Achieving better heart health has its obstacles
BY LIZ SZABO November 26, 2012 5:40PM
The recommended 2.5 hours a week of "moderate intensity" exercise can help people live 3.4 years longer than those who don't exercise at all, according to a new study. Benefits of exercise include better stress management, icreased energy and easier weigh
Updated: November 29, 2012 10:49AM
Research presented at a major medical meeting underscores the importance of preventing heart disease — but also illustrates how difficult that is to put into practice.
Several studies of drugs and supplements that doctors hoped would improve heart health, for example, proved disappointing.
Although a pill called dalcetrapib was found to improve HDL, or “good” cholesterol, it didn’t actually reduce heart attacks in people with pre-existing heart disease, according to a study presented earlier this month at the American Heart Association’s Scientific Sessions in Los Angeles. And taking fish oil, which has long been touted as good for the heart, didn’t prevent a form of irregular heartbeat after cardiac surgery, a study showed.
All of these pills had seemed promising in early, less rigorous trials. But as with so many drugs and supplements, larger, more carefully designed tests failed to uphold those benefits, says Christopher Cannon, a professor at Harvard Medical School.
Yet even when there are proven prevention strategies available, new studies found that doctors and patients may not follow them.
Nearly one in five hospitalized smokers, for example, continue to smoke during a hospital stay, according to a study published in Archives of Internal Medicine, unrelated to the heart meeting. While patients in the study weren’t allowed to smoke inside the hospital, they still found places outside to light up.
Another study found that doctors often miss critical opportunities to intervene early, and prevent major heart problems before they turn deadly. An analysis of nearly 14,000 medical records found that many doctors fail to diagnose patients with high blood pressure, even though patients’ blood pressure readings are recorded in their charts.
Doctors were 28 percent less likely to diagnose high blood pressure in college-age adults compared with patients over 60, especially if they smoked or spoke English as a second language, according to a study presented at the meeting by Heather Johnson, an assistant professor at the University of Wisconsin School of Medicine and Public Health in Madison.
Doctors failed to diagnose 54 percent of patients over age 60 with high blood pressure, and 67 percent of those who were ages 18 to 24, even after multiple visits and four years of follow-up, the study says.
Johnson says it’s possible that doctors are falling victim to stereotypes about heart disease, ignoring high blood pressure in young people because of an assumption that hypertension is a disease of the elderly.
The study reinforces other research showing that doctors may be blinded by preconceptions about heart disease, says Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York. Physicians often ignore symptoms of heart disease in women, as well, she says. “We’re missing a chance for prevention and missing the point at which we can change heart disease,” Steinbaum says. “People don’t get heart disease spontaneously. It takes decades to develop. If we don’t treat hypertension in 18- to 24-year-olds, then guess what’s going to happen 20 years from now? They’re going to be in heart failure.”
So which prevention strategies really do work? The latest research once again points to exercise.
People who get even a small amount of leisure-time physical activity live longer, according to a study from the National Cancer Institute released earlier this month and unrelated to the heart meeting.
Americans who get the recommended 2.5 hours a week of “moderate intensity” exercise live 3.4 years longer than those who don’t exercise, according to the study, published online in PloS Medicine. Even those who get only half the amount of recommended exercise still add 1.8 years to their lives.
A study presented at the heart meeting also shows that people who avoid health pitfalls live not just longer, but better.
People with good heart health at age 45 — without hypertension, high cholesterol, diabetes or tobacco use — were rewarded with an additional 14 years of healthy life, free of ailments such as heart attacks, stroke or chronic heart failure, compared with people with two of the risk factors, according to a study published in the Journal of the American Medical Association.
Gannett News Service