Category Archives: Research

Medical, Research, Science

Study shows heart attack risk up 40% for years after an infection

MEDICAL

PATIENTS who suffer common infections have a much greater risk of having a heart attack or stroke in the years to come, a major study has found.

The findings suggest hundreds of thousands should be given statins or other heart pills if they suffer a chest infection or bladder problem.

A project tracking 1.2million patients found those admitted to hospital for pneumonia or urinary tract infections were 40 per cent more likely to have a heart attack within eight years. They were also 150 per cent more likely to suffer a stroke.

This suggests infections have an even greater impact on heart health than obesity, which raises the risk of strokes and heart attacks by about 25 per cent.

The research team, from Aston Medical School in Birmingham and the University of Cambridge, believe this is because infections cause long-term inflammation in blood vessels – making them more prone to clotting and clogging.

Patients who suffer an infection should be treated in the same way as someone with high blood pressure, raised cholesterol or diabetes, the researchers said. This could involve prescribing statins or aspirin as a preventative measure to cut the risk to their heart.

Nearly 600,000 people are admitted to hospital with chest infections such as pneumonia in England alone every year. Some 300,000 are admitted with urinary infections.

The study, which has been presented to the American College of Cardiology in Orlando, also found that those who had (had) infections were more likely to die if they did suffer a heart attack or stroke.

They were three times more likely to die from a heart attack than those who had not had infections, and almost twice as likely to die if they had a stroke.

Cardiologist Dr Rahul Potluri of Aston University, said: “Our figures suggest that those who are admitted to hospital with a respiratory or urinary tract infection are 40 per cent more likely to suffer a subsequent heart attack, and 2.5 times more likely to have a stroke, than patients who have had no such infection – and are considerably less likely to survive from these conditions.”

Experts have shown greater interest in the role of inflammation in heart disease after a study last year found that treating patients with anti-inflammatory canakinumab could cut their risk of having a heart attack by 24 per cent. Doctors say this drug – not yet available for heart patients – could represent the biggest breakthrough in cardiovascular medicine since statins were developed 30 years ago.

Dr Potluri said: “Infection appears to confer as much, if not more, of a risk for future heart disease and stroke as very well-established risk factors such as high blood pressure and diabetes.

“Although inflammation has been linked to atherosclerosis [when plaque builds up in arteries], this is the largest study to showing that common infection is such a significant risk factor.”

Lead author Dr Paul Carter, an academic clinical fellow at the University of Cambridge, said: “The data illustrates a clear association between infections and life-threatening heart conditions and strokes – and the figures are too huge to ignore.

“Serious infections are amongst the biggest causes of death in the UK directly, but our research shows infections that are severe enough to lead to hospitalisation may present a delayed risk in the form of atherosclerotic diseases.

“The sheer number of people who could be affected presents a challenge that needs investigation.”

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Medical, Research, Science

Inside Track: ‘Head rush’

MIND & BODY

THE CONNECTION between cardiovascular activity and mood is more than a feeling; it’s scientific fact. There is a growing body of evidence to show that exercise doesn’t just make you happier, it makes you smarter, enhancing your ability to solve problems, brainstorm ideas, and by thinking faster.

Exercise improves your cognitive functioning no matter what your age. Cognitive functioning refers to the mental processes – awareness, perception, reasoning, and judgement – by which knowledge is acquired. While earlier research efforts have focused on children and the elderly, study populations have broadened significantly in recent times, the results proving that everybody – as well as every brain – can benefit from regular exercise.

Many studies have been completed on the relationship between physical activity and mental performance and have found that most had a shared conclusion. One such finding is that the short-term effects of a bout of exercise can lead to a greater focus and for individuals to make fewer errors in decision making. Several of the studies also found that during and/or following a bout of vigorous exercise (typically, running or cycling for 20 minutes to an hour), individual performances on tests measuring ‘executive control’ (the processes involved in achieving goals in a changing environment) improved significantly when compared with pre-exercise scores.

The use of exercise to spark creativity is hardly a novel idea. Among today’s creative exercisers, the award-winning writer Joyce Carol Oates says she avoids rest days because her craft depends on running: ‘There isn’t any piece of my writing that didn’t evolve through running,’ says Oates, who runs daily on the country roads near her home.

It’s not just literary types who see the benefit. The chief operating officer of a global junk-removal business based in Vancouver, for instance, knows his miles are anything but junk. The executive says that when out running a mental zone is soon found within that allows many of life’s problems to be solved. The business chief has a whole office of fitness diehards – and, keeps an eye out for similar types who may wish to join the firm in the future. ‘We look to hire athletes,” says the director, who finds fit people more focused and engaged.

Investigators elsewhere would also tend to agree. Previous tests carried out at the University of Ulm, in Germany, for example, asked a group of subjects to run 30 minutes twice a week for six weeks. Another group remained sedentary for the same time period. Following each session (or non-session), participants were examined to measure concentration. The runners scored higher, but it didn’t end there. The lead researcher concluded: ‘Twelve weeks after they stopped running, we could still see some effects.’

Scientists now know that the body’s dopamine and epinephrine levels are responsible for this effect. These neuro-transmitters, which enhance communication between key areas of the brain, climb during physical activity. The effects are fleeting, however, peaking about 20 minutes into exercise and petering out shortly after its conclusion, but other neurochemicals may take over where those leave off, responsible for the longer-term effects reported by researchers.

One of the next areas of intense study and research will be the exact prescription. Many agree that we need dose-response studies to see just how much exercise will produce the best cognitive results.

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Health, Medical, Research, Science

New heart drug offers biggest breakthrough since statins

MEDICAL RESEARCH

Unlike other treatments that tend to focus on cholesterol, Canakinumab works to lower inflammation in the body.

The discovery of a new heart drug is being hailed as the biggest breakthrough since statins. Thousands of lives could be saved.

In a four-year trial, scientists found that the drug – given by injection every three months – cut the risk of heart attacks by a quarter.

The study involving 10,000 patients, and around 1,000 doctors in 39 countries, also suggested that the drug could halve the risk of dying from lung cancer and prevent arthritis and gout.

Scientists said the treatment marked “a new era of therapeutics” that could save thousands of lives.

The drug, canakinumab, works by reducing inflammation – a major new approach in heart medicine. For the past 30 years cholesterol-busting statins have been given to nearly all people deemed to be at risk of cardiovascular disease in an effort to save them from heart attacks and strokes.

Yet half of the 200,000 people who have a heart attack in Britain each year do not have high cholesterol, so there is a desperate need for a different approach to treatment.

Experts have long thought that inflammation – the body’s natural responses to infection or injury – might also play a major role in causing heart attacks and strokes, possibly because it causes swelling in the arteries, increasing the risk of a blockage.

The new trial, however, is the first definitive proof that cutting inflammation slashes heart risk.

Study leader Professor Paul Ridker of Harvard Medical School said the new drug opened up a “third front” in the war on heart disease, following the previous focus on cholesterol and lifestyle.

Presenting his findings at the European Society of Cardiology congress in Barcelona, Professor Ridker said: “These findings represent the end game of more than two decades of research, stemming from a critical observation – half of heart attacks occur in people who do not have high cholesterol.

“We’ve been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk.”

Professor Ridker, whose results are published in the New England Journal of Medicine, added: “This has far-reaching implications.

“It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to improve outcomes for certain very high-risk populations.”

Canakinumab is an antibody that attacks an immune-system protein called interleukin-1, which in high levels results in increased inflammation throughout the body.

The scientific trial involved high-risk patients who had already suffered a heart attack – a group in desperate need of help because a quarter of patients suffer a second attack within five years, even with statins.

All patients in the trial took statins as well, but canakinumab cut the risk of repeat heart attacks by 24 per cent, over and above the impact of the cholesterol drug.

People who took the drug were 36 per cent less likely to be hospitalised with unstable angina, and 32 per cent less likely to require costly bypass surgery.

Researchers reported a sharp rise in infections, which killed one in every 1,000 patients. But patients had a 51 per cent reduced risk of lung cancer deaths – a finding they said was “very exciting”. Gout and arthritis, which are linked to inflammation, also fell.

Canakinumab manufacturer Novartis said it would seek a licence to use the drug for heart disease.

Canakinumab is used for inflammatory problems, including forms of arthritis, at the cost of £9,928 per jab. Experts said the price – £40,000 a year for heart patients – would have to be lowered for it to be made available on the NHS.

Professor Jeremy Pearson, of the British Heart Foundation, said: “These exciting trial results finally confirm that ongoing inflammation contributes to risk of heart disease, and could help save lives.

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