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Cardio NewsWire

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Heartfailurematters.org now in Portuguese and Arabic

Hand grip strength predicts MI and CVA

Digoxin in CHF & AF

Europe debate on trans fatty acids added to food

Heartfailurematters.org now in Portuguese and Arabic

Heartfailurematters.org is a website created by the Heart Failure Association of the ESC and designed to provide easily understood and practical information about living with heart failure for patients, their families and carers. The site was developed by heart failure specialists, nurses and primary care physicians with input from patients and caregivers from across Europe. It is presented in 6 sections:

  • Understanding Heart Failure,
  • What can your doctor do?
  • What can you do?
  • Living with Heart Failure,
  • For caregivers,
  • Warning Signs

And also provides useful downloadable tools.  Tailored information is delivered not only in the text, but also by real-life videos of patients discussing the common issues faced by these patients. In addition, the site includes a number of original and captivating animations of the heart showing how the heart works, what goes wrong in heart failure and how treatments can improve symptoms and quality of life.

The site, based on a platform at the IT dept. at the European Heart House, receives over 140 000 visits per month. It is accessed from all over the world, due to the fact that the entire site is translated into 9 languages: English, Spanish, German, French, Dutch, Greek, Russian, Portuguese/Brazilian and Arabic. The site is also currently being translated into Swedish.
An animated guide helps visitors navigate through the site in all languages. Feedback from patients and healthcare professionals on the comprehensive but patient-friendly information is extremely positive and the site is regularly updated and reviewed by an active core group with representatives from each language.

Emphasis is placed on helping patients understand their condition and on providing practical advice for living with heart failure. The value of the site as an educational tool is currently being evaluated by a large randomised trial in the Netherlands. This attractive, web-based tool is an indispensable information resource as part of a treatment programme.

It is also employed by cardiologists, nurses and primary care physicians to provide information and educate patients living with heart failure.

Visit Heartfailurematters.org

Hand grip strength predicts MI and stroke

Weak hand grip strength is linked with shorter survival and a greater risk of myocardial infarction or stroke, according to the PURE study.

Reduced muscular strength, which can be measured by grip strength, has been consistently linked with early death, disability, and illness. But until now, information on the prognostic value of grip strength was limited, and mainly obtained from select high income countries.

The Prospective Urban-Rural Epidemiology (PURE) study included nearly 140,000 adults and was conducted in 17 countries of varying incomes and sociocultural settings. Grip strength was assessed using a handgrip dynamometer and subjects were followed for a median of four years.

The researchers found that every 5kg decline in grip strength was associated with a 16% increased risk of death from any cause, a 17% greater risk of cardiovascular death, a 17% higher risk of non-cardiovascular mortality, a 7% increased risk of heart attack and a 9% higher risk of stroke.

The associations persisted even after adjusting for age, education level, employment status, physical activity level, and tobacco and alcohol use.

Grip strength was a stronger predictor of all cause and cardiovascular mortality than systolic blood pressure.

Read the paper in The Lancet

 

Digoxin increases mortality risk in CHF or AF

There is conflicting evidence about whether digoxin, might contribute to an increase in deaths in patients with atrial fibrillation (AF) or congestive heart failure (CHF). Now, the largest review of all the evidence to date shows that it is associated with an increased risk of death in these patients, particularly in those being treated for AF.

In a study published in the European Heart Journal [1], researchers from the J.W. Goethe University in Frankfurt, Germany, conducted a systematic review and meta-analysis of all studies published in peer-reviewed journals between 1993-2014 that looked at the effects of digoxin on death from any cause in AF and CHF patients.

They identified 19 relevant studies that included a total of 326,426 patients (235,047 AF and 91,379 CHF patients). They found that digoxin was associated with a 29% increased mortality risk in patients with AF and a 14% increased risk of death in CHF from any cause, when compared to patients not receiving the drug.

Stefan Hohnloser, Professor of Cardiology at Frankfurt University who led the study, said: “Definite evidence can only come from results of randomised controlled trials. However, next to these, carefully performed meta-analyses provide the best clinical guidance and serve to generate hypotheses that need to be tested prospectively. Our analysis, together with evidence from other studies, all point in the same direction: there is harm associated with the use of digoxin.”

Prof Hohnloser said that there has only been one prospective randomised controlled trial of digoxin, which was carried out in 6,800 CHF patients, and none in AF patients. “We need randomised controlled trials to examine the use of digoxin for both conditions and that test the drug versus a placebo or another, active treatment”.

Ref:
[1] “Digoxin-associated mortality: a systematic review and meta-analysis of the literature”, by Mate Vamos, Julia Erath, and Stefan H. Hohnloser et al. European Heart Journal. doi:10.1093/eurheartj/ehv143

Europe and trans fatty acids added to food

Standfirst: Europe’s policy makers call for action on industrially produced trans fatty acids in foods in the European Union

The impact of industrially produced trans fatty acids (TFAs) on the health of citizens in the European Union (EU) was debated in Brussels on 14 April 2015, by Members of the European Parliament (MEPs), representatives of the European Commission and WHO Europe.

These fats are produced by adding hydrogen to vegetable oil and are used as ingredients in some processed foods, including biscuits and ready meals.

The panel debate in the European Parliament, Brussels, is an initiative of the Members of the European Parliament (MEP) Heart Group, with the support of the European Society of Cardiology (ESC) and of the European Heart Network (EHN).

To date, only three EU Member States - Austria, Denmark and Hungary - have adopted legislation to restrict industrially produced TFAs in the food chain. It is estimated that thousands of lives and billions of Euros could be saved if these measures were introduced more widely.

In 2008, the European Parliament published a study recommending that a ban on industrially produced TFAs should be considered at EU level. In 2009, the World Health Organization (WHO) concluded that the information available was sufficient to recommend reducing significantly or virtually eliminating industrially produced TFAs from the food supply. In December 2014 the European Commission was expected to present a report on the presence of trans fats in foods and in overall diet in the EU population.

Experiences from Denmark and New York show that TFAs can be replaced with healthier substitutes without increasing the cost or reducing the quality of foods. (1,2)

Refs:

1. Stender S, Dyerberg J, Bysted A, Leth T, Astrup A. A trans world journey. Atheroscler Suppl 2006;7:47–52. doi:10.1016/j.atherosclerosissup.2006.04.011 PMID:16713385

2. Angell SY, Silver LD, Goldstein GP, Johnson CM, Deitcher DR, Frieden TR et al. Cholesterol control beyond the clinic: New York City’s trans fat restriction. Ann Intern Med 2009;151:129–34. PMID:19620165

 

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