News tips for Tuesday, Nov. 11, 2003

November 11, 2003

To complement our news releases, here are additional news tips reported by the American Heart Association's News Media Relations from more than 3,700 abstracts. Note: Stories are embargoed until papers are presented or poster sessions begin. Presentation times are indicated with each entry; however, all embargoes will lift by 4 p.m. EST each day.

8:30 a.m. - Abstract #2560 - A new approach to treating extreme artery blockages. Japanese scientists report they've experimentally improved blood flow in patients with the severest artery blockages, known as intractable arteriosclerosis obliterans (ASO). They tested a technique that's simpler than direct bone marrow cell transplantation (BMT), but could be just as effective. Forty-four ASO patients were divided into three groups: 15 received conventional medical therapy (control group), 14 got direct injections of mononuclear cells from bone marrow (BMT group), and 15 got the new therapy, involving subcutaneous injection of recombinant human granulocyte colony-stimulating factor (G-CSF), which mobilizes endothelial progenitor cells derived from bone marrow to induce new blood vessel cell growth (vasculogenesis). A month later, subjective symptoms had improved significantly in eight of 14 BMT patients and in eight of 15 in the G-CSF group, compared to only two of 15 in the control group. Ankle brachial and oxygen pressure indicators also increased, but only in the treatment groups. The non-invasive G-CSF treatment improved clinical signs and symptoms as well as the more complex BMT method and should be used to treat ASO, the researchers said.

8:30 a.m. - Abstract #P3404 (poster) - Insurance key to preventive care in diabetic minorities. Researchers suspected that ethnic minorities, despite a higher prevalence of diabetes, receive less of the preventive care practices - smoking cessation, eye and foot exams, annual checkups - that can avoid or delay diabetes-related complications. But a study of 23,434 diabetic adults in 37 states shows that a lack of insurance, not minority or ethnicity, drives disparities in such care. "Contrary to our hypothesis, after controlling for age, social class, gender and health insurance, blacks and Hispanics received more preventive care overall compared to whites," Florida researchers found. "Overall, the strongest predictor for not receiving preventive care practices among all ethnic groups was lack of insurance coverage." While their results may suggest progress in health education among minority populations, the scientists say future research should focus on barriers to health insurance and doctors' adherence to care recommendations for diabetics.

8:30 a.m. - Abstract #3440 (poster) - Anger, aggression and CVD risk: a role for testosterone? An aggressive personality may adversely affect risk factors for cardiovascular disease (CVD), and testosterone has been suspected of playing a part. In 933 healthy young men (average age 19), Polish scientists measured body mass index (BMI), cholesterol and testosterone levels. Psychological tests assessed physical and verbal aggression, anger and hostility levels. The study found that men in the highest quartile of anger index scores had higher BMI than men in the lowest quartile. Adjusting for testosterone had only minimal effects. Furthermore, men with the highest hostility index exhibited lower HDL levels than men with the lowest measure of hostility. Their difference remained significant after adjusting for testosterone. Men with a "cluster" of metabolic factors (i.e., the highest quartile of BMI plus lowest quartile of HDL) had "significantly higher" total aggression scores than those with the opposite BMI/HDL combination, despite similar male hormone levels. So the association between aggression and metabolic factors evident in young men "is not mediated by testosterone," the researchers concluded.

9:30 a.m. - Abstract #3393 (poster) - Passive smoke takes its toll among non-smokers. Researchers conducting the Scottish Health Study calculated passive smoking's effects on 3,585 people who never smoked. Individual grades were based on three levels of self-reported smoke exposure, plus blood levels of cotinine, a nicotine metabolite. During a 14-year follow-up, 239 never-smokers died, 93 from circulatory disease. Relative risk of circulatory death for those who got the highest smoke exposure was as much as twice as high as those with the lowest exposure. Researchers said their results show an increase in deaths from cardiovascular disease associated with passive smoking exposure - findings that "endorse current policies of strictly limiting smoking in shared areas."

9:30 a.m. - Abstract # 3395 - Erectile dysfunction, heart attack and age: a closer look. Is erectile dysfunction (ED) a marker for coronary heart disease (CHD)? Mayo Clinic researchers studied 1,844 men ages 40-79 in 1990 who answered questionnaires assessing urological function at baseline and every two years thereafter. Investigators found that men who had a heart attack between 1979 and 1995 were 3.5 times more likely to have ED in 1996 (when questions about ED were added) than men who did not have a heart attack. Taking age differences into account "modestly attenuated" this link. The association between ED and subsequent heart attack from 1996 to 1998 was of greater magnitude (odds ratio 4.9), but lost statistical significance when adjusted for age, in part due to a smaller number of heart attacks. But the ED-CHD link can't be attributed solely to the effects of age, said the researchers. Moreover, men with CHD appear more likely to have ED, and conversely, men with ED appear more likely to develop CHD. They said their findings underscore the need to consider cardiovascular health in men with ED as well as sexual function in men with CHD.

9:30 a.m. - Abstract #3397 (poster) - Worsening depression predicts increased risk of artery disease. While population studies have suggested that depressed individuals are at increased risk of developing coronary heart disease (CHD), mechanisms of this link are still undetermined. A prospective study of job stress and CHD assessed physical and psychological changes in 217 participants (90 percent men) over a decade. Using a standard scale, researchers measured depressive symptoms, dividing subjects into quartiles, and scanned carotid arteries for signs of disease. After adjusting for baseline variables, the team found that worsening depressive symptoms "significantly predicted" increased odds of carotid plaque, with those in the third and fourth highest quartiles more than twice as likely as those in the lowest quartile to have carotid plaque at follow-up. The study authors conclude that depression is an apparent independent risk factor for carotid disease and "may confer CHD risk partly through the development of atherosclerosis." For more on depression and heart disease, see Abstract #3551 (Wed. 4:15 p.m.) for a report finding that depression may increase CVD risk via a "prothrombotic" mechanism involving higher levels of key clotting factors.
And see Abstract #2778 (Tues. 3 p.m.) for results of a study of women recovering from coronary artery bypass surgery showing that major depression is associated with reduced "natural killer" cell activity and increased infectious illness.

2 p.m. - Abstract #2735 - Drug works best in hypertensives at highest risk of stroke. The Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) Study has taken a closer look at the angiotensin-receptor blocker losartan, shown to be superior to atenolol in lowering stroke risk in patients with high blood pressure and left ventricular hypertrophy (LVH). LIFE researchers now find that losartan therapy "is associated with consistent reductions in risk across various stroke types, with fewer (neurological) deficits." The new analysis followed 9,193 people with high blood pressure (hypertension) and LVH for 4.8 years. Participants were randomized to receive either losartan or atenolol. Results showed consistent risk reductions for losartan-treated patients across most demographic and clinical subgroups, but the absolute benefit was greatest among patients with atrial fibrillation, isolated systolic hypertension and prior stroke. Notably, there was a positive treatment-ethnicity interaction, such that atenolol tended to show a benefit in blacks. Losartan "exerts important benefits over standard therapy in hypertensives with LVH, the magnitude of which is greatest for higher-risk groups," scientists say. The public health significance of their findings, they add, is "substantial."

4:00 p.m. (presentation time 4:30) - Abstract #2654 - Most cardiac arrest survivors are not cognitively impaired. In a prospective study, 57 survivors from a group of 308 victims of out-of-hospital cardiac arrest underwent extensive neuropsychological exams. The survivors were given eight tests of memory, attention and executive functioning, six months after cardiac arrest. Researchers show that 58 percent scored "unimpaired" on all tests and 11 percent to 28 percent were cognitively impaired, depending on the test. Another 19 percent had limited daily activities. "Patients who received CPR prior to the arrival of the ambulance showed a trend towards an overall better cognitive function and significant better immediate memory," researchers reported.

American Heart Association

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