors. They were looking at how well each drug prevented the three main health consequences of hypertension — heart attack, heart failure, and stroke — and to what extent each drug caused 46 unwanted side-effects.

“This is a remarkable, massive, multinational study that has provided insights that can inform patient choices about hypertension treatment,” says Dr. Harlan Krumholz, Yale cardiologist and author on the Lancet study. “What is distinctive is not only the size, but the advanced methods that optimize the trustworthiness of the results.”

Full story at Science Daily

Once or twice weekly daytime nap linked to lower heart attack/stroke risk

A daytime nap taken once or twice a week may lower the risk of having a heart attack/stroke, finds research published online in the journal Heart. But no such association emerged for either greater frequency or duration of naps.

The impact of napping on heart health has been hotly contested. Many of the published studies on the topic have failed to consider napping frequency, or focused purely on cardiovascular disease deaths, or compared regular nappers with those not opting for a mini siesta, say the researchers.

In a bid to try and address these issues, they looked at the association between napping frequency and average nap duration and the risk of fatal and non-fatal cardiovascular disease ‘events,’ such as heart attack, stroke, or heart failure, among 3462 randomly selected residents of Lausanne, Switzerland.

Full story at Science Daily

Why Do Older Heart Attack Patients Get Worse Care?

If you’re over 65 and have a heart attack, your care may be compromised, a new study finds.

In fact, you’re less apt than younger patients to receive a timely angioplasty to open blocked arteries. You’re also likely to have more complications and a greater risk of dying, researchers say.

“Seniors were less likely to undergo [angioplasty] for a heart attack and if they do receive the procedure it’s not within the optimal time for the best possible outcome,” said lead researcher Dr. Wojciech Rzechorzek, a resident at Mount Sinai St. Luke’s and Mount Sinai West Hospital in New York City.

“Their prognosis is worse than for younger patients with the same conditions, and this lack of treatment or delay in treatment could be a factor,” he noted.

But a New Jersey heart specialist said the delays in care are not neglect, but necessary.

Full story at Health Day

Patients say lack of physician guidance and fear of side effects are why they don’t take statins as prescribed

Despite national guidelines indicating that statins can lower risk of heart attack and stroke, many patients who could benefit do not take them. More than half of eligible patients say they were never offered the cholesterol-lowering drugs; the experience of side effects or fear of side effects were reasons for stopping or refusing statins, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Statins lower the amount of low-density lipoprotein (LDL, or “bad” cholesterol) and have been shown to lower the risk of heart attack and strokes. Because statins are proven effective and have a low risk of side effects, guidelines from the American Heart Association/American College of Cardiology recommend doctors use an atherosclerotic and cardiovascular disease risk calculator to give a detailed assessment of a person’s 10-year risk for heart disease and to help create a personalized plan.

Full story at Science Daily

Weightlifting is good for your heart and it doesn’t take much

Lifting weights for less than an hour a week may reduce your risk for a heart attack or stroke by 40 to 70 percent, according to a new Iowa State University study. Spending more than an hour in the weight room did not yield any additional benefit, the researchers found.

“People may think they need to spend a lot of time lifting weights, but just two sets of bench presses that take less than 5 minutes could be effective,” said DC (Duck-chul) Lee, associate professor of kinesiology.

The results — some of the first to look at resistance exercise and cardiovascular disease — show benefits of strength training are independent of running, walking or other aerobic activity. In other words, you do not have to meet the recommended guidelines for aerobic physical activity to lower your risk; weight training alone is enough. The study is published in Medicine and Science in Sports and Exercise.

Lee and his colleagues analyzed data of nearly 13,000 adults in the Aerobics Center Longitudinal Study. They measured three health outcomes: cardiovascular events such as heart attack and stroke that did not result in death, all cardiovascular events including death and any type of death. Lee says resistance exercise reduced the risk for all three.

Full story at Science Daily

Bacterial pneumonia far more dangerous to the heart than viral pneumonia

Heart complications in patients diagnosed with bacterial pneumonia are more serious than in patients diagnosed with viral pneumonia, according to new research from the Intermountain Heart Institute at Intermountain Medical Center in Salt Lake City.

In the study of nearly 5,000 patients, researchers found that patients diagnosed with bacterial pneumonia had a 60 percent greater risk of a heart attack, stroke, or death than patients who had been diagnosed with viral pneumonia.

“We’ve always known pneumonia was a risk factor for a major adverse cardiac event, like a heart attack, within the first 90 days of being diagnosed,” said J. Brent Muhlestein, MD, a cardiovascular researcher with the Intermountain Heart Institute at Intermountain Medical Center. “What we didn’t know was which type of pneumonia was more dangerous. The results of this study provided a clear answer, which will allow physicians to better monitor patients and focus on reducing their risk of a major adverse cardiac event.”

Full story at Science Daily

Patients with sepsis at higher risk of stroke, heart attack after hospital discharge

Patients with sepsis are at increased risk of stroke or myocardial infarction (heart attack) in the first 4 weeks after hospital discharge, according to a large Taiwanese study published in CMAJ (Canadian Medical Association Journal).

Sepsis accounts for an estimated 8 million deaths worldwide, and in Canada causes more than half of all deaths from infectious diseases.

Researchers looked at data on more than 1 million people in Taiwan, of whom 42 316 patients had sepsis, matched with control patients in the hospital and the general population. All sepsis patients had at least one organ dysfunction, 35% were in the intensive care unit and 22% died within 30 days of admission. In the total group of patients with sepsis, 1012 had a cardiovascular event, 831 had a stroke and 184 had a myocardial infarction within 180 days of discharge from hospital. Risk was highest in the first 7 days after discharge, with more than one-quarter (26%) of myocardial infarction or stroke occurring in the immediate period and 51% occurring within 35 days.

Full story at Science Daily

Common painkiller linked to increased risk of major heart problems

The commonly used painkiller diclofenac is associated with an increased risk of major cardiovascular events, such as heart attack and stroke, compared with no use, paracetamol use, and use of other traditional painkillers, finds a study published by The BMJ this week.

The findings prompt the researchers to say that diclofenac should not be available over the counter, and when prescribed, should be accompanied by an appropriate front package warning about its potential risks.

Diclofenac is a traditional non-steroidal anti-inflammatory drug (NSAID) for treating pain and inflammation and is widely used across the world.

But its cardiovascular risks compared with those of other traditional NSAIDs have never been examined in large randomised controlled trials, and current concerns about these risks make such trials unethical to conduct.

Full story at Science Daily

Announcing New Guideline on Managing Disorders of Consciousness

A new guideline for managing disorders of consciousness (people in a minimally conscious state) has been published in the journals Neurology (PDF) and Archives of Physical Medicine and Rehabilitation (PDF). The development of the new guideline was partially funded by ACL’s National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), and two of its co-authors are grantees in NIDILRR’s TBI Model Systems program.

The guideline provides recommendations to improve diagnosis, health outcomes, and care of people with these disorders. About four in 10 people who are thought to be unconscious are actually aware.

Consciousness is a state of being awake and aware of one’s self and surroundings. A person with a disorder of consciousness has trouble being awake, or being aware or both. People in minimally conscious state have behaviors that show they are conscious, such as tracking people with their eyes or following an instruction to open their mouths, but the behaviors are often subtle and inconsistent. A disorder of consciousness can be caused by a severe brain injury resulting from trauma, such as a fall, a car accident or sports injury. It can also be caused by a disease or illness, such as stroke, heart attack or brain bleed.

Full story at acl.gov