FIFTY PLUS CHECKING HYPERTENSION
The incidence of hypertension increase with age. No exact cause has been determined for hypertension but it is associated with increased risk of stroke and coroary diseases.
The symptoms of hypertension are mostly headaches and heaviness in the head. But it is most commonly picked up during a general check up , says Dr. Ashwini Mehta, cardiologist, sir Ganga Ram Hospital. Ways to control hypertension in the elderly :
1: Decrease in salt intake
2: Regular eating habits
3: Daily walks
4: Regular check ups
5: Regular treatment
HEART ATTACK PREDICTOR
For the first time, researchers have shown that magnetic resonance imaging can predict the risk of heart attacks or cardiac death in coronary heart disease patients, according to a report in a rapid access issue of Circulation: Journal of the American Heart Association. MRI can be used to locate tissue damage in a heart attack or pinpoint blockages, but it has not been used to predict heart attacks.
simple test for heart failure
Researchers have revealed that a simple blood test is helping doctors to diagnose heart failure at the earliest instead of the cumbersome process that can take hours.
The new blood test can spot a hormone, called hormone B-type natriuretic peptide, present in elevated levels during heart failure. This means doctors can pinpoints who has heart disease, how sick they are and what treatment they need immediately.
The presence and level of the hormone gives you a precise measure of how high the risk is for heart failure, says San Diego cardiologist Dr. Alan S. Maisel, who developed the test. Conversely, if the levels of hormone is not high the change of heart failure is only one or two per cent.
The blood test takes 15 minutes to administer and records the levels of the hormone in the blood. A low levels means the heart is working well. But an elevated level proves the patient has heart trouble as the body releases the hormone when the heart is not pumping properly. If the blood test is added to the diagnostic methods, the accuracy of the diagnosis jumps to over 90 per cent.
NO PILLS, NO POKES, NO UNCALLED FOR PRESSURE
A new method of treating high blood pressure involves no injections or oral medicines
In the hurly-burly of what life today has come to represent, headaches, frustration, immense work pressures and sleepless night have become part and parcel of our daily regimen. As a result, the incidence of high blood pressure is increasing at an alarming rate.
Generally, any kind of tension increases this blood pressure and, interestingly, housewives and retired persons also attrack this rather common malady. There are many medicines that meet requirements, but a new method called the transdermal therapeutic system or transdermal drug delivery system deserves focus. It involves no injections or oral medicine, and herein lies its uniqueness and growing popularity among high BP patients.
The transdermal therapeutic system is more reliable in that it has no side-effects that may result from oral drugs or injections. In this case, a strip or patch is stuck below the ear near the neck and the drug enters the blood through the skin. In medical terms, the drug enters through intravenous infusion and mixes with the blood. The medicine does not move through the liver so the chances of side-effects are reduced, as are the chances of overdose.
The transdermal therapeutic system has multifarious applications, but its fundamental use lies in reducing high blood pressure. Well known cardiologist Tarun Kumar Praharaj of the BM Birla Heart Research Centre describes hypertension as a common complication resulting in acute stroke and very poor outcomes. So Transdermal glyceryl trinitrate, a no donor, lowers BP by five to eight per cent. It is clinically significant and relevant. However, GTN has no effect on platelet aggregation. Since other no-donors increase cerebral blood flow in patients with acute ischaemic cerebral stroke, GTN is the appropriate drug for testing the effect of lowering BP on a functional outcome.
Pregnancy also induces hypertension. In this case, too, it has been found that administering Transdermal glyceryl trinitrate for 24 hours or 16 hours yields positive results by controlling systolic and diastolic BP. Further studies are being done to verify the possible use of Transdermal glyceryl trinitrate as an anti-hypertensive drug during pregnancy
Transdermal oestrogen reduces daytime BP in hypertensive women. Also transdermally administered 17 beta oestradiol produces a very positive effect on ambulatory BP in hypertensive post menopausal women. Recent treatment records reveal that transdermally administered oestrogen also help in reducing BP during daytime in hypertensive postmenopausal women.
A low does of transdermal scopalamine decrease blood pressure in mild hypertension and also increase cardiovascular parasympathetic activity.
Transdermal clonidine therapy reduces blood pressure in hypertensive male patients. In this regard, Dr. Praharaj explains, Transdermally administered clonidine lower both systole and diastole BP within 14 to 24 hours of application. The anti-hypertensive effect persists at the end of the first week, as well as after 14 days. The lowest values of systolic and diastolic BP documented were not better than the levels reported in normotensive men. Therefore, transdermal clonidine seems to act as an anti-hypertensive agent rather than a hypotensive one since it normalises BP without lowering it below physiological levels.
The transdermal therapeutic system has also opened up a new dimension in transdermal estrogen replacements therapy. This replacement therapy is associated with a reduction in mean ambulatory BP whereas oral treatments does not alter BP. Although the overall effect of estrogen is to lower BP, it varies from individual to individual. Therefore, long term monitoring of ambulatory measurements may be required.
BYPASS ON BEATING HEARTS HELPS ELDERS
For elderly heart patients, especially those above 80 years bypass surgery on a beating heart may help boost survival rates by cutting down on the number of strokes, says a new Canadian study published in the special surgery issue of circulation : Journal of the American Heart Association.
Since patients above 80 years of age are at a higher risk of complications after bypass surgery, some physicians have suggested that the less invasive surgery on a beating heart may be a better option for these patients.
PIG PARTS FOR PEOPLE?
It wont happen for years, but a new breakthrough puts an unlimited source of organs a step closer
If you or a loved one has a heart that falling or kidneys that are giving out, you already know the grim statistics on transplants. A new organ can turn a death sentence into a full healthy life but the supply of replacement body parts lags for behind the demand. According to the non-profit United Network for Organ sharing, which maintains America transplant waiting lists, nearly 80,000 patients in the U.S. alone are standing by for new organs and more than 5,000 people die each year before their turn comes.
Those dismal numbers have prompted scientists to consider organs from other mammals especially pigs, which are easily bred and whose physiology is similar to ours. But pig biology is different enough from human biology that rejection, a surmountable problem in human to human transplants, is disastrous in so-called xenotransplants.
But a solution may be on the horizen. Recently two research teams said they had removed the pig gene responsible for the most severe form of rejection. Not only that. Both teams one from PPL Therapeutics, which in 1996 helped make Dolly the sheep, the first mammal cloned from an adult animal, and the other from the University of Missouri-Columbia and Immerge Bio-Therapeutics, of Charlestown, Massachusetts then cloned their little pigs, producing five and four piglets, respectively.
By itself, this breakthrough wont lead directly to pig transplants. For one thing, pigs carry two copies of gene, called GGTA1; the scientists knocked out only one. Researchers expect to create double-knockout pigs within a year, but until they do, rejection will remain an insurmountable problem. And even if they do eliminate the most problematic form of inter species rejection, other exist, and they will have to be dealt with.
Another danger arises because animals carry viruses that are harmless to their hosts but can turn deadly in another species. If such a virus hitchhiked aboard transplanted tissue, it could not only infect its new host but also spread to other humans much as HIV did when it jumped from monkeys to man.
Finally, cloning often produces animals that are deformed or die young; they may age prematurely as well. Researchers at Scotland Roslin Institute, PPL partner in the Dolly experiment, reported that their famous ewe has come down with arthritis at age 5 a condition that may be related to her cloning.
Still, interspecies transplantation is so promising that researchers are determined to tackle each hurdle as it comes. It could be a decade or more before clinical trials become routine and even longer for transplants. But they seem to be on their way.
Talk about a sign of acceptance. Researchers in the U.S. studying men who received heart transplants from women discovered male cells growing in the donated female hearts a surprising upheaval of the conventional wisdom that the heart cannot regenerate tissue the way other organs can. Doctors are now searching for cardiac stem cells that could repair hearts without a transplant.
Heart attacks sometimes do not spare even those who stay away from a risky lifestyle. About 3 per cent of reported heart conditions are caused by unexplained factors even though risk factors such as genetic predisposition play a major role, says Dr. Naresh Trehan
This happened in the case of 28 year old Madhav Verma, who suffered a heart attack even though he had none of the high risk factorr. The only positive thing on this jeopardy score a scoring procedure for risk factors was a positive C reactive protein
The New England Journal of Medicine reported recently that a chemical called C-reactive protein in the blood is a better predictor for a heart attack than low-density lipoprotein or bad cholesterol. Researchers are now linking heart disease with inflammation, the body first line of defence against infection and injury.
The American Heart Association and the US centers for Disease Control and prevention have also recommended that doctors use a test that measures inflammation when trying to decide how to treat patients as risk for cardiovascular disease.
In India, some doctors such as Purushottam Lal of the Metro Heart Centre are already doing the test. We have adopted a jeopardy score procedure that includes a CRP measure and an ankle brachial index, says Lal. While a positive CRP indicates inflammation and in turn a heart risk, an ankle branchial test indicates a stiffness of the branchial artery, which can be an early indicator of coronary artery disease.
Coronary Artery disease are no longer a predominantly male disease. More and more doctor are reporting larger numbers of women patients coming in even in the pre- menopausal stage. Earlier, it was believed that women developed heart diseases only post-menopause as they were protected from the disease before that by the hormone oestrogen which reduces post-menopause.
There is a marked increase in the number of overweight and obese young women. This coupled with an upward trend in cigarette smoking among women, switching to potentially dangerous weight loss practices and crash diet has led to a steep rise in sudden cardiac deaths in women, says Dr. OP Yadava of Sir Ganga Ram Hospital. Dr. Ashwini mehta, cardiologist in the same hospital, says this increase is in keeping with the trend of rising incidence of coronary diseases.
Stress of urban life, sedentary lifestyle, bad eating habits and rise in cholesterol levels is affecting women heart too says Dr Mehta.
Dr. Yadava study of 1,500 patients in his hospital has shown that women constitute 25 percent of total bypass surgeries. Nearly 10 percents of the women needing needing bypass were in the relatively younger perimenopausal age group of 40-49 years. Moreover 65 percent of the women under going bypass surgeries were diabetic and 61 percent had high blood pressure, suggesting a high correlation between diabetes, high BP and heart attacks in women, says Dr. Yadava. He points out that nearly twice as many woman die of heart disease and related stroke as all forms of cancer, including breast cancer.
Doctor warn that 42 per cent of the women having a heart attack die within one years itself, as compared with just 24 per cent of the men.