ARE YOU GETTING ENOUGH?

 

A study indicates that getting less than seven hours sleep a night may significantly increase the risk of suffering heart disease. Researchers found that people who get more rest are less likely to have calcium clogging their arteries, which can lead to heart attacks and heart failure. Scientists believe that the body is better able to clear the build-up from the crucial blood vessels if it gets more rest. High levels of cholesterol, high blood pressure and smoking/are known to affect the risk of suffering hardened arteries. 

 

Scientists have proven that the amount of regular sleep a person gets can also affect their chances of developing the condition. They tested 495 people, aged from 35 to 47, over five years, none of whom had evidence of hardened arteries at the start of the study. By the end, however,12% of the volunteers were sufferers. Most people in the study got between six and seven hours sleep a night.  After adjusting for factors, including age and sex, researchers found that one extra hour of sleep, a night could cut the chance of developing hardening of the arteries by 33% according to the results published in the Journal of the American Medical Association. Christopher Ryan King, from the University of Chicago, who led the study said that the findings showed a “robust and novel” link between the number of hours slept a night and the risk of heart disease, but he said that his team was still unsure what caused the association.

Future studies will be needed for crucial extensions to these results, he said, for example does sleep moderate the rate at which calcification accumulates?

 

The British Heart Foundation commented that it is not yet clear quite how sleep affects heart disease risk but this study adds to previous research suggesting that getting enough sleep may help, to keep our heart and circulation healthy. Sleep is essential for our body’s ability to repair itself.  Experts recommend that adults should get between seven and eight hours sleep a night.

 

STATINS.............YET AGAIN!

A rheumatologist, Dr. Andrew Bamji, writing in the Daily Mail recently, recounts the problems he had with statins prescribed to lower his high cholesterol level.  He developed tenosynovitis, severe tendon inflammation, a condition he recognised from his own experience in treating his patients.  The condition manifested itself by a pain in the shin - an unusual location for tenosynovitis - and this led him do a little research.  The only similar case he could find was linked to a patient on statins.  He decided to stop his statin and within a couple of weeks the pain was gone.  He then went to his General Practitioner and between them they tried many variants of the drug but all gave problems, night cramp, muscle pain, severe muscle disorder known as myopathy and general fatigue. Whenever he stopped the statin the symptoms went away within a few weeks.  He realised that many of his own patients with musculoskeletal problems such as polymyalgia - pain, stiffness and tenderness in the muscles - were on statins.  These he advised to try stopping the statin and in most cases their problems disappeared.  He argues that taking a

statin only marginally improves the chances of dying from a heart attack and if the side effects are so bad, why bother.  As for the suggestion of giving all the elderly a statin (a cheaper alternative to treating coronary heart disease) he points out that elderly people must be the fittest to have survived and it is questionable whether they should be given pills to prevent a condition they do not have.  One imagines that the majority of THROB members are on statins and if that includes you, then it is certainly worth seeing your GP if you have any of the side effects referred to above.  

 

NOTES FROM THE BCPA

 

I   receive a copy of the BCPA Journal which is the official magazine of the British Cardiac Patients Association and this issue contained several articles which are of interest to THROB Members.

There has been a three year clinical trial using 10,000 patients run, at the Royal Brompton Hospital, by Professor Kim Fox, whom I suspect many THROB members may have met, though he was plain Dr Fox when doing my angioplasties. I have commented before on the artistic naming of clinical trials and this was called BEAUTIFUL and primarily compared a new medicine called Ivabradine, which lowers the heart rate without reducing blood pressure. The results of the trial showed that patients with a resting heart beat of less than 70 beats per minute were less likely to have a heart attack or need angioplasty than patients with a higher pulse rate. Anything between 60 and 100 beats per minute is considered normal.

 

There was also an article on the use of acupuncture as a treatment for heart disease. I am an enthusiast for many complementary treatments and would be happy to try acupuncture. I was, however, pleased to see that the article only recommended acupuncture as an adjunct to drug therapy and medical interventions and not as a replacement. It is, I believe, foolish to rely on complementary techniques to the exclusion of current medical thinking.

 

Finally, there was an article which reported the Government announcement that, within three years, they would like to have a service whereby at least 97% of heart attack patients would have immediate angioplasty rather than thrombolysis. It is estimated that this would reduce the death rate by about 5% to 7%, saving 240 lives a year. This would require a major change in the way the ambulance service handles emergency calls, as patients would be taken directly to a cardiologist who would not necessarily be in the nearest hospital. There have been trials on this in various parts of the country and it has been routine practice in the USA for many years. When I had my heart attack, I was helicoptered to a hospital 250 miles away and, by the time my wife had caught up with me, I was coming out of the cardiac laboratory having had an immediate angioplasty.

 

Roger Mills

 

MICRO-ROBOTICS TO THE RESCUE

A tiny robot that could be injected into a patient’s blood stream to carry out potentially life-saving operations has been designed by scientists in Australia. They hope that the miniscule "submarines", which measure less than the width of two human hairs, could help surgeons to treat stroke patients and those with dangerous heart conditions. The devices, which are controlled remotely, have been made possible by the development of one of the world’s smallest motors.

Scientists at Monash University in Melbourne have called their device Proteus. The “microbot” is strong enough to swim against blood flow and travel to parts of the body, such as the brain, which could be damaged by larger instruments. 

Prof. James Friend, who helped to design the device, said that it could be used to great effect. He said: “We have a neurologist on the team who deals with stroke patients who come in needing urgent treatment. At the moment about 30 per cent of his interventions fail or end up killing the patient. One of our hopes would be that these microbots can increase his success rate, by allowing him to act more quickly and with greater precision.

Researchers plan to attach a scraping device to the microbot, which they say would help to clear blockages in arteries. The microbot could also be used to collect cells for tests and carry a camera to show doctors the inside of blood vessels, as reported in the Journal of Micromechanics and Microengineering. The team has tested the device in human blood and in artificial arteries and later this year it will begin experiments in pigs.

(All this within a size of two human hairs!  Someone has to be pulling my leg!  Ed.)

 

FRUIT AND NUT RISOTTO

4 tablespoons olive oil

chicken or vegetable stock cube

225g brown rice

2 onions (chopped)

1 green pepper (de-seeded, chopped)

150g cashew nuts

200g mushrooms (sliced)

4 tomatoes (skinned and chopped)

50g raisins

salt and fresh-ground black pepper

Fry the rice in half the oil for about 3 minutes. Cover with stock and cook for 45 minutes.  Fry onions in the rest of the oil until soft.  Add the green pepper,nuts and mushrooms and cok for about 7 minutes.  Add thecooked rice, tomatoes, raisinsand adjust seasoning to taste.  Reheat the mixture gently.  Serves four.

(Based on a recipe by Carole Handslip)

 

NUT AND VEGETABLE LOAF

 

25g butter

1 small onion (chopped)

1 small carrot (chopped)

1 stick of celery (chopped)

1 tablespoon tomato puree

225g tomatoes (skinned and chopped)

2 eggs

1 tablespoon chopped parsley

salt

fresh ground black pepper

225g mixed nuts (finely chopped or minced)

 

Melt the butter in a pan and add onion, carrot and celery. Cook until softened. Add tomaotes and tomato puree and cook for 5 minutes.  Put the eggs into a bowl beat well adding  parsley, salt and pepper. Stir in the nuts and vegetables.  Transfer to a greased ovenproof dish, place in a preheated oven(220C) and bake for 30 to 35 minutes.  Serves 4 to 6.  

 

MEDITERRANEAN DIET

 

A Mediterranean style diet has been well studied in patients with coronary heart disease.

The origin of this diet spreads across 16 different countries and is usually defined as the

diet that was consumed in many regions of Greece and in southern Italy in the early

1960’s. This style of diet is characterised by large amounts of olive oil, nuts, seeds, whole

grains, fruits, vegetables, and oily fish with a reduction in saturated fats and processed

foods. In November’s edition of the THROB newsletter the benefits of oily fish were

considered. Over the next few issues of the newsletter each component of the

Mediterranean diet will be discussed. However, to achieve maximal benefits from the diet

each aspect should be included in your diet on a regular basis. Consuming large amounts

of olive oil, nuts, seeds, whole grains, fruits, vegetables, and oily fish with a reduction in

saturated fats and processed foods will help reduce cardiac mortality by 31%.

In this additional article I will focus on nuts, which form part of the Mediterranean diet.

Studies have suggested that those who eat nuts on a regular basis (25 grams per day) are

less likely to suffer from heart disease. The cardioprotective effect of nuts have been

attributed to the high amounts of unsaturated fat, protein, vitamin E, fibre, potassium

and magnesium, which are found in most nuts. In addition, nuts are also low in salt.

The consumption of nuts in small amounts can be eaten as a healthy snack between

meals and they have the advantage of satisfying appetite. Although, nuts are very good

for us they contain monounsaturated and polyunsaturated fats which are high in calories. Therefore, if you are trying to lose weight, limit your nut consumption to 25 grams per day (see table below)

 

NUT TYPE        Approx. No. per         Calories

                                     25g portion   

 

 almonds                                  23                                            153

 brazil nuts                                 7                                            170

 cashews                                  20                                            152

 chestnuts                                  3                                              43

 hazelnuts                                15                                            162

 macademias               15                                            187

 peanuts                                   20                                            141

 pistachios                               25                                            150

 walnuts                                    4                                            172

 

            The above table was adapted from the HEART UK Fact Sheet on nuts (available at

www.heartuk.org.uk)

            Finally, remember............Do not eat nuts if you have a nut allergy!

 

Tim Grove     

 

IT’S ALL IN THE GENES!

 

Around one in 100 people has a gene defect that almost guarantees heart failure, scientists have found. The gene is believed to have first appeared in India tens of thousands of years ago and now affects around 60 million people worldwide. Researchers studying the genetic mutation said carriers tend to remain well until middle age but go on to experience symptoms of a weakening heart. In the worst cases a sudden cardiac arrest can result in death.

 

Dr Kumarasamy Thangaraj from Hyderabad, India, who led the research, said: “The mutation leads to the formation of an abnormal protein. Young people can degrade this and remain healthy, but as they get older it builds up and eventually results in the symptoms we see.”

 

For people whose ancestry can be traced to the Indian subcontinent, the risk is much higher. They have more than a one in 25 chance of inheriting the mutation, which is a deletion of 25 letters of code from the heart protein gene MYBPC3.

 

Sir Mark Walport, the director of the Wellcome Trust Sanger Institute, who took part in the study said the findings were of great importance. Heart disease is one of the world’s leading killers, but now that researchers have identified this common mutation carried by one in 25 people of Indian origin we have hope in reducing the burden that the disease causes. The research should lead to better screening to identify those at risk and may ultimately allow the development of new treatments. Such harmful mutations are normally, rare because they get weeded out by natural selection. The MYBPC3 mutation is an exception.

 

.............A  WEBMASTER WORRIES....................................

 

As you may know our Webmaster, Sid, has been doing battle with the British Heart Foundation (BHF) concerning the state of their website and also with York University who is a specialist centre for matters cardiac.  When I asked Sid how the battle was going he reminded me that some months ago we had communication regarding the lack of an on-line database that had anything like a comprehensive list of Cardiac Support Groups searchable by postcode. The York University site was restricted to NHS Facilities and the BHF site postcode search gave information of little practical use. To help the situation the York website kindly introduced a link to the BHF Help Desk but as the BHF Help Desk telephone number has recently been changed from 08450 70 80 70 to 0300 330 3311 the York website now gives wrong direction and all those thousands of frig magnets previously distributed by the BHF displaying the Help Desk number are completely wasted! Over the same period the on-line data search facility for Heart Support Groups has been completely removed from the BHF website!  Sid decided to explain his dilemma once again to the BHF and emailed them once again and got the following reply:

 

"Thank you for your email and your continued involvement with Heart Support Groups and the BHF. Let me first explain why this information isn’t currently available, and then I will outline our plans change this situation. At present our data-protection agreement with our Heart Support Groups states that we will only share contact information with patients or carers looking for support. This was arranged so that groups were able to opt into a relationship with our fundraising team and were not approached by non-BHF parties including researchers and pharmaceutical companies. Due to this data-protection agreement we are unable (and historically have not felt that it is appropriate) to publish the contact information given to us by the groups on the BHF website. It was our belief that we were acting in the best interest of our groups by doing this. However, recent feedback from yourself, and other Heart Support Group members who attended our 2008 networking days have alerted us to the fact that many groups would be happy to for their details to be available more widely .Our difficulty is that with only 30% of our Heart Support Groups represented at the networking days, we cannot simply assume that all groups are happy for their details to be published. As the majority of contact details provided are people’s home addresses we feel strongly that we need to ask people’s permission before we change the way we handle the data they provide.  We have now finalised our communications schedule for Heart Support Groups in 2009, and I am able to confirm that in early March all of our Heart Support Groups will be contacted to ask them permission to publish their contact details on our website. We are also giving the groups the option of displaying a link to their own website (if they have one), and writing a paragraph about their group which will be displayed with their contact details. Groups who do not respond will be followed up with a second letter in early April. It is our hope that a high percentage of groups will give us permission so that we are able to build up a comprehensive database that can be viewed   online".

Our Sid was delighted by the news of the BHF intentions but worried that they didn't provide the complete picture and emailed the BHF and York University again:

"Good to hear from you and good to hear of your good intentions. I am very delighted to hear what the BHF is intending to do. Such a database could however be implemented in stages starting even now with the Heart Support Groups that are willing to have their contact details “exposed” bringing other Groups “on line” as and when they agree. The problem would still remain as to how to include non-BHF related Heart Support Groups in such a scheme. It would seem to me that the easier and better option would be for the York University cardiac-rehab website to expand its remit to include both BHF-related Groups (fed in by you) and non BHF-affiliated Groups as they come to light. Anyway it’s easy for me because I wouldn’t have to do the work!

No sooner had Sid’s email hit the ether than back came York University in the shape of Prof. Bob Lewin to say that he had beaten our Sid to it by suggesting to the BHF the very points that Sid had made since they appeared to be a good idea.  It’s not that York University wanted to create any extra work and would not be heart-broken if the BHF was not interested..........but the two data bases do seem to go together well. In essence value of putting the support group details on the same postcode finder as the Rehabilitation Programme website that York maintains provides for:

1. People looking for one would find details of both, raising their awareness of both.

2. Each Patient Support Group (PSG) would have a page that they could easily edit (just need a password) to put up meeting times, photos, notices and a description of what they do, basically giving each an easily maintained webpage at no cost to themselves, obviously this could be linked to their own site if they already have one. 

3. General Practitioners, Rehabilitation people, BHF Area Teams, and the PSGs could use it to tell people from other areas where the facilities exist. It also provides for a member of a PSG moving their residence to another district to identify a new local Heart Group.

4. It would help to map where programmes have a local group to refer-on to and where there is lack of a PSG and other Phase 4 long-term provisions.

Well that's wonderful, and if and when it all gets put into place our Sid can stop worrying........about this, anyway...

 

David Read