Heart Attacks have become more common in Women

November 2, 2009

In the first study, Amytis Towfighi, M.D., of the University of Southern California, Los Angeles, and colleagues analyzed data from U.S. adults age 35 to 54 who participated in the National Health and Nutrition Examination Surveys (nationally representative surveys conducted by the government) during 1988 to 1994 (4,326 participants) and 1999 to 2004 (4,075 participants).

The researchers assessed how often men and women had heart attacks and also compared their Framingham coronary risk score, a measurement of heart disease risk over 10 years that includes factors such as age, cholesterol levels, blood pressure and smoking history.While the incidence of heart attacks has increased, all women - and especially those younger than 55 - have also experienced a greater increase than men in their chances of survival following a heart attack.

Two new US studies have shown that heart attacks have become more common in middle-aged women over the past two decades.In both study periods, men age 35 to 54 years had more heart attacks than women in the same age group. However, the gap narrowed in more recent years as heart attacks decreased in prevalence among men and increased in prevalence among women (2.5 percent of men and 0.7 percent of women reported a history of heart attack in 1988-1994, whereas 2.2 percent of men and 1 percent of women did so in 1999-2004).

"Although men in their midlife years continue to have a higher prevalence of myocardial infarction and a higher 10-year risk of hard coronary heart disease than women of similar age, our study suggests that the risk is increasing in women, while decreasing in men," the authors said. The only risk factor that improved among women was HDL levels. Diabetes prevalence increased among both men and women, likely due to insulin resistance and the obesity epidemic in both sexes.
 
While the incidence of heart attacks has increased, all women - and especially those younger than 55 - have also experienced a greater increase than men in their chances of survival following a heart attack.

In the first study, Amytis Towfighi, M.D., of the University of Southern California, Los Angeles, and colleagues analyzed data from U.S. adults age 35 to 54 who participated in the National Health and Nutrition Examination Surveys (nationally representative surveys conducted by the government) during 1988 to 1994 (4,326 participants) and 1999 to 2004 (4,075 participants).

The researchers assessed how often men and women had heart attacks and also compared their Framingham coronary risk score, a measurement of heart disease risk over 10 years that includes factors such as age, cholesterol levels, blood pressure and smoking history.

In both study periods, men age 35 to 54 years had more heart attacks than women in the same age group. However, the gap narrowed in more recent years as heart attacks decreased in prevalence among men and increased in prevalence among women (2.5 percent of men and 0.7 percent of women reported a history of heart attack in 1988-1994, whereas 2.2 percent of men and 1 percent of women did so in 1999-2004).

Between the two time periods, the average Framingham coronary risk score showed an improving trend among men but decreased among women.
In male participants, total cholesterol levels remained stable, high-density lipoprotein (HDL or "good" cholesterol) levels and systolic (top number) blood pressure levels improved and smoking levels declined.

The only risk factor that improved among women was HDL levels. Diabetes prevalence increased among both men and women, likely due to insulin resistance and the obesity epidemic in both sexes.

"Although men in their midlife years continue to have a higher prevalence of myocardial infarction and a higher 10-year risk of hard coronary heart disease than women of similar age, our study suggests that the risk is increasing in women, while decreasing in men," the authors said.

In the second study, Viola Vaccarino, M.D., Ph.D., of Emory University School of Medicine, Atlanta, and colleagues investigated trends in the rate of in-hospital deaths following heart attack from June 1, 1994, through Dec. 31, 2006. Data were collected from 916,380 patients through the National Registry of Myocardial Infarction.

In-hospital death rates decreased among all patients between 1994 and 2006, but decreased more markedly in women than in men. The reduced risk of death was largest in women younger than 55 years (a 52.9 percent reduction) and lowest in men of the same age (33.3 percent). The absolute decrease in the risk of death among patients younger than 55 was three times larger in women (2.7 percent) than men (0.9 percent).

"A large part (93 percent) of this sharper decrease in mortality of younger women compared with men in recent years was because the risk status of women on admission improved compared with that of men," the authors said.

The two studies appear in the October 26 issue of Archives of Internal Medicine , one of the JAMA/Archives journals .

(edited by Tim)

Robotic Surgery may reduce impotence

October 24, 2009
‘’Professor Costello’s website says the use of this procedure may reduce impotence and urinary incontinence,'’ professor Chapman said. ‘’The use of the word ‘may’ is very important. Obviously, it may not, either.
The study, published in the Journal of the Amercian Medical Association, has sparked renewed debate over robotically assisted surgery, and over how much surgeons should be obliged to tell patients about their success rates.Evidence suggests that robotic prostate cancer surgery, far from being the saviour of men, is leaving them with more incontinence and impotence than traditional techniques.However, the pioneers of robotic surgery in Australia have defended the procedure, saying the research was flawed.

It found that robotic assistance meant men left hospital a day earlier and they were 10 times less likely to need a blood transfusion.However, more than twice as many (4.7 per cent) suffered ‘’genitourinary'’ complications. Almost a third more (16 per cent) were diagnosed with urinary incontinence, and the rate of erectile dysfunction rose by 40 per cent (to 27 per cent).

Professor Simon Chapman, a public health expert from the University of Sydney, said the study casts strong doubts on the claims made on behalf of the robots by proponents such as the Epworth Hospital’s Tony Costello.The Epworth, in Richmond, pioneered robotic-assisted surgery in Australia in 2003, and now runs two of the country’s five da Vinci robots.

‘’Men are in an enormously vulnerable position. They are not in a position at all to adequately evaluate the claims put to them by a doctor. The issues of urinary incontinence and sexual impotence are really very important for a lot of men, especially now men as young as 40 are being screened [for prostate cancer].'’

The Epworth’s associate professor, David Webb, recently published a paper that found robotic-assisted prostatectomies had completely eliminated ‘’bladder neck'’ problems - previously almost one in 10 prostate surgery patients had experienced a bladder neck contracture.

Neuroscientist Janet Keast, from the University of Sydney, said it was almost impossible to avoid nerve damage during a prostate operation.

‘’I am concerned that people get unrealistic expectations because it is called ‘nerve sparing’ surgery,'’ she said. The skill of the surgeon, rather than use or otherwise of a robot, was a better guide to how likely major nerve damage would be.

Swine flu H1N1 vaccine gets to metro Detroit

October 22, 2009

Detroit Medical Center has ordered about 35,000 doses of H1N1, but only has 100 or so for pregnant women, said Dr. Michelle Schreiber, chief quality officer. Henry Ford Health System spokesman David Olejarz said their H1N1 vaccine schedule was not available.

The vaccinations are intended for high-risk groups: pregnant women, those ages 6 months to 24, those living with babies 6 months or younger, adults ages 25 to 64 with conditions like asthma, health care workers and first-responders.

Those 10 and older are to get one dose, said Mary Mazur, Wayne County Department of Public Health spokeswoman, and children 6 months to 9 years are to get two doses, spaced one month apart.

Get free blog up and running in minutes with Blogsome | Theme designs available here