Tee-Total but Drinking Yourself to Death?

According to research presented at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism meeting last week, sugar-sweetened sodas, sports drinks and fruit drinks may be associated with a staggering 180,000 deaths around the world each year,

Researchers calculated the quantities of sugar-sweetened beverage intake around the world by age and sex.  They also looked at the effects of this on obesity and diabetes. Using data from the 2010 Global Burden of Diseases Study, they linked intake of sweetened beverages to 133,000 diabetes deaths, 44,000 cardiovascular disease deaths and 6,000 cancer deaths.

78% of these deaths were in low and middle-income countries.  But that doesn’t mean America is off the hook.

“In the U.S., our research shows that about 25,000 deaths in 2010 were linked to drinking sugar-sweetened beverages,” said Gitanjali M. Singh, PhD, co-author of the study.

Of nine world regions in 2010:

• Latin America/Caribbean had the most diabetes deaths (38,000) related to sugar-sweetened beverages
• East/Central Eurasia had the largest numbers of cardiovascular deaths (11,000) related to sugary beverage consumption

Among the world’s 15 most populous countries, Mexico had the highest death rate due to these beverages, with 318 deaths per million adults.

Japan, one of the countries with lowest per-capita consumption of sugary beverages in the world, had the lowest death rate associated with the consumption of sugary beverages, at about 10 deaths per million adults.

“Because we were focused on deaths due to chronic diseases, our study focused on adults. Future research should assess the amount of sugary beverage consumption in children across the world and how this affects their current and future health,” Singh said.

In the meantime, the American Heart Association recommends adults consume no more than 450 calories per week, from sugar-sweetened beverages.

And don’t assume you’re OK just because you drink diet, rather than regular soda. According to research presented at the American Stroke Association’s International Stroke Conference in  2011, drinking diet soda daily is linked to a higher risk of stroke, heart attack and vascular-related deaths, compared to those who don’t drink soda.  Even though you are avoiding the sugar calories, the high salt content may double the risk of ischemic stroke, independent of sodium’s role in hypertension.

Here at SRxA’s Word on Health we’re canning the cans and from now on it will be water all the way!

SATS & CPR

Go Gov. Beverly Perdue!  SRxA’s Word on Health applauds the North Carolina Governor who has just passed a law requiring all high school students in the state to have basic emergency-response training before they can graduate.

Although high schools have been required to teach CPR since 1997, until now this has been unenforced.

But starting with the class of 2015, the bipartisan plan requires that schools teach American Red Cross or American Heart Association curriculum for cardiopulmonary resuscitation and obstructed airway treatment.

The new law comes as great news to Tracey Stell, assistant director of education services at Durham Regional Hospital.  “It melds wonderfully into Durham County’s strategic plan to increase the rate of bystander CPR and it’s really going to help people get more immediate care, which will make a difference in survival,” Stell said. “You shouldn’t have to wait for an ambulance to arrive for CPR to start. Man, that’s a huge win.”

The new law signed on Thursday joins another aimed at saving lives: a law requiring at least one defibrillator kit in every state building in North Carolina and training for state employees to use them.

North Carolina joins four other states that have signed CPR graduation requirements into law this year: Iowa, Alabama, Tennessee and Minnesota.

By making CPR as important as ABC’s, we hope the next generation of students will be better equipped to start college life and save the lives of others.

Simple, Fast, and Beautiful

Take a good look at the image to the left.  Could it be the latest high tech cardio machine from a swanky new-age gym, a computerized gold club that provides instant feedback on your swing or perhaps a revolutionary whole-house Bluetooth speaker system?

No, no and no!

What you are looking at, ladies and gentlemen, is a revolutionary new device for the treatment of high blood pressure.  Yes, that’s right. Not monitoring, but treatment.

The Vessix Vascular V2 Renal Denervation System™  is the result of a collaboration between two California based companies –  Vessix Vascular, Inc., a pre-revenue stage medical technology company, and product innovation consultancy Karten Design.

This new technology has the potential to help the 68 million (one in three) adults in the United States who suffer from hypertension — a condition that is more common than cancer, diabetes, and coronary artery disease combined.

Hypertension is a major risk factor for heart disease, stroke, congestive heart failure, and kidney disease and was listed as a primary or contributing cause of death for more than 347,000 Americans in 2008.

In 2010, high blood pressure cost the United States $93.5 billion in health care services, medications, and missed days of work

Today, anti-hypertensive drugs are the primary treatment for hypertension. But despite the widespread use of drugs, only about half of hypertensive patients around the world are well controlled, even when multiple medications are taken at optimal dosages.

This new device could potentially change all that.

In as little as 30 seconds per artery, the Vessix V2 System performs a one-time minimally invasive catheter-based percutaneous procedure that has been shown to significantly reduce blood pressure.
Using a short blast of radiofrequency (RF) energy to disable the sympathetic nerves surrounding the arteries leading to the kidneys, in a procedure called renal denervation.

TV’s  Dr. Mehmet Oz has called  this treatment “a profound game changer.”

Hyperactivity of the renal nerves leads to uncontrolled high blood pressure, also called resistant hypertension. According to the American Heart Association, a 5 mm Hg reduction in systolic blood pressure results in a 14% decrease in stroke, a 9% decrease in heart disease, and a 7% decrease in overall mortality. In clinical studies, renal denervation has shown to reduce systolic blood pressure by as much as 20%.

Vessix’s patented V2 Catheter delivers precise temperature-controlled energy to both renal arteries in 60 seconds, while the only other competitively marketed Renal Denervation system takes 50-60 minutes. The rapidity of the V2’s treatment promises to reduce patient discomfort as well as exposure to radiation for both the patient and the interventional cardiologist performing the procedure.

“I wanted a design that immediately communicates that there’s something new and exciting going on — even before I explain how the product works,” said Vessix CEO Raymond Cohen. “The goal was to have the product look faster, sexier, and more advanced than any other piece of equipment found in the hospital.”

To ensure the system’s design supports the physician’s natural workflow in the catherization lab, Karten Design worked with Vessix during the early phases of product definition, visiting hospital cath labs and interviewing doctors to determine the system’s ideal usage. Karten Design researchers and designers learned about the human factors surrounding a catheter-based procedure, including visibility, access, and sterility.

Vessix began a 64-patient human clinical in February in Europe. The first patient treated was 39 years old with pre-treatment blood pressure readings of 174/114 despite taking four anti-hypertensive medications. The second patient was 44 years old with a blood pressure of 168/106 despite taking six anti-hypertensive medications. The 10 center study will follow patients for 24 months following their renal denervation procedure.

Although the system has already received a CE Mark approval for the treatment of hypertension, it is not yet available in the US.

Assuming all goes well with the clinical studies, we look forward to the day it is.

Patients are from Mars, Physicians are from Venus!

Or so it would seem.  According to a study just published in the Annals of Internal Medicine there is a huge disparity between patients’ expectations of angioplasty versus those of their cardiologists.  While the majority of heart patients harbor the notion that angioplasty, a procedure performed to unblock clogged arteries, will cut their risk of heart attacks and death, cardiologists believe that its value is limited to reducing chest pain.

The research involved 27 cardiologists and 153 patients who consented to elective coronary catheterization and possible angioplasty, from Baystate Medical Center, Springfield, and Tufts University School of Medicine, Boston.

During angioplasty, a tube is inserted at the groin and snaked up to the affected artery, where a balloon opens the blockage. A stent is often left in place to help prop open the artery and maintain blood flow. Angioplasty involves some risk but the rate of death during the procedure is less than 1 percent, experts note.

Although 63% of cardiologists believed that the benefits of angioplasty were limited to angina symptom relief:

• 88% of patients believe that angioplasty would prevent heart attacks or fatal heart attacks

• 74% of patients thought that without the procedure  they would probably have a heart attack within 5 years

Furthermore, most patients stuck to their beliefs even after spending time with a cardiologist who explained the risks and benefits to them, and had them sign an informed consent form prior to the angioplasty.

The authors of the study noted that the benefits obtained by angioplasty can often be achieved with medication alone, and only patients who are actually having a heart attack or coronary event can expect a reduced risk of future heart attacks and death from angioplasty.

The number of angioplasties done for stable heart patients has decreased lately.  According to the American Heart Association, about 1.3 million such procedures are done in the United States each year.

Once again, this study highlights the “disconnect” between what doctors know and what patients understand. In order to have real informed consent, patients have to understand not just the risks, but also the benefits of whatever treatment is proposed.

One reason for patients’ misunderstanding is the common belief, that if a treatment is offered, it must have curative benefits.

However, the problem of patient understanding isn’t limited to angioplasty but is common in many areas of medicine. According to a previous study from the Mayo Clinic, doctors don’t always do a good job of knowledge transfer in a way that patients and family members can understand. Graphs and charts are not going to work for many patients.

SRxA and our team of problem based learning expert Advisors can help physicians, institutions and device manufacturers produce patient-centric materials to assist with informed consent. Contact us today to find out more.