Weight-loss drug cuts risk of heart attack, strokes: Novo Nordisk

COPENHAGEN - Shares in Danish pharma group Novo Nordisk soared to a record high on Tuesday after a late-stage trial suggested its obesity drug Wegovy could reduce the risk of heart attacks or stroke by 20 percent.

Preliminary results showed that patients taking Wegovy had a 20 percent lower risk of suffering from a heart attack or stroke compared to those who took a placebo, Novo Nordisk said in a statement.

"We are very excited about the results," the company's executive vice president for development Martin Holst Lange said, adding the drug "has the potential to change how obesity is regarded and treated."

Novo Nordisk's share price closed up by more than 17 percent on the Copenhagen stock exchange on Tuesday.

The medical community also welcomed the results.

While the trials "still need to be confirmed through careful peer review, they demonstrate the urgent need for patients living with obesity to be offered this effective and safe drug to prevent future disease," said Simon Cork, senior lecturer in physiology at Anglia Ruskin University.

"This will not only provide significant financial savings for health bodies, but provide people with a greater quality of life," he said.

Novo Nordisk, the world's biggest insulin maker which manufactures both Wegovy and diabetes drug Ozempic, in May announced a 39 percent rise in its first-quarter profit, buoyed by sales of its obesity treatments.

In mid-July, the Amsterdam-based European Medicines Agency said it was reviewing data "on the risk of suicidal thoughts and thoughts of self-harm" with three popular weight-loss drugs, Ozempic and Wegovy -- which both have semaglutide as their main ingredient -- and Saxenda, whose main ingredient is liraglutide.

The detailed results of the trial will be presented at a scientific conference later this year, Novo Nordisk said, adding that it plans to apply for regulatory approval to expand the uses for Wegovy in the US and the EU in 2023.

Competition among pharmaceutical groups over obesity treatments is fierce, with more than a billion people in the world suffering from obesity, according to the World Health Organization.

Agence France-Presse

Scientists just beginning to understand the many health problems caused by COVID-19

CHICAGO - Scientists are only starting to grasp the vast array of health problems caused by the novel coronavirus, some of which may have lingering effects on patients and health systems for years to come, according to doctors and infectious disease experts.

Besides the respiratory issues that leave patients gasping for breath, the virus that causes COVID-19 attacks many organ systems, in some cases causing catastrophic damage.

"We thought this was only a respiratory virus. Turns out, it goes after the pancreas. It goes after the heart. It goes after the liver, the brain, the kidney and other organs. We didn't appreciate that in the beginning," said Dr. Eric Topol, a cardiologist and director of the Scripps Research Translational Institute in La Jolla, California.

In addition to respiratory distress, patients with COVID-19 can experience blood clotting disorders that can lead to strokes, and extreme inflammation that attacks multiple organ systems. The virus can also cause neurological complications that range from headache, dizziness and loss of taste or smell to seizures and confusion.

And recovery can be slow, incomplete and costly, with a huge impact on quality of life.

The broad and diverse manifestations of COVID-19 are somewhat unique, said Dr. Sadiya Khan, a cardiologist at Northwestern Medicine in Chicago.

With influenza, people with underlying heart conditions are also at higher risk of complications, Khan said. What is surprising about this virus is the extent of the complications occurring outside the lungs.

Kahn believes there will be a huge healthcare expenditure and burden for individuals who have survived COVID-19.

LENGTHY REHAB FOR MANY

Patients who were in the intensive care unit or on a ventilator for weeks will need to spend extensive time in rehab to regain mobility and strength.

"It can take up to seven days for every one day that you're hospitalized to recover that type of strength," Kahn said. "It's harder the older you are, and you may never get back to the same level of function."

While much of the focus has been on the minority of patients who experience severe disease, doctors increasingly are looking to the needs of patients who were not sick enough to require hospitalization, but are still suffering months after first becoming infected.

Studies are just getting underway to understand the long-term effects of infection, Jay Butler, deputy director of infectious diseases at the US Centers for Disease Control and Prevention, told reporters in a telephone briefing on Thursday.

"We hear anecdotal reports of people who have persistent fatigue, shortness of breath," Butler said. "How long that will last is hard to say."

While coronavirus symptoms typically resolve in two or three weeks, an estimated 1 in 10 experience prolonged symptoms, Dr. Helen Salisbury of the University of Oxford wrote in the British Medical Journal on Tuesday.

Salisbury said many of her patients have normal chest X-rays and no sign of inflammation, but they are still not back to normal.

"If you previously ran 5k three times a week and now feel breathless after a single flight of stairs, or if you cough incessantly and are too exhausted to return to work, then the fear that you may never regain your previous health is very real," she wrote.

Dr. Igor Koralnik, chief of neuro-infectious diseases at Northwestern Medicine, reviewed current scientific literature and found about half of patients hospitalized with COVID-19 had neurological complications, such as dizziness, decreased alertness, difficulty concentrating, disorders of smell and taste, seizures, strokes, weakness and muscle pain.

Koralnik, whose findings were published in the Annals of Neurology, has started an outpatient clinic for COVID-19 patients to study whether these neurological problems are temporary or permanent.

Kahn sees parallels with HIV, the virus that causes AIDS. Much of the early focus was on deaths.

"In recent years, we've been very focused on the cardiovascular complications of HIV survivorship," Kahn said.

-reuters-

High blood pressure during pregnancy tied to heart problems decades later

Women who develop high blood pressure during pregnancy may be more likely than those who don’t to have heart attacks or strokes decades later, a Norwegian study suggests.

Compared to women with normal blood pressure during every pregnancy, women who developed hypertensive disorders, or high blood pressure, during one or more pregnancies were 57% more likely to have a heart attack or stroke at some point between ages 40 and 70.

“We knew that women who experienced hypertensive disorders in pregnancy have a 2-fold increased risk of cardiovascular disease compared to women without these complications,” said lead study author Eirin Beate Haug of the Norwegian University of Science and Technology in Trondheim.

“From our current study, we learned that most of the excess cardiovascular risk in women who had hypertensive disorders in pregnancy can be explained by higher levels of traditional cardiovascular risk factors, especially blood pressure and BMI,” Haug said by email.

High blood pressure and a high BMI (body mass index, a measure of weight relative to height) explained 77% of the excess risk of events like heart attacks and strokes among women who had hypertensive disorders during pregnancy, researchers report in JAMA Cardiology.

The study followed 23,885 women who had one or more pregnancies before age 40, including 2,199 women who had hypertensive disorders during pregnancy.

A total of 728 women only had “gestational” hypertension, when women who normally don’t have high blood pressure develop it during pregnancy. Gestational hypertension progressed to a more serious and potentially life-threatening version of high blood pressure known as preeclampsia in 1,391 women.

Overall, 1,155 women who never had hypertensive disorders during pregnancy still had events like heart attacks or strokes during the study period.

Compared to women who didn’t have high blood pressure during pregnancy, women who had any type of gestational hypertensive disorder were 64% more likely to have a heart attack between ages 40 and 70. Women with a history of hypertension during pregnancy were also 47% more likely to develop heart failure and 40% more likely to have a stroke.

The risk was even greater for the subset of women who had preeclampsia. They were 78% more likely to have a heart attack, 83% more likely to have heart failure, and 46% more likely to have a stroke between ages 40 and 70 compared to women without pregnancy high blood pressure.

Hypertensive disorders in pregnancy didn’t appear to influence the risk of heart problems after age 70, however.

One limitation of the study is that researchers only had data for hospitalized patients, and it’s possible some women had nonfatal events that were treated in other settings, the study team notes.

Another limitation of the results is that researchers didn’t examine whether women had risk factors for heart disease before they conceived.

Still, the findings suggest that women with a history of hypertensive disorders during pregnancy can minimize their risk of future heart issues by keeping their weight and blood pressure within healthy ranges as they age, said Laura Benschop, a researcher at Erasmus Medical Center in Rotterdam, who wasn’t involved in the study.

“Women should be aware of these cardiovascular risk factors and check their blood pressure and BMI regularly (annually) after pregnancy,” Benschop said by email.

While doctors typically screen for these cardiovascular disease risk factors in older adults, women with high blood pressure during pregnancy develop these risk factors earlier in life than women with normal blood pressure in pregnancy, said Jennifer Stuart, a researcher at Brigham and Women’s Hospital and Harvard Medical School in Boston who wasn’t involved in the study.

“Therefore, it is especially important for these women to regularly see their doctor after pregnancy to monitor their blood pressure, body mass index, glucose, and cholesterol,” Stuart said by email.

SOURCE: bit.ly/2XqFiQv JAMA Cardiology, online June 12, 2019.

Half of statins patients don't hit 'healthy' cholesterol levels

PARIS, France - Millions of patients around the world taking statins to lower the risk of heart disease fail to achieve the recommended levels of cholesterol reduction after two years of treatment, new research said Monday.

Statins -- a class of medicines designed to reduce cholesterol linked to heart disease and strokes -- are among the most commonly prescribed drugs in the United States and Britain.

The cholesterol-lowering industry is worth billions of dollars, but guidelines over who should take statins are often unclear.

A team of researchers in Britain reviewed public health records of 165,000 patients taking the medicine and found that fewer than one in two reached the recommended "healthy" 40 percent cholesterol reduction within two years.

"Statins do work and are effective, but some trials have highlighted there have been variations in responses among some patients," said Ralph Kwame Akyea, research associate at the University of Nottingham's Faculty of Medicine and Health Sciences.

"But we've shown there are some people not reaching this (safe cholesterol level) and the reducing of their risk is lower," he told AFP.

Akyea's study, published in the journal Heart, found that people on average started taking statins aged 62. It found nearly 23,000 cases of cardiovascular disease within six years of statin treatment among patients. 

In total, 51 percent of patients had an insufficient drop in cholesterol even while taking the drugs. 

Akyea stressed that the study -- the largest of its kind to date -- could not establish why some patients responded positively to statins while others didn't.

"Probably some people would have stopped taking their medication, maybe they had side effects," he said. 

"There might also be a role played by genetic variation. Not everyone responds to the medication and there are currently studies looking at the genetics of drug response."

MILLIONS MORE PATIENTS EXPECTED

Recent changes to prescription guidelines are set to see statins given to more than 55 million people in the US and 12 million people in Britain in the next few years.

Akyea and his team suggested that better guidance and monitoring was needed to ensure those given statins were taking the correct doses for the prescribed amount of time. 

Writing in a linked editorial, Marcio Bittencourt, from Sao Paulo's University Hospital, said the study's results were "clearly alarming". 

He stressed, however, that statins had been shown to significantly reduce the likelihood of heart attacks and strokes in a large percentage of at-risk patients. 

"Patients and society should be educated on the scientific evidence documenting the benefits of lipid lowering therapy," said Bittencourt. 

"Anti-statin propaganda based on pseudoscience should be strongly disavowed."

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source: news.abs-cbn.com

Short walk once-a-week can lower risk of death: study

PARIS, France - A brisk stroll once or twice a week is enough to reduce the risk of dying from heart attack, stroke or cancer, according to a statistical study of nearly 90,000 people released Tuesday.

People who walked or gardened 10 minutes to an hour each week had an 18-percent lower risk of death from any cause compared to full-on couch potatoes, researchers reported in the British Journal of Sports Medicine.

Two-and-a-half to five hours weekly of such "moderate physical activity" -- broken into segments of no less than 10 minutes -- resulted in a 31 percent reduction in risk, they found.

And those who clocked up at least 25 hours almost halved the risk.

Not everyone, however, has that much time to spend on leisure-time exercise, the authors acknowledged.

Heart-pumping and pulse-quickening activities such as biking, running and competitive sports "are more time-efficient than moderate intensity activity," they said.

For cardiovascular disease alone, there was no additional benefit to be gained by graduating from five to 25 hours, they noted.

Researchers led by Bo Xi, a professor in the Department of Epidemiology at Shandong University in northern China, sifted through data collected annually on 88,140 people in the United States between 1997 and 2008 for the National Health Interview Surveys.

That data on exercise was then matched against registered deaths through 2011.

The authors cautioned that the study was observational, meaning that no firm conclusions can be drawn about cause and effect. The fact that exercise data was self-reported was also a potential weakness.

But the large number of people covered by the research goes a long way to compensate for these methodological limitations, they added.

mh/nla

source: news.abs-cbn.com

More evidence links exercise to lower stroke risk

Women who consistently get the minimum recommended amount of exercise for a healthy heart may be less likely to have a stroke than their counterparts whose exercise habits shift over time, a recent U.S. study suggests.

Researchers examined data on more than 61,000 women in the California Teachers Study who reported their exercise habits at two points in time, once from 1995 to 1996 and again from 2005 to 2006. The women were current and retired teachers when the study began.

Overall, 987 women had a stroke by the end of the study period.

But the women who got at least 150 minutes a week of moderate intensity exercise at both points in time were 30 percent less likely to have what’s known as an ischemic stroke, the most common kind, which occurs when a clot blocks an artery carrying blood to the brain.

“How people exercise changes over time and some individuals exercise when they are a young adult but do not keep it up when they are older,” said lead study author Dr. Joshua Willey of Columbia University Medical Center in New York.

“In our study, we found that maintaining exercise levels was protective against stroke, and that taking up exercise when not being active while younger was also protective,” Willey said by email. “Similarly, those who no longer exercised on the follow up assessment did not have a lower risk of stroke.”

The American Heart Association recommends that adults get at least 150 minutes a week of moderate-intensity exercise or at least 75 minutes of more vigorous physical activity.

More than 22,000 women met these minimum recommendations at both points when they were assessed in the study, mostly with moderate exercise.

Almost 19,000 women failed to get enough exercise at either point in time.

Another 11,500 women fell short of this goal in the beginning but achieved it at the end, while about 8,600 women started out getting enough exercise but failed to do so by the end of the study.

Compared to women who failed to meet exercise recommendations at either point in time, women who got enough moderate activity at both points were 38 percent less likely to have a fatal stroke and 12 percent less likely to have any kind of stroke, the study found.

Meeting moderate exercise guidelines by the end of the study, but not at the start, was associated with 35 percent lower odds of a fatal stroke and 27 percent lower odds of any stroke.

But the chance of any stroke, including fatal ones, was similar for women who never got enough exercise and women who started out meeting the activity recommendations but didn’t do so at the end of the study, researchers report in the journal Stroke.

The results were similar for women who did higher-intensity exercise.

The study wasn’t a controlled experiment designed to prove whether or how exercise habits might influence the odds of having a stroke or dying from it.

Other limitations include the lack of data on other factors that could influence stroke risk such as blood pressure, obesity or diabetes, the authors note.

Even so, the findings add to growing evidence for the benefits of moderate exercise, said Joe Northey of the University of Canberra in Australia.

“Moderate intensity seems to be optimal for increasing blood flow to the brain,” Northey, who wasn’t involved in the study, said by email. “Increasing cerebral blood flow through exercise improves the health and function of the brain.”

Enjoyment, rather than intensity, should be the focus, said Dr. James Burke, of the University of Michigan and the Ann Arbor VA.

“The best exercise is the one a person enjoys doing because he/she is more likely to make it a habit,” Burke, who wasn’t involved in the study, said by email.

Inactivity, meanwhile, can take a toll on health, said Sandra Billinger of Kansas University Medical Center in Kansas City.

“When we don’t exercise, our blood vessels become more stiff, we tend to gain weight, our lungs are not well used and our muscles become weak and lose size,” Billinger, who wasn’t involved in the study, said by email.

source: news.abs-cbn.com

Migraine sufferers at higher surgery stroke risk: study

PARIS - People who suffer migraines are at a higher risk of stroke after surgery, researchers said on Wednesday.

This means that a history of migraines, which affect about one in five people, should be taken into account when weighing the pros and cons of undergoing an operation, said a study in The BMJ medical journal.

"Given the high prevalence of migraine in the general population, the... association (with stroke) carries public health importance," the authors wrote.

A research team from the United States, Denmark and Germany analysed the records of nearly 125,000 surgical patients at Massachusetts General Hospital and two satellite campuses between January 2007 and August 2014.

Of the group, 771 (0.6 percent) suffered a stroke within 30 days of surgery.

Just over eight percent (10,179) of the surgery group had a history of migraine, compared to 11.5 percent (89) of the 771 who suffered a stroke.

The team calculated the risk of stroke at 2.4 attacks for every 1,000 surgeries -- a number which rose to 4.3 in 1,000 for migraine patients.

The risk was highest for those whose migraines had an "aura" -- described as flashing lights or other warning signals experienced before an attack.

According to the World Health Organization, about 6.7 million people died of stroke in 2012. Survivors often suffer long-term disability.

Stroke occurs when blood flow to an area of the brain is cut off due to a clot blocking the path or due to a leak in a blood vessel. Brain cells are starved of oxygen, and die.

Migraine, more common in women, is characterised by a severe headache often associated with disturbed vision, sensitivity to sounds, smells and light, and nausea.

Migraine has long been considered to increase the risk for stroke, the study authors said, but is still widely perceived as a benign condition.

This study was the first to assess whether migraines boost stroke risk after surgery.

"Physicians should be aware of this increased... risk," said the team. And further research was needed into preventing post-operative stroke in migraine sufferers.

source: news.abs-cbn.com

Stroke risk lower among women who drink moderately - study

Women who drink up to seven glasses of wine or beer a week are slightly less likely to suffer a stroke than those who steer clear of alcohol, according to a U.S. study that covered thousands of women for nearly 30 years.

The results, published in the journal Stroke, fall in line with guidelines from the American Heart Association that recommend women have no more than one drink a day -- but that doesn't mean people should take up drinking to stave off strokes, researchers said.

"We do not encourage women who do not currently drink to initiate drinking," said Monik Jimenez, a researcher at Brigham and Women's Hospital in Boston, who led the study.

"Alcohol is a double-edged sword, because higher levels can increase high blood pressure and atrial fibrillation, which are risk factors for stroke as well," she told Reuters Health.

Several previous reports have shown that low levels of alcohol drinking are tied to a smaller chance of having a stroke.

Jimenez and her colleagues used data from the massive Nurses' Health Study, which tracked the health, diet and lifestyle of more than 83,000 middle-aged women for 26 years.

They compared the drinking habits of women in the study who had had a stroke, to women who hadn't, dividing the women into five categories: from those who never drank, to the heaviest drinkers who had at least two and a half beers or two shots' worth of hard liquor or about three glasses of wine a day.

Of the roughly 25,000 women who never drank, about four percent had a stroke at some point during the study.

In contrast, two percent of the more than 29,000 women who had up to half a drink a day on average had a stroke. And of those downing between a half glass and a full glass daily, just one in 200 ended up suffering a stroke.

After the researchers took into account certain risk factors for stroke, such as smoking, being overweight and a history of heart disease, they found that having up to one drink a day was linked to a 17 to 21 percent lower chance of having a stroke.

The study didn't prove that alcohol prevented the strokes, and there's no known explanation for the relationship between the two.

It may have something to do with socioeconomic status, said Cheryl Bushnell of Wake Forest Baptist Medical Center, who was not involved in the study and noted that lower socioeconomic status is known to be linked with a higher risk of stroke and cardiovascular disease.

"My thought is that alcohol costs money. And I think that people who may be drinking light to moderate amounts with a meal are basically people who may have slightly higher means to buy that," Bushnell told Reuters Health.

"It's something that's a lifestyle."

But she did say that it's possible alcohol itself is responsible for the lower stroke risk. Jimenez suggested that alcohol might do so by preventing blood clots or altering cholesterol levels.

Her study did not show an increased risk of stroke among the women who drank the most, but other research has suggested that possibility. One found that having several drinks was actually linked to an increased risk of stroke in the next 24 hours.

source: interaksyon.com

Diet soda tied to heart attack, stroke risks: study

NEW YORK (Reuters Health) - Diet soda may benefit the waistline, but a new study suggests that people who drink it every day have a heightened risk of heart attack and stroke.

The study, which followed almost 2,600 older adults for a decade, found that those who drank diet soda every day were 44 percent more likely than non-drinkers to suffer a heart attack or stroke.

The findings, reported in the Journal of General Internal Medicine, don't prove that the sugar-free drinks are actually to blame.

There may be other things about diet-soda lovers that explain the connection, researchers say.

"What we saw was an association," said lead researcher Hannah Gardener, of the University of Miami Miller School of Medicine. "These people may tend to have more unhealthy habits."

She and her colleagues tried to account for that, Gardener told Reuters Health.

Daily diet-soda drinkers did tend to be heavier and more often have heart risk factors like high blood pressure, diabetes and unhealthy cholesterol levels.

That all suggests that people who were trying to shed pounds or manage existing health problems often opted for a diet soda over the sugar-laden variety.

But even after the researchers factored in those differences -- along with people's reported diet and exercise habits -- they found that daily diet soda was linked to a 44-percent higher chance of heart attack or stroke.

Nevertheless, Gardener said, it's impossible for a study to capture all the variables that could be at work.

The findings do build on a few recent studies that also found diet-soda drinkers are more likely to have certain cardiovascular risk factors, like high blood pressure or high blood sugar.

This is the first study, Gardener said, to look at actual "vascular events" -- that is, heart attacks, strokes and deaths from cardiovascular causes.

The findings are based on 2,564 New York City adults who were 69 years old, on average, at the outset. Over the next decade, 591 men and women had a heart attack, stroke or died of cardiovascular causes.

That included 31 percent of the 163 people who were daily diet-soda drinkers at the study's start. In contrast, 22 percent of people who rarely or never drank diet soda went on to have a heart attack or stroke.

There was no increased risk linked to less-than-daily consumption. Nor was regular soda tied to heart attacks and strokes.

If diet soda, itself, somehow contributes to health risks, it's not clear how, Gardener said.

There's research in rats suggesting that artificial sweeteners can end up boosting food intake and weight. But whether results in rodents translate to humans is unknown.

"I don't think people should change their behavior based on this study," Gardener said. "And I wouldn't advocate drinking regular soda instead."

Regular soda is high in calories, and for people who need to shed pounds, experts often suggest swapping regular soda for the diet version.

A study out this month found that the advice may be sound. Obese people who were randomly assigned to drink water or diet drinks in place of sugary ones lost about five pounds over six months.

Gardener said that further studies such as hers are still needed to confirm a connection between diet soda and cardiovascular trouble.

Ultimately, she noted, clinical trials are considered the "gold standard" for proving cause-and-effect. That would mean randomly assigning people to drink diet soda or not, and then following them over time to see if there were differences in their rates of heart problems or stroke.

A study like that, Gardener said, would be "difficult and costly" -- since it would have to follow large groups of people over many years, and rely on people to stick with their assigned beverages.

source: mb.com.ph