The infographic urges patients not to ignore symptoms, especially if they have a heart condition, and reassures them that hospitals have safety measures to protect patients from infection with the novel coronavirus.
From a “Circulation: Heart Failure” Journal study (Feb 25, 2020):
The study shows that wearable sensors coupled with machine learning analytics have predictive accuracy comparable to implanted devices.
We demonstrate that machine learning analytics using data from a wearable sensor can accurately predict hospitalization for heart failure exacerbation…at a median time of 6.5 days before the admission.
Heart failure (HF) is a major public health problem affecting >23 million patients worldwide. Hospitalization costs for HF represent 80% of costs attributed to HF care. Thus, accurate and timely detection of worsening HF could allow for interventions aimed at reducing the risk of HF admission.
Several such approaches have been tested. Tracking of daily weight, as recommended by current HF guidelines, did not lead to reduction of the risk of HF hospitalization, most likely because the weight gain is a contemporaneous or lagging indicator rather than a leading event. Interventions based on intrathoracic impedance monitoring also did not result in reduction of readmission risk. The results suggest that physiological parameters other than weight or intrathoracic impedance in isolation may be needed to detect HF decompensation in a timely manner. In fact, 28% reduction of rehospitalization rates has been shown with interventions based on pulmonary artery hemodynamic monitoring. More recently, in the MultiSENSE study (Multisensor Chronic Evaluation in Ambulatory HF Patients), an algorithm based on physiological data from sensors in the implantable cardiac resynchronization therapy defibrillators, was shown to have 70% sensitivity in predicting the risk of HF hospitalization or outpatient visit with intravenous therapies for worsening of HF.
“Patients can go home after a shorter length of stay in the hospital without increased risk of complications and rehospitalizations,” said Dr. Malaisrie. “Because we found no detrimental effect of accelerated discharge, both patients and physicians should not be averse to discharging patients when medically ready.”
Dr. Malaisrie anticipates that the Northwestern Medicine cardiac ERAS program will result in faster recoveries, reduced complications, decreased time in the hospital, lower costs, and improved patient/family satisfaction. In the future, the researchers plan to closely examine both traditional clinical endpoints and patient-reported outcomes from the program.
“Expectations for recovery after cardiac surgery are being reset in the current era,” he said. “What does this mean for patients? It means that prolonged or taxing recovery is no longer required. Patients should know that recovery from heart surgery is not only quicker, but also better with ERAS programs.”
“Our data showed that rates of accelerating blood pressure elevation were significantly higher in women than men, starting earlier in life,” said Cheng, the Erika J. Glazer Chair in Women’s Cardiovascular Health, who also serves as director of Cardiovascular Population Sciences at the Barbra Streisand Women’s Heart Center. “This means that if we define the hypertension threshold the exact same way, a 30-year old woman with high blood pressure is probably at higher risk for cardiovascular disease than a man with high blood pressure at the same age.”
(January 15, 2020) – New research from the Smidt Heart Institute at Cedars-Sinai showed for the first time that women’s blood vessels – including both large and small arteries – age at a faster rate than men’s. The findings, published Wednesday in the journal JAMA Cardiology, could help to explain why women tend to develop different types of cardiovascular disease and with different timing than men.
From a Wall Street Journal online article (01/14/20):
Americans are dying of heart disease and strokes at a rising rate in middle age, normally considered the prime years of life. An analysis of U.S. mortality statistics by The Wall Street Journal shows the problem is geographically widespread.
Death rates from cardiovascular disease among people between the ages of 45 and 64 are rising in cities all across the country, including in some of the most unlikely places.
In the Journal’s analysis, three metro areas east of Colorado’s Rocky Mountains—Colorado Springs, Fort Collins and Greeley—recorded some of the biggest increases. Death rates in each rose almost 25%. The three cities boast robust access to exercise and health care. There are bike trails, good heart-disease treatment-and-prevention programs and nearby skiing and hiking.
Among asymptomatic patients with very severe aortic stenosis, the incidence of the composite of operative mortality or death from cardiovascular causes during the follow-up period was significantly lower among those who underwent early aortic-valve replacement surgery than among those who received conservative care.
Researchers matched 7,743 people with osteoarthritis with 23,229 healthy people who rarely or never took NSAIDs. People with osteoarthritis had a 42% higher risk of heart failure and a 17% higher risk of coronary artery disease compared with healthy people. After controlling for a range of factors that contribute to heart disease (including high body mass index, high blood pressure, and diabetes), they concluded that 41% of the increased risk of heart disease related to osteoarthritis was due to the use of NSAIDs.
To manage the painful joint disease known as osteoarthritis, people often take ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox). But these and related drugs — known as NSAIDs — may account for the higher rates of heart disease seen in people with osteoarthritis, a new study suggests.
The rapid aging of the population, together with high rates of obesity and diabetes in all ages, are pushing both the rate and number of deaths from heart failure higher, the study said. Most deaths from heart failure occur in older Americans, but they are rising in adults under 65, too, the study showed.
The findings help explain why a decadeslong decline in the death rate from cardiovascular disease has slowed substantially since 2011 and started rising in middle-aged people, helping drive down U.S. life expectancy.
Deaths from heart failure, one of the nation’s biggest killers, are surging as the population ages and the health of younger generations worsens.
The death rate from the chronic, debilitating condition rose 20.7% between 2011 and 2017 and is likely to keep climbing sharply, according to a study published Wednesday in the journal JAMA Cardiology.