Kidney, Heart Problems May Be Linked

(HealthDay News) -- Damaged kidneys could put older adults at a greater risk of heart failure, stroke and other cardiovascular disease, a new report says.

The University of Glasgow study of adults ages 70 to 82 found that participants whose kidney function was most impaired had a three times greater risk of having non-fatal heart failure or heart disease and were more likely to die from the heart conditions as were those with healthier kidneys. They were also twice as likely to die from any cause as were people with healthier kidneys.

Given the findings, seniors with impaired kidney function should try to control other risk factors, such as high blood cholesterol and high blood pressure, to help prevent cardiovascular issues from arising, according to a news release from PLoS Medicine, which published the study online.

The study, originally started to learn whether the medication pravastatin (Pravachol), a statin, affected the development of cardiovascular disease, also noted that the drug seemed to help reduce the number of heart problems in people with the most kidney damage, but the finding was considered statistically questionable.

More information
The National Kidney Foundation has more about kidney disease.

Health Tip: Why You May Have Erectile Dysfunction

(HealthDay News) -- Erectile dysfunction occurs when a man can't achieve or maintain an erection during sex.

The American Academy of Family Physicians says the condition doesn't have to be a natural part of getting older. ED often is attributed to physical or psychological causes. Physical reasons may include:

• Having a side effect of surgery on the prostate or bladder, or radiation therapy to the testicles.
• Having low testosterone levels, kidney failure, liver failure, multiple sclerosis or Parkinson's disease.
• Having chronic conditions such as diabetes, high blood pressure, or hardening of the arteries.
• Having had a stroke or an injury to the brain or spinal cord.
• Using too much tobacco or alcohol.
• Being tired.

Beta Blocker Use Questioned in Non-Heart Surgery

(HealthDay News) -- An analysis of 33 studies on drugs known as beta blockers has concluded that they are not useful in any surgical procedure other than heart surgery. In fact, using beta blockers for non-coronary surgery may actually increase the risk of stroke, the scientists say.

The researchers who conducted the study -- known as a meta-analysis -- recommend that the guidelines committees of both the American College of Cardiology and the American Heart Association "soften" their recommendations that beta blockers be used to prevent surgical complications in non-coronary operations.

"Our study says that if you look at the overall picture, do a meta-analysis, studies that are not particularly well-done come to the conclusion that they are useful," said Dr. Franz Messerli, professor of medicine at Columbia University and an author of a report published online by The Lancet to coincide with the annual heart meeting now underway. "But if you look at the high-quality studies, there are distinctly more strokes with beta blockers." Beta blockers are drugs that inhibit adrenaline and slow the nerve impulses to the heart. They can also be used to treat irregular heartbeat, known as arrhythmia.

The meta-analysis did show a 35 percent reduced risk of heart attacks and a 64 percent reduction in less serious heart artery blockages among the more than 12,000 participants in all the studies where beta blockers were prescribed before surgery. But there was no overall reduction in total deaths, heart failure or deaths due to heart disease, and a doubled risk of nonfatal stroke.

Beta blocker usage was also associated with a high risk of bradycardia, low heart rate requiring medical treatment, which occurred in 1 of every 22 people getting beta blockers, and of lower blood pressure dangerous enough to require treatment.

In September 2008, researchers writing in the Journal of the American College of Cardiology concluded that beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for hypertension.

The increased risk of stroke, occurring in 1 of every 293 beta blocker recipients, is especially important, Messerli said. "Stroke is one of the most devastating complications of cardiovascular disease," he said. "For that reason, we would be very reluctant to use beta blockers in noncomplicated patients."

There is a presurgical role for beta blockers in many cases, Messerli said. "If a patient has coronary artery disease, he or she should certainly be on beta blockers," he said. "If they are on beta blockers already, they should remain on beta blockers. But if there is no particular cardiovascular risk, beta blockers should not be prescribed for noncardiac procedures."

Existing recommendations that call for routine use of beta blockers before surgery should be revised, Messerli said. "This is regarded as a quality measure for physicians," he said. "If they don't prescribe a beta blocker, it is considered to be falling short of a quality measure. Since the data are relatively soft, it certainly should not be a quality measure."

But an argument for use of beta blockers before surgery was made in an accompanying comment to the study by Dr. Don Poldermans, professor of medicine at Erasmus Medical Center in Rotterdam, the Netherlands. One major problem with studies showing difficulties when beta blockers were prescribed was that the doses were too high, Poldermans said.

"A low dose is safe, so why not use it?" Poldermans said, citing a study that he presented to the American Heart Association's annual scientific sessions, in New Orleans.

The study of 1,066 people who underwent surgery and were classified as being of intermediate risk of cardiovascular complications found that 2.1 percent of those getting a moderate daily dose of bisoprolol, a widely used beta blocker, suffered heart attacks or died of heart disease, compared to 6 percent of those not getting the beta blocker, Poldermans reported.

What might help decide the issue would be "a study to clarify dose and regimen" of beta blockers before surgery, he said. But such a study might be difficult to do, because the dangers of high-dose beta blockers are clear, Poldermans said.

"I would be very careful with high doses of beta blockers," he said. "There could be an increased risk of stroke. But a low dose is safe, so why take a high dose?"

More information
Learn why and how beta blockers are used from the Texas Heart Institute.

Fat Cells in Obese People Are 'Sick'

(HealthDay News) -- Fat cells in obese people are "sick" compared to those in lean people, a new study shows.

Published in the September issue of Diabetes, a group of researchers from the Temple University School of Medicine analyzed fat samples from the upper thighs of six lean and six obese people.

They found significant differences in the fat cells of the obese participants compared with the lean participants.

"The fat cells we found in our obese patients were deficient in several areas," study author Guenther Boden, the Laura H. Carnell Professor of Medicine and chief of endocrinology, said in Temple press release.

Boden said that the obese people's fat cells showed stress on the endoplasmic reticulum (ER), which helps cells synthesize proteins and monitor how they are folded. When the ER is stressed, Boden explained, it produces several proteins that ultimately lead to insulin resistance. Insulin resistance, in turn, plays a major role in the development of obesity-related conditions.

The differences in the fat cells between obese and lean people may help explain the link between obesity and a higher risk of diabetes, heart disease, and stroke, Boden theorized.

More information
The National Heart, Lung, and Blood Institute has more about overweight and obesity.

Secondhand Smoke Raises Stroke Risk for Spouses

(HealthDay News) -- Nonsmokers who are married to smokers run a significantly higher risk for experiencing a stroke, a new study suggests.

Researchers also found that ex-smokers married to men and women who still smoke carry an even greater risk for stroke. However, nonsmoking spouses of former smokers do not appear to bear any higher risk for stroke than those married to someone who had never smoked.

"This adds to the growing evidence that secondhand smoke is bad for you, and I hope that it will help people who want to stop smoking to know that it will probably be good for their spouse's health, too," said Maria Glymour, an assistant professor of society, human development and health at the Harvard School of Public Health in Boston. Glymour is also a health and society scholar in the department of epidemiology at Columbia University in New York City.

She and her team were expected to publish the findings in the September issue of the American Journal of Preventive Medicine.

Glymour pointed out that hers is one of the few studies to specifically focus on the potential link between secondhand smoke and stroke risk. She further noted that indications that the association is real and strong stem from a larger National Institute on Aging research effort that tracked a wide range of social factors and their relationship to stroke risk.

In that study, all 16,000-plus participants were 50 and older and married. All were categorized according to smoking habits, and observed for stroke incidence over an average of about nine years between 1992 and 2006.

Nonsmokers married to a current smoker were found to have a 42 percent increased risk for stroke, compared with those married to spouses who had never smoked. Similarly compared, ex-smokers married to a current smoker had a 72 percent increased risk for stroke.

As for those married to ex-smokers, Glymour and her team only observed that the former smokers had kicked their habit at some point one to 50 years before the start of the study. They could not pinpoint exactly how much time would need to elapse after a smoking spouse quits before their husband or wife's stroke risk fully dissipated.

"But we think the risk to the spouse probably starts to decline right away," Glymour noted. "And that would be consistent with what we already know about stroke and active smoking, which is that if you stop smoking your own health risks decline quickly."

Thomas J. Glynn, director of cancer science and trends at the American Cancer Society, said that he found Glymour's analysis to be "very reasonable."

"I agree that one might expect a fairly steep drop-off in stroke risk for the spouse once the smoking partner quits," he said. "We know, for example, that although it takes about 15 years of not smoking to halve your risk for lung cancer, with heart disease it may take not much more than one to two years of cessation to cut back one's own risk to basically that of a nonsmoker, depending on how long you had been smoking. So, this conclusion makes sense."

"And, in general, I would say that this study provides further valuable evidence of the general dangers of secondhand smoke, and, in particular, the great and often over-looked danger of heart disease, he said. And, of course, it emphasizes the need for anyone who smokes to stop smoking, and at a minimum to establish smoke-free zones in the home, or not smoke in the home at all."

More information
For more about secondhand smoke and health risks, visit the American Lung Association.

Seizures Likely Sign of Brain Injury After Stroke

(HealthDay News) -- Stroke patients who suffer seizures are more likely to die within 30 days than stroke patients who don't have seizures are, a new study shows.

Seizures may be a sign of significant brain injury and may occur in patients who've suffered any type of stroke. This study found that the overall incidence of seizures within 24 hours of a stroke is 3.1 percent. Patients with intracranial hemorrhages (bleeding within the brain) have a higher rate of seizures (8.4 percent) in the first 24 hours after stroke. Overall, there was a 30 percent mortality rate within the first 30 days of a stroke.

The researchers also investigated any racial differences in post-stroke seizures and found that, even though blacks are known to have higher rates of both seizures and strokes, there were no racial differences in seizure incidence or death rates.

"Patients with seizures in the setting of acute stroke may constitute a target population for the development of drugs that may prevent seizures," study author Dr. Jerzy P. Szaflarski, said in a prepared statement.

"Because patients with stroke have high incidence of immediate and long-term seizures and epilepsy, they constitute a population where seizure prevention with anti-epileptic drugs can be studied," Szaflarski said.

The study was published in the June issue of Epilepsia.

More information
The American Stroke Association has more about stroke effects.