Flu shot linked to reduced heart attack risk

NEW YORK (Reuters Health) - Middle-aged and older adults who get the flu vaccine may be less likely to suffer a first-time heart attack in the following year than those who skip the shot, according to a study published Monday.

Furthermore, the findings, reported in the Canadian Medical Association Journal, do not prove that the flu shot itself can prevent heart attacks. But they add to evidence that flu infection can trigger heart attacks in some people, and that preventing the flu through vaccination might curb that risk.

They also support existing recommendations that older adults and people with established heart disease get a flu shot each season, researchers say.

For the study, UK researchers compared the medical records of 16,000 first-time heart attack patients age 40 and older with those of nearly 62,700 people who had no history of heart attack and served as a "control" group. Each heart attack patient was matched with four control group members who were the same age and sex, and received care at the same general practice.

Of the heart attack patients, 53 percent had received the flu vaccine in the previous year; the same was true of 51 percent of the control group.

When the researchers accounted for a range of other factors in heart attack risk -- like high blood pressure, diabetes, smoking and family history of heart disease -- they found that flu vaccination was associated with a 19 percent reduction in the odds of suffering a heart attack over the next year, as compared with no vaccination.

In addition, earlier vaccination -- from September through mid-November -- was related to a stronger protective effect than vaccination later in the flu season: a 21 percent reduction in first-time heart attack risk, versus a 12 percent reduction.

This type of study design, known as "case-control," cannot prove cause-and-effect. Nor does it give an idea of the degree to which a flu shot might trim a person's absolute risk of having a heart attack.

While the researchers tried to factor in the study subjects' general health and lifestyle, they were limited to the information available in medical records.

And there may have been other differences between flu vaccine recipients and non-recipients that could explain the lower heart attack risk, noted lead researcher Dr. A. Niroshan Siriwardena, of the University of Lincoln in the UK.

However, he told Reuters Health in an email, the findings build on evidence from previous, smaller studies linking flu vaccination to a decreased risk of heart attack. That includes two clinical trials in which people with established heart disease were randomly assigned to get a flu shot or remain unvaccinated -- the type of study design considered the "gold standard" for showing cause-and-effect.

One theory on why flu vaccination may be protective is that the inflammatory reaction set off by flu infection, which may include an increase in blood clotting, can lead to heart attacks in vulnerable people.

Experts already recommend a yearly flu shot for adults age 65 and older, as well as those with heart disease and certain other chronic medical conditions. That, Siriwardena noted, is largely because these individuals are at increased risk of hospitalization and potentially fatal flu complications such as pneumonia.

The current findings suggest that a reduced heart attack risk might be an additional benefit, he said.

Moreover, the results, according to Siriwardena, also argue for clinical trials to test whether flu vaccination curbs the risk of heart attack in people who do not have underlying heart disease but do have risk factors for it -- like high blood pressure or high cholesterol.

Of the first-time heart attack sufferers in this study, only one-quarter had been diagnosed with underlying heart problems before the attack.

In other findings, the researchers found no association between pneumococcal vaccination and heart attack risk. Like the flu shot, the pneumococcal vaccine, which protects against pneumonia, meningitis and bacteremia (a blood infection), is recommended for older adults, and those with established heart disease.

This result could be considered somewhat surprising, according to Siriwardena, as one recent study did suggest a potential protective effect of the pneumococcal vaccine. However, that study did not take into account participants' flu vaccination.

As a result, In their study, Siriwardena's team found that once they factored in flu shots, there was no relationship between pneumococcal vaccination and heart attack risk.

SOURCE: http://link.reuters.com/nuv54p Canadian Medical Association Journal, online September 20, 2010.

Source: healthnews.com

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When You Are Most Likely to Have a Heart Attack

Odds are, you or someone you love will have a heart attack, also known as a myocardial infraction or MI. Heart attacks occur about every 35 seconds in the United States, and most occur in the morning, a time when the platelets in the blood are especially "sticky" and prone to form clots. "Many people are awakened by a heart attack at four in the morning," says Sharonne Hayes, MD, director of the Mayo Clinic's Women's Heart Clinic. At least one study, however, has found that morning isn't a prime time for heart attacks among people who regularly take aspirin, which helps keep platelets from sticking together.

Even though someone in the U.S. dies from a heart attack every three and a half minutes, this is one medical event the majority of doctors and emergency medical technicians are trained to respond to. Care tends to be swift and efficient, if a little rote. "When I had my heart attack, the doctors at the hospital practically yawned—they had seen so many cases like mine," laughs Rene Delgado, 52, of New York City, who had a heart attack in 2006. "They knew exactly what to do, and because the care I got was so well-organized and precise I lost no heart muscle. If you must have a life-threatening medical emergency, a heart attack isn't the worst one to have."

While treatments for heart attacks are more effective than ever, half of all deaths still occur within one hour after a heart attack. That means getting to a hospital should be priority one if you or someone else experiences the first symptoms of a heart attack. How well you respond—and how fast—is a matter of life and death.

Source: health.com

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Weighing Your Risk for a Heart Attack

Coronary artery disease (CAD) is the major cause of heart attacks. So the more risk factors you have for CAD, the greater your risk for developing unstable angina or having a heart attack. Smoking, diabetes, high cholesterol, high blood pressure, and a family history of early CAD are all strong risk factors for coronary artery disease. For more information, see the What Increases Your Risk section of the topic Coronary Artery Disease.

Use the heart attack risk calculator to estimate your risk of having a heart attack over 10 years. This tool is designed to estimate risk in adults age 20 and older who do not have heart disease or diabetes.

Even if you already have coronary artery disease or have had a heart attack, you can still lower your risk of another heart attack. To lower your risk:

• Stop smoking. Quitting smoking is probably the most important step to decrease your chance of a heart attack. Avoid secondhand smoke too.
• Reduce high cholesterol. High cholesterol can lead to a buildup of cholesterol inside your arteries.
• Lower high blood pressure. High blood pressure damages the coronary arteries and increases the heart's workload.
• Manage diabetes. People who have diabetes develop hardening and narrowing of the arteries more frequently and at a younger age than those not affected by diabetes.
• Stay at a healthy weight. Weight loss frequently improves blood pressure and cholesterol levels and may also help control diabetes.
• Be physically active. Regular exercise can help reduce your risk of heart attack by helping you to control cholesterol and blood pressure, regulate blood sugar (important for people with diabetes), and lose weight. Try to do activities that raise your heart rate. Aim for at least 2½ hours of moderate exercise a week.¹ One way to do this is to be active 30 minutes a day, at least 5 days a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.
• Manage depression and emotions. Treating depression and treating anger problems are important steps in improving cardiac and overall health and quality of life.
• Reduce stress. Stress causes increased blood pressure and heart rate and causes your arteries to narrow, increasing your risk for heart attack.
• Evaluate birth control pill and hormone replacement therapy use. Birth control pills are more likely to increase a woman's risk if she is older than 35 and smokes cigarettes. Hormone therapy (estrogen with or without progestin) may increase the risk for heart disease. This risk is higher for some women than others.
• Take an aspirin every day (check with your doctor first to make sure you have no medical reasons for not taking it).
• Avoid getting sick from the flu. Get a flu shot every year.
• Take all of your medicines correctly. Taking medicine can lower your risk of having another heart attack or dying from coronary artery disease.

Some risk factors are beyond your control. These include:

• A family history of early coronary artery disease.
• Your age and gender. The number of people affected by heart disease increases with age in men after age 45 and in women after age 55. Also, men and women have different risk factors.

A type of protein in your blood may help find your risk of a heart attack. This protein is called a high-sensitivity C-reactive protein (hs-CRP). It is found with a C-reactive protein (CRP) blood test. This test may help find your risk for a heart attack, especially when it is considered along with other risk factors such as cholesterol, age, blood pressure, and smoking. But the connection between high CRP levels and heart disease risk is not understood very well.

Most nonsteroidal anti-inflammatory drugs (NSAIDs), which are used to relieve pain and fever and reduce swelling and inflammation, may increase the risk of heart attack. This risk is greater if you take NSAIDs at higher doses or for long periods of time. People who are older than 65 or who have existing heart, stomach, or intestinal disease are more likely to have problems.

Aspirin, unlike other NSAIDs, has been shown to reduce the risk of heart attack and stroke. But it also carries the risks of serious stomach and intestinal bleeding as well as skin reactions. Regular use of other NSAIDs, such as ibuprofen, may make aspirin less effective in preventing heart attack and stroke.

Source: health.com

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What Are Your Odds of a Heart Attack?

Actually, each year heart attacks kill more than 150,000 Americans, nearly half of them women. If such a grim statistic can have a bright side, it's this: Most heart attacks today aren't fatal.

About 75% of men and 60% of women live at least one year after an attack.

Who is most at risk?
While most heart attack victims are middle-aged or older—the average age for a first attack is 66 for men and 70 for women—people in their 20s and 30s suffer attacks too.

The risk of a heart attack climbs for men after age 45 and for women after age 55.

When do heart attacks strike?
Heart attacks occur roughly every 35 seconds in the United States, and most occur in the morning, a time when the platelets in the blood are especially "sticky" and prone to form clots.

At least one study, however, has found that morning isn't a prime time for heart attacks among people who regularly take aspirin, which helps keep platelets from sticking together.

Beating the odds
Survival odds for people who have had a heart attack keep getting better thanks to advances in diagnosis, medication, and lifesaving technology.

It's worth noting that survival rates for heart attack patients are better on weekdays compared to weekends, because medical personnel are more likely to use invasive procedures (including angioplasty and bypass surgery) during the week.

Nonetheless, cardiologists are optimistic about the rate of improvement in cardiac care. When Sharonne Hayes, MD, director of the Mayo Clinic's Women's Heart Clinic, started practicing in the mid-1980s, doctors couldn't do much for people having heart attacks. "Now we can stop a heart attack in its tracks," she says. "Patients have a much better chance at recovery."
Source: health.com

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Some Causes Of Heart Attack

 

Definition

A heart attack is when blood vessels that supply blood to the heart are blocked, preventing enough oxygen from getting to the heart. The heart muscle dies or becomes permanently damaged. Your doctor calls this a myocardial infarction.

Symptoms

Chest pain is a major symptom of heart attack. You may feel the pain in only one part of your body, or it may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back.
The pain can be severe or mild. It can feel like:

• A tight band around the chest
• Bad indigestion
• Something heavy sitting on your chest
• Squeezing or heavy pressure

The pain usually lasts longer than 20 minutes. Rest and a medicine called nitroglycerin do not completely relieve the pain of a heart attack. Symptoms may also go away and come back.
Other symptoms of a heart attack include:

• Anxiety
• Cough
• Fainting
• Light-headedness, dizziness
• Nausea or vomiting
• Palpitations (feeling like your heart is beating too fast)
• Shortness of breath
• Sweating, which may be extreme

Some people (the elderly, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). A "silent heart attack" is a heart attack with no symptoms.

Source: yahoo.health

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