Screening for cardiovascular disease by age alone?

Researchers have insinuated that predicating heart and circulatory disease events could be best done purely on the basis of age, and that all older members of the population should be offered preventative treatments.

The study published on the 4th of May by Barts and the London School of Medicine and Dentistry suggests that predicting cardiovascular events in those over 55 is as good as using the current Framingham screening system, which involves testing for other risk factors associated with cardiovascular disease i.e. blood pressure and high cholesterol.

This study has lead to controversy with the British Heart Foundation (BHF) offering a viewpoint on the study. It is pointed out that using only age, as a predictive factor for cardiovascular disease would miss those at risk in younger age groups. These are patients who may have a family history of heart or circulatory disease and are for this reason more likely to suffer cardiovascular disease themselves.

This view is followed up with the statement that those with other risk factors such as high cholesterol and blood pressure at the age of 40-55 could be treated to prevent heart and circulatory disease before it takes place. This would also make economic sense for the National Health Service (NHS). This point is strengthened by the lack of evidence to suggest that everyone of a certain age should be offered treatment such as statins.

Study published in the Journal PLoS ONE

Another reason why frequent exercise is so important for heart health

New research has highlighted the protective effect of exercise on the heart via a chemical called Nitric Oxide and the enzyme that produces it eNOS.

It is known that exercise reduces the risk of heart attack and protects the heart to an extent from heart injury if a heart attack does occur. It has been a major aim for doctors to understand how this second method of protection works, and how it may help protect the heart after heart attacks occur.

Researchers at Emory University may have gone some way to identifying an important part to the puzzle. The group have identified that the heart has the ability to produce and to an extent store Nitric Oxide during exercise.

Nitric oxide has the ability to relax blood vessels, increase blood flow and critically help the heart tissue better survive heart attacks. This would mean that during exercise your body will build up Nitric Oxide stores that can be later used when the body needs it.

However, the study found that the effects of exercise are not long lived. Mice were allowed to voluntarily exercise on exercise wheels for four weeks. The mice were then given heart attacks. Those mice that had been voluntarily exercising for the four weeks leading up to the heart attack had less severe heart attacks.

Unfortunately this cardio protective effect was shown to be short-lived.  If the wheel was taken away from the mice that had been exercising for four weeks the beneficial effect seemed to be lost after a week of non-exercise. This evidence highlights the need for regular moderate exercise as a good way of reducing the risk of heart attack and it’s severity if it does occur.

Full article at Circulation Research.

Putting Cardiovascular Disease into Perspective

Heart disease or cardiovascular disease are the terms used to commonly describe diseases that involves the heart or blood vessels (arteries and veins).

These diseases commonly fall into the categories of coronary heart disease (angina and heart attack) and stroke.

Most developed countries face high and ever increasing rates of cardiovascular illness. Each year heart disease kills more Americans than even cancer.

In recent years cardiovascular disease has been increasing in women and has killed more women than breast cancer. This is an important point as there is a common misconception that heart disease only affects men, whereas in actuality it affects nearly as many women as men.

In the case of vascular disease large histological studies have determined that vascular injury accumulates from adolescence making preventative efforts from childhood necessary. By the time that heart disease is detected, the underlying cause (atherosclerosis) is often quite advanced having progressed for decades.

Therefore a huge emphasis is put on preventing atherosclerosis by modifying risk factors, which can be achieved through healthy eating, exercise and the avoidance of smoking i.e. living a healthy lifestyle.

This however does not account for all disease. As certain heart diseases are genetic and members of the population may be at a far higher risk of suffering from these cardiovascular diseases. Emphasising the need for early detection and treatment of certain cardiovascular disorders.

For more Information about preventing heart disease: BHF, WHO & patient.co.uk