Newsbriefs: Light Activity; Arrhythmia; Stroke; Atherosclerosis

Keep Moving to Extend Life.

A recent study that measured light activity in older women found that older women with higher levels of physical activity are less likely to die than women who engage in lower levels of physical activity, no matter the cause of death. Performance was measured using accelerometer. Findings revealed: One percent performed “low” light-intensity physical activity; 29 percent performed “high” light-intensity physical activity; 15 percent performed moderate to vigorous physical activity. Most participants were in their late 70s and were considered overweight using BMI standards; 30 percent were considered obese. Researchers concluded that older women should be encouraged to increase their daily amount of time spent in light-intensity activity and reduce the amount of time spent sitting. The study was published in the Journal of the American Geriatrics Society, Nov. 16, 2017.

Cancer Treatment May Be Effective In Stopping a Deadly Arrhythmia.

Patients who survive ventricular tachycardia (VT), a very fast arrhythmia that prevents the heart from pumping blood, are often fit with a cardioverter-defibrillator implanted in the chest to serve as internal shock paddles, should VT recur. Now physicians report success with mapping the source of the electrical malfunction and precisely zapping (ablating) it with stereotactic radiation therapy, a treatment normally reserved for treating tumors. As detailed in the Dec, 12, 2017, New England Journal of Medicine, a single session of radioablation used on five patients with VT that could not be controlled with other measures was 99.9 percent effective in preventing VT from recurring. In the three months prior to radioablation, the five patients had endured 6,577 episodes of the arrhythmia. After a six-week healing period, the number of VT episodes dropped to four.

Adding a Second Cholesterol-Lowering Agent Reduces the Likelihood of Recurrent Stroke.

In acute coronary syndrome (ACS), blood flow to the heart muscle is severely compromised and must be quickly restored to prevent a heart attack. Whether or not a heart attack is prevented, a person who has experienced ACS remains at elevated risk of heart attack or stroke. Statins can lower this risk. Adding ezetimibe (Zetia) to statin therapy lowers this risk even further. Now a study has shown that the combination of ezetimibe plus simvastatin (Vytorin) reduces the risk of a future ischemic stroke in patients who had suffered a stroke prior to their ACS episode. The study, published in Circulation on Dec. 20, 2017, followed more than 18,000 patients who had been randomized to simvastatin plus ezetimibe or simvastatin plus placebo. Over the study period, 641 (3.5 percent) suffered at least one stroke. The two regimens were similarly effective in preventing a first stroke. However, when compared with simvastatin alone, the addition of ezetimibe reduced the absolute risk of stroke by 8.6 percent in patients who had suffered a previous stroke (10.2 percent vs 18.8 percent).

Lack of Cardiovascular Risk Factors Does Not Guarantee Freedom from Atherosclerosis.

The risk of atherosclerosis is closely tied to conventional cardiovascular risk factors, particularly blood pressure, blood glucose levels, blood lipid levels and smoking. But a study of more than 1,779 middle-aged men and women with optimal or normal levels of these risk factors nevertheless found atherosclerosis in 50 percent; 30 percent had the disease in multiple vessels. The strongest associations with atherosclerosis were age, male sex and LDL-cholesterol level. LDL was the strongest modifiable risk factor associated with atherosclerosis, even when all other risk factors were optimal. As the researchers explained in the Dec. 19, 2017, issue of JACC, this finding suggests that LDL levels should probably be much lower than are currently recommended.

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