Lifestyle factors can halve heart failure risk after 65

Older people who walk briskly, are moderately active in their free time, drink moderately, don’t smoke and avoid obesity may be half as likely to develop heart failure as people who don't engage in these healthy habits, a new study suggests.

Based on the findings, optimizing a few healthy lifestyle factors can cut heart failure risk in half, according to lead author Liana Del Gobbo, a research fellow at Tufts University in Boston, Massachusetts.

“A key finding is that physical activity among older adults does not have to be strenuous to reduce heart failure risk,” Del Gobbo told Reuters Health by email.

“We saw benefits for adults who walked at moderate or brisk pace (more than 2 or 3 miles per hour) and burned calories through leisure activity, like house or yard work, walking, engaging in outdoor activities, or other forms of physical activity, equivalent to about 30 minutes per day of moderate-intensity activity,” she said.

According to the US Centers for Disease Control and Prevention, more than five million people in the US have heart failure, in which the heart fails to pump enough blood and oxygen to support the rest of the body. Heart failure can be treated with medication, a reduced-sodium diet and increased physical activity, but about half of those diagnosed with heart failure die within five years.

For the new study, researchers followed 4,490 men and women age 65 and older without initial signs of heart failure. The average age at the start of the study was 72.

For up to 21 years, with annual physical exams and questionnaires, the researchers collected data on study subjects’ diet, walking pace and distance, leisure activity, exercise intensity, alcohol use, smoking status, weight and waist circumference.

During the study, 1,380 people developed heart failure.

Walking “briskly,” or at least two miles per hour, taking part in calorie-burning leisure activities, modest alcohol intake of no more than one or two drinks per day, avoiding smoking and maintaining a healthy weight were all tied to lower heart failure risk.

Those who optimized at least four of these factors were half as likely to develop heart failure as those who only optimized zero or one of the factors, as reported in JACC: Heart Failure.

“At a population level, we especially need to work on encouraging adults to engage in physical activity,” she said.

The researchers accounted for other factors, like socioeconomic status, that could affect heart failure risk.

Surprisingly, specific dietary pattern was not tied to heart failure risk, and exercise intensity was less important than walking pace and leisure activity.

Researchers did see an increased risk of heart failure with higher salt intake, which “makes sense,” Del Gobbo said, because too much salt increases a person's risk for high blood pressure, which is a key risk factor for heart failure.

Many “healthy lifestyle messages” about lowering heart attack risk also apply to heart failure, said Dr. David J. Maron, director of Preventive Cardiology at Stanford University School of Medicine in California, who coauthored a commentary on the new findings.

“We spend a tremendous amount of money in this country on heart failure-related events,” Maron told Reuters Health by phone. “Living a good life can help prevent a very expensive illness.”

“The amazing thing from this study is if you do these four behaviors that you can reduce your risk of heart failure by 50%,” he said. “It’s just an association, and doesn’t prove cause and effect,” but is still a powerful finding, he said.

source: www.abs-cbnnews.com

More than 100 cases of measles now confirmed in US

LOS ANGELES - More than 100 people in the United States have been confirmed as infected with measles including 91 in California, most of them linked to an outbreak that began at Disneyland in December, public health officials said on Friday.

The California Department of Public Health said at least 58 of the cases of the highly infectious disease in the state have been epidemiologically linked to the Disneyland cluster. More than a dozen other cases have been confirmed in 13 other U.S. states and in Mexico.

No deaths have been reported in connection with the outbreak, which public health officials suspect began when an infected person from outside the United States visited Disneyland in Anaheim between Dec. 15 and Dec. 20.

The White House on Friday urged parents to heed the advice of public health officials and scientists in getting their children vaccinated.

"People should evaluate this for themselves with a bias toward good science and toward the advice of our public health professionals," President Barack Obama's spokesman Josh Earnest told reporters.

Asked whether people should be getting vaccinated, Earnest said: "That's what the science indicates."

The measles outbreak has renewed a debate over the so-called anti-vaccination movement in which fears about potential side effects of vaccines, fueled by now-debunked research suggesting a link to autism, have led a small minority of parents to refuse to allow their children to be inoculated.

Some parents also opt not to have their children vaccinated for religious or other reasons.

Earnest said Obama believes decisions about vaccinating children should rest with parents but that "the president believes that everybody should be listening to our public health professionals." Earnest said the White House will continue to closely monitor the outbreak.

Earnest's comments came one day after the U.S. Centers for Disease Control and Prevention urged Americans to get vaccinated for measles.

Measles was officially declared eliminated in the United States in 2000 after decades of intensive childhood vaccine efforts. But last year the nation had its highest number of measles cases in two decades.

In addition to California, since December cases of measles have been confirmed in Arizona, Colorado, Illinois, Minnesota, Michigan, Nebraska, New York, Oregon, Pennsylvania, South Dakota, Texas, Utah and Washington state, as well as Mexico.

Most people recover within a few weeks, although it can be fatal in some cases.

source: www.abs-cbnnews.com

Flu reaches epidemic level in US - CDC

Influenza has officially reached epidemic proportions in the United States, with 7.3 percent of deaths last week caused by pneumonia and the flu, the U.S. Centers for Disease Control and Prevention said on Friday.

The early start and fast spread of flu this season - especially after 2011-2012's very mild outbreak - has overwhelmed doctors' offices and hospitals, forcing some patients to wait through the night to be seen in emergency departments.

Nine of the 10 U.S. regions had "elevated" flu activity last week, confirming that seasonal flu has spread across the country and reached high levels several weeks before the usual late January or February, CDC reported.

Only one region - the Southwest and California - had "normal" flu activity last week.

Tens of thousands of Americans die every year from flu, even in non-epidemic years. The threshold for an epidemic is that it causes more than 7.2 percent of deaths, but as yet there is no definitive count of the total caused by flu this year.

In Boston, flu cases are 10 times higher than they were last year, causing Mayor Thomas Menino to declare a public health emergency on Wednesday.

In Illinois, 24 hospitals struggling to cope with the flood of flu cases had to turn away people arriving in the emergency department, while in Pennsylvania, the Lehigh Valley Hospital outside Allentown has set up a tent for people who arrive with less-severe flu.

A total of 20 children have now died from this season's flu, up two from the previous week, the CDC said. That compares to 34 during the full 2011-2012 flu season and 282 during the severe 2009-2010 season.

The outbreak has led to attempts at prevention that go beyond the standard advice of getting vaccinated, avoiding contact with sick people and frequently washing hands with soap.

In Boston, the Catholic Archdiocese has told priests they could suspend the offering of communion wine using a shared chalice and bow rather than shake hands while exchanging the Sign of Peace, a Christian greeting.

Auxiliary Bishop Robert P. Deeley urged priests to use hand sanitizer before and after communion and to avoid touching congregants' tongues or hands. He said parishioners who were ill "should remain at home and return to church when they are well."

'MODERATELY EFFECTIVE' VACCINE

While flu vaccines offer protection, they are not failsafe.

This year's flu vaccine is 62 percent effective, scientists reported on Friday in the CDC's weekly publication, meaning that almost four in 10 people who receive the vaccine and are exposed to the virus will nevertheless become infected.

This is considered "moderate" effectiveness and is in line with previous years' flu vaccines, which range from 50 percent to 70 percent effective, Dr. Joseph Bresee, chief of the CDC's influenza division, told reporters.

Experts recommend the vaccine for everyone over 6 months of age. Even if it does not prevent flu, immunization can reduce the severity of the illness, preventing pneumonia and other life-threatening results of flu.

Public health authorities were correct in their forecast of which flu strains would emerge this season and therefore what vaccine to make: one that contains two strains of influenza A and one strain of influenza B. An A strain, called H3N2, predominates this season, though the B strain has caused about 20 percent of cases.

About 10 percent of cases have been caused by a B strain that is not in the vaccine, which "has space for only three strains," CDC Director Dr. Tom Frieden said.

Dr. Arnold Monto of the University of Michigan, a co-author of the vaccine-effectiveness study told Reuters this year's vaccine was "a good vaccine, but not a great vaccine."

It is less effective for the frail elderly, for people receiving chemotherapy for cancer, and for people taking oral steroids, as their immune systems have been weakened and are often unable to produce an effective number of antibodies in response to the vaccine.

One reason flu vaccines are far from perfect, said Monto, is where in the body the viruses find a home - congregating on the surface of small airways in the respiratory tract, while virus-fighting antibodies that are stimulated by vaccines mostly stay in the bloodstream.

According to the most recent CDC data, 37 percent of Americans - 112 million people - had received the flu vaccine as of mid-November.

Of the 135 million doses produced this year, 128 million have been distributed to doctors' offices, drug stores, clinics and other facilities.

Although public health officials believe enough doses were produced, some spot shortages have developed. "You may have to call a few places," before finding one with vaccine, said the CDC's Bresee, "but it should be available."

MAY HAVE PEAKED

In its weekly flu update on Friday, the CDC reported that 24 of the 50 U.S. states as well as New York City had experienced "high activity" in flu-like illnesses last week. In 16 states, activity was moderate, while in 10 it was low or minimal.

The 24 states reporting high activity was down from 29 the previous week, raising hopes that the disease may have peaked in some regions, particularly the Southeast, and that a flu season that began early may also end early. It typically starts in December, peaks in January or February and peters out by late March or early April.

The percentage of visits to healthcare providers last week for flu-like illness - 4.3 percent - is comparable to that during the 2007-2008 flu season, which was characterized as "moderately severe" but which peaked some two months later. By comparison, in the 2009 H1N1 "swine" flu pandemic, 7.7 percent of visits were for flu-like illness.

source: abs-cbnnews.com