4:30 p.m. PST – Abstract #P53 – Few female patients meeting CHD secondary prevention goals. A new study of women who have been hospitalized for coronary heart disease (CHD) has found a "substantial lack of adherence" to lifestyle goals intended to prevent a second heart disease event, especially among minorities and young women. Researchers analyzed data on 304 women, average age 62, treated at three medical centers. Four lifestyle goals were measured: non-smoking status, body mass index (BMI) of 18.5-24.9 kg/m2, waist circumference less than 35 inches, and exercise at least 3 days a week for 30 minutes a day. Only 4 percent of the women studied met all four goals. The proportion of women who met each goal was: 82 percent were non-smokers; 22 percent were at waist goal; 19 percent were at exercise goal; and 17 percent were at BMI goal. Women age 65 or older were more likely to be non-smokers and to meet the BMI goal. Minority women were also more likely to be non-smokers but less likely to reach the BMI goal. Investigators say their findings underscore the need for more effective interventions to improve compliance with lifestyle recommendations among high-risk women. Allison Linfante, Columbia University College of Physicians and Surgeons, New York See also 4:30 p.m. PST – Abstract #P84 for a report from the Nurses' Health Study finding blood levels of HDL cholesterol to be a "superior predictor" of coronary heart disease in women.
4:30 p.m. PST – Abstract #P64 – Baby-boomers' CHD deaths: women fared worse than men in '90s. Researchers say overall declines in coronary heart disease mortality mask key differences in trends by age and sex in the 1980s and 1990s, especially for "baby-boomers" -- those born between 1946-1964 and aged 36-55 in 2000. U. S. statistics show that overall CHD mortality per 100,000 declined from 345 in 1980 to 187 in 2000. In men, the decrease in rates slowed for age groups 35-44 and 45-54, and the numbers of deaths were constant or increased. But for women ages 35-44 and 45-54, CHD death rates actually increased or decreased more slowly in the 1990s, and the numbers of CHD deaths in those age groups went up annually by 3.2% and 1.6%, respectively. "Coronary heart disease deaths in the U.S. changed little in absolute numbers from 1980-2000 due to increases not only at ages 85+ but also among baby-boomers, especially women," the researchers find.
4:30 p.m. PST – Abstract #P73 – Now, some good news: more Americans get cholesterol checked. The proportion of American adults who report having their cholesterol checked has increased from 56% in 1988-94 to 67% in 1999-2000. This encouraging trend is found in data from the National Health and Nutrition Examination Survey (NHANES). During the same period, the number who reported having high blood cholesterol (HBC) stayed about the same: 34% in 1988-94, 35% in 1999-2000. More than twice as many adults report being told to take medicine for HBC: 45% in 1999-2000 vs. 21% in 1988-94. And the proportion of adults being told to make lifestyle changes increased, from 48% to 54%. Researchers will report demographic aspects of these trends.
4:30 p.m. PST – Abstract #P80 – Phobic anxiety increases risk of sudden death, CHD among women. In a major study, high levels of phobic anxiety as measured on a psychological test are associated with increased risk of sudden cardiac death (SCD) and fatal coronary heart disease (CHD) in women. Researchers tested the relationship between phobic anxiety, shown in scores on the Crown-Crisp Index (CCI), and sudden cardiac death, heart attack and total coronary disease deaths among 72,357 Nurses' Health Study participants. The women, with no history of heart disease, answered at least 6 of 8 questions on the CCI in 1988 and were followed for 12 years. During follow-up there were 930 non-fatal heart attacks, 97 SCDs and 267 CHD deaths among the women. After researchers adjusted for other CHD risk factors and numerous variables including age, women who scored 4 or higher on the CCI had a 50 percent increased risk of SCD (relative risk of 1.53) and a 30 percent higher risk of fatal CHD (relative risk of 1.32). "Some, but not all, of this risk can be accounted for by CHD risk factors and lifestyle factors associated with phobic anxiety," scientists say.
4:30 p.m. PST – Abstract #P108 – Heart disease risk factors still running amok. The proportion of the population with low risk for heart disease is apparently not growing, according to a review of data from four National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2000. Researchers found that prevalence of low CHD risk – defined as blood pressure below 120/80 mmHg, total cholesterol below 200 mg/dl and not currently smoking – increased from 6 percent in 1971-1975 to 17 percent in 1998-1994, with diastolic blood pressure control leading the way. Further increases in low-risk prevalence, however, haven't been seen since 1994. Low-risk prevalence was twice as high in women as in men throughout the survey period. Since low-risk status can be achieved primarily through a healthy lifestyle, researchers say this goal should be pursued, especially now to offset the anticipated negative impact on heart disease risk from a recent "dramatic increase" in obesity.
4:30 p.m. – Abstract #P109 - Newly diagnosed cancer may provoke coronary events. The diagnosis of a serious cancer may put people with heart disease at increased risk of heart attack or stroke, a new analysis of data from the Framingham Heart Study suggests. The researchers looked at data that had been collected on cancer diagnoses among the 5,209 women and men aged 28 to 62 years enrolled in the original Framingham cohort between 1948 and 1951 and the 5,124 men and women, aged 5 to 70 years, in the offspring cohort enrolled in 1971-1975. Of these serious cancers, 1,654 appeared between 1949 and 1999 in subjects 37-97 years old. Each cancer case was matched to two subjects of the same generation by age, sex and whether the subjects already had documented coronary or cerebrovascular disease at the date of the cancer diagnosis. Within 6 months of follow-up, 44 men and women suffered a coronary event, half of them among people with newly diagnosed cancer. Coronary events included angina, heart attack, insufficient blood flow to the heart (coronary insufficiency), transient ischemic attack, stroke, and death from heart disease. Eleven of 271 people with a new cancer and known heart disease had a new coronary event, compared with 11 of 1,383 cancer patients without known heart disease. Compared with people without a newly diagnosed cancer, those with a new cancer were at more than double the risk of a new coronary event, the study showed. While the study was not designed to look at how cancer might provoke heart disease, the researchers note that the diagnosis of a serious cancer is thought to be a major stress for a patient, beyond the direct effects of the malignancy.
See Abstract #P6 for study finding that depression, but not anger proneness or social isolation, may be a risk factor for peripheral artery disease.