Pumping Marvellous

Heart Failure Nurses Conference

On Wednesday 8th of May, Pumping Marvellous hosted a conference with the East Lancashire Hospital Trusts Heart Failure Nursing Team where over 80 Nurses attended and learn’t about the innovative approach to heart failure patient management. Pumping Marvellous founder Nick Hartshorne-Evans represented the patient voice and gave his story of what happened to him and the resulting after effects of a diagnosis of heart failure.

Both the nursing team and the charity have received great feedback and we will be doing this on a regular basis. This just highlights the needs and requirement of parity in care for patients and their carers.

Heart Failure Nurses Conference with 80 attendees

Economic costs of Heart Failure set to Sky Rocket 

The journal “Circulation” has published today that the number of Americans with heart failure could rise 46%, from 5 million in 2012 to 8 million in 2030, new research says. This should be awake call for the UK considering similar public health profiles.

Also potentially the direct and indirect costs of treating the condition could more than double, from $31 billion to $70 billion, over the same time period.

This means that by 2030, every U.S. taxpayer could be paying $244 a year to care for heart failure patients, according to the American Heart Association policy statement. It said the findings highlight the need for strategies to prevent and treat heart failure.

Heart failure is the leading cause of hospitalisation for Americans over age 65. The rising number of people with heart failure is the result of an aging population and an increase in the rates of conditions that contribute to heart failure, such as high blood pressure, diabetes and heart disease.

“If we don’t improve or reduce the incidence of heart failure by preventing and treating the underlying conditions, there will be a large monetary and health burden on the country,” said Dr. Paul Heidenreich in an American Heart Association news release. “The costs will be paid for by every adult, not just every adult with heart failure.”

“Awareness of risk factors and adequately treating them is the greatest need,” said Heidenreich, a professor of medicine at Stanford University School of Medicine and director of a chronic heart failure research initiative at the VA Health Care System in Palo Alto, Calif.

The statement includes recommendations on how to tackle the issue. These include the following:

• More effective distribution and use of therapy recommended in guidelines to prevent heart failure and improve patient survival.
• Improving the coordination of care when hospitalised patients go home in order to help them achieve better outcomes and reduce their risk of having to return to the hospital.
• Specialised training for physicians, nurses, pharmacists and other health care professionals on advanced heart failure care.
• Improving heart failure prevention and care for minority groups and lower-income people.
• Increasing access to palliative and hospice care for patients with heart failure in advanced stages.

The statement was published online April 24 in the journal Circulation: Heart Failure.

Heart Failure + Depression = Bad Chemistry 

Now we all know how important it is to not get depressed about your condition so certainly to us this is not surprising however this is a strong step in the right direction to demonstrate the importance of being positive.

Depression could make heart failure even more fatal, a new study suggests.

Researchers from the Mayo Clinic in the US found that people with heart failure who are moderately to severely depressed have a 4x higher risk of death, compared with people with heart failure who are not depressed. They also have a 2x higher risk of being hospitalised or having to go to accident and emergency.

The study shows just how important it is to pay attention to patients’ mental health, as “depression is a key driver of healthcare use in heart failure,” study researcher Alanna M. Chamberlain, Ph.D., M.P.H., an assistant professor of epidemiology at the Mayo Clinic, said in a statement. The new study is published in the journal Circulation: Heart Failure.

The findings are based on 402 people with heart failure, with an average age of 73, who were from three Minnesota counties in the US. The study participants completed a survey with nine questions some time between 2007 and 2010 that analyzed their depression status. Then, the participants were followed for about a year and a half.

Researchers found an association between having depression and risk of being hospitalized or dying in the followup period. The risks went up with severity of depression. For example, according to the survey, people with mild depression were 60% more likely to die, and 35% more likely to have to visit the emergency room than those without depression. They were also 16% more likely to be hospitalised.

However, researchers did note a caveat to the findings. “We measured depression with a one-time questionnaire so we cannot account for changes in depression symptoms over time,” Chamberlain said in the statement. “Further research is warranted to develop more effective clinical approaches for management of depression in heart failure patients.”

Similarly, another new study published in the Journal of the American Heart Association shows that anxiety and depression raise risk of death among people with heart disease. Specifically, anxiety doubles risk of death from any cause among heart disease patients, and patients with both anxiety and depression have a tripled risk of dying. That finding, from Duke University researchers, is based on data from 934 people with an average age of 62.

Omega 6 not too be confused with Omega 3

This is very confusing as there is so much conflicting information and Omega 6 is not to be confused with Omega 3. This information has been extrapolated from The American Journal of Clinical Nutrition, November 28, 2012.

Despite evidence suggesting omega-6 fatty acids might protect the cardiovascular system, a large new study of men finds the fats typically found in flax seeds and some vegetable oils do nothing to prevent heart failure. ”Although we know omega-6 fatty acids could influence blood pressure in a good way, we don’t see that translate into a lower risk of heart failure,” said Dr. Luc Djousse, one of the authors of the study and a professor at Brigham and Women’s Hospital in Boston.

Omega-6 fatty acids are relatively abundant in the Western diet, and are found in many cooking oils, such as sunflower and canola oils.

The effect of omega-6s on heart health has been controversial, however, according to William Harris, a professor at the University of South Dakota‘s Sanford School of Medicine and a senior scientist at Health Diagnostic Laboratory in Richmond, VA.

“Some people like me and others at the American Heart Association say higher intake of omega-6 is good for your heart from the heart attack point of view. Another group of people are saying high omega-6 is causing inflammation, so that’s a bad thing,” said Harris, who was not part of the current study.

One heart benefit linked by past research to omega-6 consumption is lower blood pressure and because high blood pressure is a risk factor for heart failure, Djousse and his colleagues wanted to see if people who ate more omega-6s also had a lower risk of heart failure.

They used data from a long-term study of 22,000 male physicians in the U.S. At the beginning of the study the men gave a blood sample, from which the researchers determined the level of omega-6 fatty acids in the men’s bodies. Over an average follow-up period of 17 years, 788 of the participants developed heart failure.

Djoussa’s group compared these men to 788 others in the study, who were otherwise similar in age and other measures but had not experienced heart failure.

They found no differences between the two groups of men in the amount of omega-6 fats in their blood. “There’s no evidence of benefit. It’s just one of those things where it doesn’t appear to be playing a role in this particular disease,”  indicated William Harris.

Djoussa said his findings suggest that researchers can shift their priorities away from looking to omega-6s as a possible way to reduce the risk of heart failure.

Another recent study by Djousse and his colleagues found that getting a lot of omega-3 fatty acids in the diet by eating fish is tied to a lower risk of heart failure.

New Novartis Heart Failure Drug

Novartis is a leading Pharmaceutical company who has developed a potential new drug to focus on acute Heart Failure. You will see a lot more activity from device and pharma companies in the future on new drugs and treatments. This is all to do with the size of the market opportunities that exist around preventing hospital admissions and re-admissions. Anyway enjoy the commentary and if you don’t understand it see it as a positive step towards helping heart failure patients.

Novartis a pharma company based in Basle, Switzerland said the drug, serelaxin, reduced shortness of breath for up to five days using one measure, but results weren’t significant, using another, which looked at a shorter time frame.

However the trial was deemed successful because only one of the main study goals had to be met. Serelaxin was given to patients upon hospitalization via a 48-hour infusion. The study failed to show that it kept patients alive or out of hospital longer than the standard treatment, meaning that it failed a secondary study goal to demonstrate the drug’s working. It did, however, show a reduction of 37% in all-cause mortality compared with placebo at the end of six months. The drug was also shown to improve a measure of kidney function, doctors said. Side effects were balanced between treatment groups, suggesting the drug is safe.

Results from the study were good enough to give Novartis the confidence to start talks with health regulators in Europe and the U.S. as it hopes to file the drug for approval next year, Dr. Ameet Nathwani, a cardiologist and global business franchise head critical care at Novartis said “It is the first time in acute heart failure that a drug showed a reduction in mortality.”

Novartis sponsored the study, which involved 1,161 patients. It was to be presented at the American Heart Association conference Tuesday in Los Angeles and published in an upcoming issue of medical journal The Lancet. Novartis said the drug was well tolerated, with side effects such as low blood pressure generally comparable to placebo.

A treatment for acute heart failure would fill an important unmet medical need.

“While we have good medications at hand which can improve the symptoms and the prognosis of patients with chronic heart failure, there is currently no good treatment if the situation becomes suddenly worse,” said Dr. Pascal Meier, a cardiologist and assistant professor adjunct at Yale Medical School. Current treatments merely ease the symptoms, without addressing the condition. “New treatment options for these patients are urgently needed,” said Dr. Meier, who wasn’t involved in the study.

Progress in repairing Hearts

The Heart by Pumping Marvellous

Scientists have turned back the hands of a biological clock to rejuvenate ageing and damaged human heart cells. Using stem cells, they reset a molecular mechanism that determines the rate at which cells age. Although the work on human cells was confined to the laboratory, the same technique has been successfully tested in mice and pigs.Researchers in the US managed to get new heart tissue to grow in the animals in just four weeks. They hope the advance will lead to new treatments for heart failure.

“Modifying aged human cardiac cells from elderly patients adds to the cell’s ability to regenerate damaged heart muscle, making stem cell engineering a viable option,” said lead scientist Dr Sadia Mohsin, from San Diego State University in California.

In the laboratory studies, Dr Mohsin’s team worked on heart tissue surgically removed from elderly patients. Stem cells from the samples were treated with a growth protein called PIM-1.

The effect was to boost activity of an enzyme called telomerase, which has a direct impact on ageing. The research was presented at a meeting of the American Heart Association in New Orleans and published in the Journal of the American College of Cardiology.

Careful about Coffee and Heart Failure

English: A photo of a cup of coffee. Esperanto: Taso de kafo. Français : Photo d’une tasse de caffé Español: Taza de café (Photo credit: Wikipedia)

There is a lot in the press about coffee and it’s effect on Heart Failure. We would ask you to tread carefully and use common sense before acting on press reports as the important word used by the clincian in the report below is “association”. Remember coffee has caffeine that is a stimulant and definitely makes your rate increase which is not what we are trying to do when we have a Heart Condition.”Drinking coffee moderately may reduce the risk of heart failure, but drinking  too much makes this benefit disappear, according to a new review.

People who drank two cups of coffee a day were 11 percent less likely to have  heart failure, compared with people who drank no coffee. Heart failure occurs  when the heart cannot pump enough blood to meet the demands of the body, and can  be caused by factors ranging from high blood pressure to pregnancy.

Constantly drinking too much coffee, however, negates this benefit: no  difference in heart failure risk was seen between non-coffee drinkers’ and those  who drank more than three cups a day.

“As with so many things, moderation appears to be the key here,” said study  author Dr. Murray Mittleman, director of the Cardiovascular Epidemiology  Research Unit at Beth Israel Deaconess Medical Center in Boston.

The study showed an association, not a cause-and-effect link.

Still, there is reason to think coffee lowers heart failure risk, the  researchers said. Moderate coffee consumption may increase drinkers’ caffeine  tolerance, which could in turn limit their susceptibility to high blood  pressure. Additionally, coffee drinking has been shown to lower the risk of type 2 diabetes.  Diabetes and hypertension are major risk factors for heart failure, Mittleman  said.

People who have already have heart failure should consume no more than one to  two cups of coffee per  day, according to the American Heart Association.

The finding “is good news for coffee drinkers,  of course, but it also may warrant changes to the current heart failure  prevention guidelines, which suggest that coffee drinking may be risky for heart  patients,” said study author Elizabeth Mostofsky, a research fellow at the  center.

The researchers looked at data collected on 140,220 people in Sweden and  Finland who participated in five previous studies. There were a total of 6,522  cases of heart failure between 2001 and 2011. The causes of heart failure often  cannot be reversed, but the condition can be treated.

The researchers took into account the differing serving sizes between Europe  and the United States (European servings are generally smaller), however, they  did not account for coffee’s strength or whether the coffee was caffeinated,  though they noted that in northern Europe, it typically is.

The study was published yesterday (June 26) in the journal Circulation Heart  Failure.

The seasonings aisle at the supermarket can be overwhelming, especially if  you’re trying to find a healthy alternative to salt. There are many seasoning  products on the market and the ways the food industry promotes them can make it  difficult to find a healthy choice.  Sea salt has long been touted as a  healthy alterative to table salt and it’s no surprise that 61% of respondents in  a survey conducted by the American Heart Association believed sea salt to be  low-sodium alternative to table salt. Sea Salt is no better for you than normal table salt.

There are many other products  that are marketed as being healthy alternatives to salt. Commercial “salt  substitutes” are one such product.  Most salt substitutes contain potassium  chloride in place of sodium chloride.  By replacing sodium with potassium  in the chemical structure of salt, food scientists have developed a variety of “salt substitutes” that taste similar to table salt and that can help reduce  overall sodium intake when used in place of table salt.

You might be using a potassium based salt substitute  without realising it. It would be wise to go through your cupboard and  check ingredient labels — if you see potassium chloride listed, the seasoning is  a potassium based salt substitute.

Eat FRESH and manage that SODIUM

This is an excellent piece of advice from Donna Arnett president elect of the American Heart Association. In the excerpt it talks about sodium so what you need to know is the calcualtion that works this through to Salt. Here is the calculation –

“A healthy diet sustains us, but a poor diet can lead to increased blood pressure, cholesterol, blood sugar levels and weight and put you at heart disease risk.

According to Donna Arnett, Ph.D., chair of the Department of Epidemiology in the University of Alabama at Birmingham School of Public Health and president-elect of the American Heart Association, diet is only ‘one component of the overall cause of heart disease.’ But, Arnett asserted that it can exert a strong influence.

Sodium also is considered the culprit for the one in three Americans who develop high blood pressure. Sodium attracts water into your cells; the increased fluid raises your blood pressure and subsequently raises your risk of stroke and heart attack, heart failure and death, Arnett says.

Race also plays a role in risk. UAB researchers recently examined the effects of sodium intake by race using data from the ongoing Reasons for Geographic and Racial Differences in Stroke and found a stronger association with death in black participants than whites, says Suzanne Judd, assistant professor of biostatistics at UAB and the study’s lead author.

Blacks with the highest sodium intake (average of 2,600 mg/day) had a 62 percent increased risk of dying, while whites had no increased risk, she said. “This supports the AHA recommendation that there may need to be race-specific sodium guidelines, but everyone should reduce their sodium intake,” Judd says. The AHA has an aggressive sodium goal of 1,500 mg per day for everyone.

First, Arnett said, increase the amount of fruits and vegetables you eat daily, especially the leafy kind. “This provides more potassium, which is associated with lower blood pressure,” Arnett said.

“Fresh is the best source for fruits and vegetables, but canned versions can provide nutrition.” The primary drawback to canned and frozen foods is added sodium. But Arnett offers a solution: “Rinse these foods before cooking to help reduce sodium. Once rinsed, I think they are a great option for people on the go.” Fish also is on Arnett’s list of better food choices. “You should eat fish twice per week; fish are sources of the good fats associated with reduced risk of heart disease,” said Arnett.

When preparing your food, limit saturated fats such as those in butter, hard cheeses and red meats. “Avoid trans fats because they raise your bad cholesterol levels. So read food labels and look for partially hydrogenated oils, which is another name for trans fats,” Arnett says. Fats considered to be suitable for low consumption ? avocados, nuts, olives and olive oil ? are monounsaturated and polyunsaturated fats, which can help reduce the cholesterol levels in your blood and lower your risk of heart disease.

A big calorie-causing culprit is fizzy drinks and sports and energy drinks, Arnett says. “The hidden sugars in these beverages are a common cause of weight gain among young people. Limiting yourself to two 12 oz. cans per week to reduce the risk of obesity and diabetes,” Arnett added.” end