Sunday News Tips
- U.S. emergency room visits for irregular heartbeat soar
- Electronic monitoring device may help lower salt intake
- High hospital admissions for acute aortic dissection coincide with peak flu season
- High blood pressure control in United States continues to improve
- Young heart health linked to better overall health in later years
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Emergency room visits for atrial fibrillation have increased significantly in the United States — causing a major healthcare burden, according to research presented at the American Heart Association’s Scientific Sessions 2014.
Atrial fibrillation (AF), the most common kind of arrhythmia or irregular heartbeat, can lead to blood clots, stroke, heart failure and other heart-related complications.
Researchers analyzed patients from the Nationwide Emergency Department Data who visited the emergency department with AF listed as the first diagnosis in 2006-11. They found:
- The average AF hospital admission rate was 65 percent.
- The admission rate for AF varied from 62.5 percent in 2006 to 67 percent in 2011.
- The rate of AF emergency room visits steadily increased 24 percent, from 133 visits per 100,000 persons in 2006 to 165 visits per 100,000 persons in 2011.
- The total admissions for AF (2006-11) was more than 2.7 million.
- While AF admission rates have risen, there was a decrease in in-hospital death rates (1.18 percent in 2006 to 0.97 percent in 2011) which points to improving care of hospitalized patients.
Patient characteristics associated with higher admissions rates include those who were elderly, female, had Medicare or Medicaid insurance, lived in areas with low median income, or visited teaching hospitals and those in the northeast and metropolitan areas.
“The huge demographic and geographic variations highlight the unmet need for interventions to decrease hospitalization rates,” said Sourabh Aggarwal, M.D., study lead researcher.
Sourabh Aggarwal, M.D., Chief Resident, Department of Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, Michigan
Using an electronic monitoring device may help heart failure patients and their families stick to a low-salt diet, according to research presented at the American Heart Association’s Scientific Sessions 2014.
The Family Sodium Watcher Program (Family SWAP) focuses on a partnership between the heart failure patient and a caregiver/member of the family to adapt to the taste of a low-salt diet and includes using an electronic monitoring device to detect salt content in food and avoid high-salt food during the adaptation period.
In the three-month trial of 15 patient-caregiver pairs:
- The intervention group of eight patients received 12 weeks of self-care education for heart failure with gradual adaptive strategies in salt intake. Participants said the device was easy to use and helped them maintain a low-sodium diet. Some said they enjoyed their low-salt diets more and 90 percent noticed a change in their ability to taste salt in their food. Caregivers reported no increased burden due to the program.
- The usual care/control group of seven patients didn’t change behavior.
The Family SWAP may help the entire family improve their lifestyles, researchers said.
The pilot study was funded by the American Heart Association and the University of Kentucky.
Misook L. Chung, R.N., Ph.D., associate professor, University of Kentucky College of Nursing, and co-director, RICH Heart Program, Lexington, Kentucky
Hospital admissions for acute aortic dissection were highest during peak flu season November-March, according to research presented at the American Heart Association’s Scientific Sessions 2014.
Acute aortic dissection (AAD) is a life-threatening condition in which blood leaks from the aorta, the major artery that carries blood from the heart to the body. The leak is often caused by a tear in the inside wall of the aorta. The most common symptom of aortic dissection is sudden and severe chest or upper back pain.
Researchers at the University of Texas Health Science Center at Houston compared national flu activity from the U.S. Centers for Disease Control to monthly admissions for AAD at their center for 2001-13. They found:
- Doctors treated 869 AAD patients at UT-Houston during the period.
- Admissions for AAD were highest in November-March (3.1 per month during this period compared to 2.1 per month for the remaining months).
- Flu activity (percent of office visits for flu-like illness) averaged 2.6 percent during the peak AAD period (November-March) compared to 1.1 percent in the remaining months.
- A mathematical model showed statistically significant seasonality and showed type A dissection and flu activity moving cyclically and generally in synchrony throughout the period.
- Type A dissection was significantly linked with peak flu activity.
Type A dissection, the most devastating type of AAD dissection, involves the ascending aorta and/or aortic arch and possibly the descending aorta. Type A generally requires surgery.
“We suspect that flu creates an inflammatory reaction that could theoretically increase chances of dissection in susceptible individuals,” said Harleen K. Sandhu, M.D., M.P.H., study senior researcher. “While more research is needed to further explore this association, we suggest at-risk patients, such as older Americans, should get seasonal flu shots.”
Harleen K. Sandhu, M.D., M.P.H., senior researcher, Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center at Houston
High blood pressure control continues to improve in the United States, with more than half of those with the condition now achieving readings below 140/90 millimeters of mercury (mm Hg), according to new research presented at the American Heart Association’s Scientific Sessions 2014 and simultaneously published in the American Heart Association’s journal Hypertension.
Using data from the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2012, researchers found:
- The percentage of patients with hypertension achieving optimal blood pressure (less than 120/80 mm Hg) rose from 13 percent to 27 percent.
- The percentage of patients attaining pre-hypertensive levels of blood pressure (between 120/80 mm Hg and 139/89 mm Hg) rose from 19 percent to 33 percent.
This data is from interviews with 9,255 adults with high blood pressure, which was defined as the use of blood pressure medications or a reading of at least 140/90 mmHg.
“This is definitely good news,” say the researchers, as increased hypertension control has reduced the numbers of heart attacks and strokes, and the number of deaths and hospitalizations due to heart disease.
However, the percentage of patients with high blood pressure that remains uncontrolled is 48 percent, far higher than the goal of 38 percent set for the federal Healthy People 2020 initiative.
To reach the goal, researchers said high blood pressure has to be a priority for everyone at every medical visit, including the clinician, the patient, the pharmacist, and other members of the healthcare team.
High blood pressure affects about one in three adults in the United States. While often creating no symptoms, the condition raises the risk for heart disease and stroke.
Sung Sug (Sarah) Yoon, Ph.D., R.N., National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
Maintaining a healthy heart while young may help prevent future disease and disability, according to research presented at the American Heart Association’s Scientific Sessions 2014.
In this study spanning more than three decades, participants who were at low risk for heart and blood vessel disease when young adults were 60 percent less likely to report disability as older adults. To determine risk level, researchers used blood pressure, cholesterol and body mass index measurements, as well as diabetes and smoking status.
“People should adopt and maintain a healthy lifestyle at all ages,” said Thanh Huyen T. Vu, M.D., Ph.D., study lead author and research assistant professor at Northwestern University in Chicago, Illinois. “It is important that healthcare providers promote a healthy lifestyle early in life for their patients, as healthy lifestyle has been shown to be associated with favorable levels of cardiovascular disease risk factors.”
Researchers correlated data from 3,669 men and 2,345 women from The Chicago Heart Association Detection Project in Industry with the participants’ later responses to a 2003 health survey about functional disability and quality of life. Participants were aged 29-68 when the study began in 1967 to 1973.
Thanh Huyen T. Vu, M.D., Ph.D.; Northwestern University; Chicago, Illinois
- Any available multimedia resources (photos/videos/graphics) are available on the right column of the release link http://newsroom.heart.org/news/sunday-news-tips-2775532?preview=1d8911e43d5c77ef5cebdf52f60892c6
- Treatment and Prevention of Atrial Fibrillation
- Prevention and Treatment of Heart Failure
- The Flu and Heart Disease
- For more news from AHA’s Scientific Sessions, follow us on Twitter @HeartNews #AHA14
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