Diabetes drug ‘increases heart failure risk’

London, Aug 21 (ANI): Commonly prescribed diabetes drug increases the risk of heart failure compared with a similar medication, says a new study.

The research, published on bmj.com, has concluded that rosiglitazone is associated with an increased risk of heart failure and death among older patients compared to pioglitazone.

Both the drugs belong to a class of drugs called thiazolidinediones and are widely used for the treatment of type 2 diabetes. They help to control blood sugar levels, but both drugs can also cause side effects including weight gain, fluid retention and heart failure.

It is not clear whether there are clinically important differences in the cardiac safety of these two drugs, so researchers in Canada compared the risk of heart attack, heart failure and death in patients treated with rosiglitazone and pioglitazone.

With the help of prescription records, boffins identified nearly 40,000 patients aged 66 years and older who started treatment with either rosiglitazone or pioglitazone between April 2002 and March 2008.

Data on hospital admission for either a heart attack or heart failure during the six-year study period were recorded and deaths were identified from a national database.

Detailed analysis showed that patients treated with pioglitazone had a significantly lower risk of heart failure and death compared to patients treated with rosiglitazone, but there was no significant difference in the risk of heart attack.

The researchers estimate that, for every 93 patients treated with rosiglitazone rather than pioglitazone, one additional cardiovascular event or death would be predicted to occur annually.

“Our findings suggest clinically important differences in the cardiovascular safety profiles of rosiglitazone and pioglitazone in clinical practice,” say the authors.

“Given the accumulating evidence of harm with rosiglitazone treatment and the lack of a distinct clinical advantage for the drug over pioglitazone, it is reasonable to question whether ongoing use of rosiglitazone is justified,” they conclude. (ANI)

How diabetes drugs raise heart failure risk

London, June 23 (ANI): A new study may help explain how a class of diabetes drugs increases the risk of heart failure.

Thiazolidinediones (TZDs) have been controversial since a 2007 analysis of Avandia (rosiglitazone), a TZD made by GlaxoSmithKline, suggested that patients taking it are at higher risk of heart attack.

Less controversial are data linking TZDs with heart failure, a distinct condition in which the heart cannot pump enough blood through the body.

“We already knew if you had heart failure you probably should not be taking these drugs, but this paper provides an additional explanation why,” Nature quoted Clay Semenkovich, an endocrinologist at the Washington University School of Medicine in St Louis, Missouri, as saying.

In the study, the researchers found that a molecule activated by TZDs, called PPAR-?, underlies one aspect of heart failure.

When the authors started the study, they were not thinking about diabetes drugs. Instead, they wanted to know what happens when tissues enlarge.

Wilhelm Krek, a cancer biologist at the Swiss Federal Institute of Technology in Zurich, said: “If a cancer grows, it outstrips its nutrient and oxygen supply.”

Researchers thought that something similar might happen when the heart enlarges, as it often does after a heart attack or during chronic high blood pressure.

The increased size enables the heart initially to pump more blood but can ultimately weaken the organ.

Enlarged hearts labour to get oxygen, and they switch from burning fat to glucose, which can provide energy without oxygen but is less efficient.

Heart cells can then weaken, accumulate fat and eventually commit suicide.

Researchers found that PPAR-? might lead in this downfall.

They found high levels of PPAR-? in heart tissue from people with heart failure, as well as in hearts of mice experimentally manipulated to model the condition.

When they knocked PPAR-? out in mouse heart cells, the cells did not accumulate fat and did not die.

The study has been published in the June issue of Cell Metabolism. (ANI)

iet prescribed to reduce BP may also lower women’s heart failure risk

Washington, May 12 (ANI): The DASH (short for Dietary Approaches to Stop Hypertension) diet prescribed to help patients lower their blood pressure may also significantly reduce women’s risk of developing heart failure, a new study has suggested.

The study led by investigators at Beth Israel Deaconess Medical Center (BIDMC) demonstrates that a diet high in plant foods and low in sugar and saturated fats is good for health.

“High blood pressure is always of concern because it has the potential to lead to major adverse events, including strokes, heart attacks and heart failure,” said senior author Emily Levitan, ScD, a research fellow in the Cardiovascular Epidemiology Research Center at BIDMC.

Therefore, she and her colleagues hypothesized that the DASH diet would also reduce a woman’s risk of heart failure through its blood pressure lowering effects as well as its secondary effects on cholesterol and other heart-disease risk factors.

The DASH diet is plentiful in fruits, vegetables, low-fat dairy products and whole grains.

“These foods are high in potassium, magnesium, calcium and fiber, moderately high in protein, and low in saturated fat and total fat,” said Levitan.

For the study, Levitan analyzed data from women participants in the Swedish Mammography Cohort, in which women aged 48 to 83 who had no evidence of heart failure were invited to participate.

In the fall of 1997, 36,019 women completed food frequency questionnaires to determine how closely their diets matched the DASH guidelines. Participants were given a ‘score’ based on their diet’s similarity to the DASH diet.

“We then used records from the Swedish national healthcare system to determine whether the women went on to be hospitalized or to die from heart failure. We compared women with diets most similar to the DASH diet to women with diets that were not similar and found that those women whose diets most closely resembled DASH had the lowest risk of heart failure,” said Levitan.

The study is published in issue of the Archives of Internal Medicine. (ANI)

Eating fatty fish once a week can cut men’s heart failure risk

Washington, Apr 22 (ANI): Eating salmon or other fatty fish just once a week can help reduce men’s risk of heart failure, says a new study.

However, the effect of fatty fish and marine omega-3 fatty acids can be seen only in men.

The study provided no evidence that taking food supplements containing marine omega-3 fatty acids made any difference. The men in this study, which is published in Europe’s leading cardiology journal, the European Heart Journal, obtained most of their marine omega-3 fatty acids from the food they ate.

Researchers in the USA and Sweden followed 39,367 Swedish men, aged between 45-79, from 1998 to 2004. They recorded details of the men’s diet and tracked the men’s outcome through Swedish inpatient and cause-of-death registers.

During the period, 597 men without a history of heart disease or diabetes developed heart failure, of which 34 died.

The researchers found that men who eat fatty fish, such as herring, mackerel, salmon, whitefish and char, once a week were 12 percent less likely to develop heart failure compared to men who never eat fatty fish.

Although this association with fatty fish did not reach statistical significance, the researchers also found a statistically significant association with the intake of marine omega-3 fatty acids (found in cod livers and other fish oils); men who consumed approximately 0.36 grams a day were 33 percent less likely to develop heart failure than men who consumed little or no marine omega-3 fatty acids (0.15-0.22 grams a day).

The men were divided into five groups depending on their intake of fatty fish, with the first group consuming none, or very little, and the fifth group consuming the most – three of more servings of fatty fish a week.

The researchers found that while the middle group, which eat one serving of fatty fish a week, had a 12 percent reduced risk compared to the men who never eat fatty fish, the men in the next two groups, who eat either two servings a week or three or more servings a week, had nearly the same risk as the men who eat none.

The researchers also divided the men into five groups based on their intake of marine omega-3 fatty acids. Again, the same U-shape was seen, with the middle group who consumed 0.36 grams a day of fatty acids having a 33 percent reduced risk of heart failure, while the men who consumed more (either approximately 0.46 grams per day or approximately 0.71 grams per day) had a risk similar to men who consumed none or very little.

Dr Emily Levitan, a cardiology research fellow at Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA, who led the research, said: “Our study shows that a moderate intake of fatty fish and marine omega-3 fatty acids is associated with lower rates of heart failure in men, but that the men did not gain a greater benefit by eating more of these foods.

“The apparent U-shaped relationship of fatty fish and marine omega-3 fatty acids with heart failure was unexpected. The higher rate of heart failure in men who consumed the most fatty fish or marine omega-3 fatty acids compared with moderate consumption may be due to chance. Alternatively, these may be men in poor health who ate more fish to try to improve their ill-health, and therefore the fatty fish and fatty acids appear to be risk factors for heart failure. I suspect this is the most likely explanation, but we cannot be certain from our data.” (ANI)

Study: BMI and waist size influence heart failure risk

According to a new study related to belly fat and heart failure, the body mass index (BMI) and the waist size of people influence their risk of being hospitalized with the heart failure condition or even death from the same.

The findings of the study indicated that each additional BMI point increased the risk of heart failure hospitalization or death by 3 percent in women and 7 percent in men; while a waist-size increase of 10 centimeters furthered the risk by 19 percent in women and 30 percent in men.

Heart failure does not mean that the heart has ceased functioning; it means that the organ is not robust enough to pump blood competently through a person’s body; causing difficulty in breathing, and fatigue.

Lead researcher Dr. Emily B. Levitan, of Boston’s Beth Israel Deaconess Medical Center, said: “Obesity has effect on blood pressure and lipids and increases the risk of heart disease,” by increasing the “workload of the heart. The bigger someone’s body, the harder the heart has to work to pump the blood around!”

For the Swedish study spanning six years, the researchers observed 36,873 women, aged 48 to 83 years, and 43,487 men, aged 45 to 79 years. The follow up of these people revealed that as many as 382 women and 718 men were either hospitalized for heart failure or died from the ailment.

Big belly raises heart failure risk

Washington, Apr 8 (ANI): Carrying an extra four inches of fat around the waist can increase a person’s risk of being hospitalised with heart failure, warn researchers.

A study led by investigators at Beth Israel Deaconess Medical Center (BIDMC) has found that larger waist circumference is associated with increased risk of heart failure in middle-aged and older populations of men and women.

The findings, published online in the April 7 Rapid Access Report of the journal Circulation: Heart Failure, showed that increased waist size was a predictor of heart failure even when measurements of body mass index (BMI) fell within the normal range.

A life-threatening condition that develops when the heart can no longer pump enough blood to meet the body’s needs, heart failure (also known as congestive heart failure) is usually caused by existing cardiac conditions, including high blood pressure and coronary artery disease.

Heart failure is characterized by such symptoms as fatigue and weakness, difficulty walking, rapid or irregular heartbeat, and persistent cough or wheezing.

To reach the conclusion, researchers examined two Swedish population-based studies, the Swedish Mammography Cohort (made up of 36,873 women aged 48 to 83) and the Cohort of Swedish Men (43,487 men aged 45 to 79) who responded to questionnaires asking for information about their height, weight and waist circumference.

Over a seven-year period between January 1998 and December 2004 the researchers reported 382 first-time heart-failure events among the women (including 357 hospital admissions and 25 deaths) and 718 first-time heart-failure events among men (accounting for 679 hospital admissions and 39 deaths.)

Their analysis found that based on the answers provided by the study participants, 34 percent of the women were overweight and 11 percent were obese, while 46 percent of the men were overweight and 10 percent were obese.

“By any measure – BMI, waist circumference, waist to hip ratio or waist to height ratio -our findings showed that excess body weight was associated with higher rates of heart failure,” explains Emily Levitan, ScD, the study’s first author and a Research Fellow in the Cardiovascular Epidemiology Research Unit at BIDMC.

Further breakdown of the numbers showed that among the women with a BMI of 25 (within the normal range), a 10-centimeter higher waist measurement was associated with a 15 percent higher heart failure rate; women with a BMI of 30 had an 18 percent increased heart failure rate. In men with a BMI of 25, a 10-centimeter higher waist circumference was associated with a 16 percent higher heart failure rate; the rate increased to 18 percent when men’s BMI increased to 30.

Furthermore, adds Levitan, among the men, each one-unit increase in BMI was associated with a four percent higher heart failure rate, no matter what the man’s waist size. In women, she adds, BMI was only associated with increased heart failure rates among the subjects with the largest waists. Finally, the authors found that the association between BMI and heart-failure events declined with age, suggesting that the younger the person, the greater the impact of weight to heart health.

“This study reinforces the importance of maintaining a healthy weight,” says Levitan. (ANI)