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By admin, May 31, 2010 6:23 pm

When a young person dies suddenly and inexplicably and drugs aren’t involved, the cause will probably turn out to be sudden cardiac arrest. If this ever happens to a member of your family — heaven forbid — you must schedule an appointment with your own doctor to determine whether you, too, are in danger.

If I sound a little pushy it’s because I learned from a recent study that when a person under age 50 dies suddenly, an autopsy usually reveals underlying heart disease… and not uncommonly it turns out there is an underlying genetic problem that puts the rest of the family at higher risk for cardiac arrest as well.

Heartbreak Followed by Heart Disease?

Researchers in Amsterdam studied 127 families in which young members (average age at death was 30) died suddenly and no heart disease had been identified before or after the death. The research team collected the personal and family medical histories of the victims’ parents, siblings and children and used ECGs to check their heart function. They then performed additional exams on those who were found to have abnormalities. When possible, the researchers conducted a second cardiac autopsy and performed a genetic study of the cardiac arrest victim as well.

Research findings showed some form of inherited heart disease in the lineage of one-third of the families — and noted that at present only a small percentage of families of young victims of sudden cardiac death get themselves tested to determine their own status, putting themselves at risk for future problems that can be prevented.

This research was presented at the 2009 annual conference of the European Society of Human Genetics in Vienna.

Get Tested, Save Lives

I called Gordon F. Tomaselli, MD, chief of the division of cardiology at Johns Hopkins University School of Medicine, to see what he thought of this study. He agreed that it is important for people with first-degree relatives who die suddenly to undergo medical evaluation and told me that he’s already a proponent of this practice. When he encounters such a situation, he collects as much relevant information from family members as he can — taking detailed personal and medical histories and performing physical exams that include ECGs and, often, other cardiac tests such as echocardiograms and cardiac MRIs.

If you experience such a loss, getting your own heart tested may be the last thing you feel like doing under the circumstances — but you should do it anyway. Consider it heartbreak prevention — by taking care of your own health, you’re doing all you can to be sure the rest of the family doesn’t have to suffer from another unnecessary tragedy.

Source(s):

Gordon F. Tomaselli, MD, professor of medicine, department of cardiology, professor of medicine and molecular medicine, chief, division of cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.

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By admin, February 14, 2010 4:11 pm

There are millions of people nationwide dealing with depression which has escalated the number of cardiac problems over the years. This is slowly posing a problem to many lives and most people are not even aware of the issues. Become one of the people that prevent themselves from having unwanted cardiac problems in the future.

Be happy... be healthy

Depression has long been associated with cardiac problems. We know, for instance, that people who are physically healthy but depressed are more likely to develop cardiovascular disease… that being depressed puts people who already have heart disease — including those who have had a heart attack or bypass surgery — at higher risk for recurrence of a cardiac event… and that people who are depressed after a cardiac event are at greater risk for death within the next few years. What we haven’t known until now iswhy.

A recent study, published in the Journal of the American Medical Association, identified a critically important factor explaining this link: lack of exercise. Researchers followed 1,017 outpatients with stable coronary heart disease for nearly five years and were surprised to discover that physiological changes (elevated cortisol and norepinephrine, for example) were not responsible for the increased risk of cardiac events associated with depression. Instead, the researchers discovered that the increased rate of cardiovascular events in depressed patients has more to do with physical inactivity. The study team found that lack of exercise was associated with a 44% greater rate of cardiovascular events. After accounting for lack of exercise and other health behaviors (such as medication non-adherence and smoking), depression by itself was no longer associated with an increased risk of cardiovascular events. The current study reveals that the sedentary habits of depressed individuals creates a cycle of depression and poor cardiac health.

Depressed Patients Don’t Exercise

I called an expert in the matter of cardiovascular disease and exercise, Gordon Blackburn, PhD, program director of Cardiac Rehabilitation at the Cleveland Clinic, to ask about his thoughts on the study. Dr. Blackburn told me that many patients experience some level of depression after a heart attack. Many go on to develop a new attitude, becoming invigorated about the process of a new, healthier lifestyle, but even a mild and transient bout of depression can increase the risk of future cardiac problems.

Making matters worse, Dr. Blackburn said that those with depression tend to not be compliant with other lifestyle or management strategies such as medications, nutrition guidelines or follow-up medical care. Clearly all these factors contribute to a worsening of heart disease, putting people at higher risk, notes Dr. Blackburn.

How Exercise Helps

There is a solution to this problem. Cardiac rehabilitation programs, which are part of follow-up care for months after cardiac surgery or a heart attack at many hospitals, get patients up and moving with a regular exercise routine. Unfortunately, only about 20% of eligible patients participate, even though these programs are covered by many insurance companies and Medicare. If more patients did take part, Dr. Blackburn says, their health would improve in a variety of ways, all of which would help them feel better and live longer.

Dr. Blackburn told me he is disturbed that some patients assume cardiac procedures or bypass surgery will fix their heart problems. Heart disease continues, he says, and if patients don’t address their risk factors, it will surely progress. Doctors have not routinely focused on depression as a significant issue with cardiac patients, says Dr. Blackburn, but perhaps the results of this study may change this. Regular screening for depression would show health care teams which patients need treatment for it, as well as underscore for patients the importance of a cardiac exercise program that could help save their lives.

Source(s):

Gordon Blackburn, PhD, program director of Cardiac Rehabilitation at the Cleveland Clinic.

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