Supercomputer can predict heart attack

Mon, Sep 20,2010
EPFL Laboratory of Multiscale Modeling of Materials, in Switzerland, has developed a flowing 3D model of the cardiovascular system that should allow for predictions of certain heart diseases before they become dangerous. The supercomputer Cadmos, installed at the Ecole Polytechnique Fédérale de Lausanne (EPFL) in August of 2009, has bared one of its first fruits: the Laboratory of Multiscale

Modeling of Materials has recently developed a computer program the accurately models the complex system of blood flow in the heart for individuals at an unheard-of precision of ten millionths of a meter or ten microns. These individual-specific models-which take up to six hours using a supercomputer-will allow for a detailed study of the cardiovascular system and lead to early predictions of heart conditions such as arteriosclerosis, or the hardening of arteries that often leads to heart attacks. Plans are in the works to develop the program for individual PCs for clinical applications within the next two to three years.

\"When studying the blood flow in arteries, one has to take into account a vast number of different fluid interactions that happen on different time scales and of different sizes,\" explains Simone Melchionna, who heads the project. Based on a detailed heart scan, the simulation juggles over a billion different variables in order to represent a fluid containing ten-million red blood cells. Using another supercomputer based in Juelich (Germany), the research team has achieved even greater precision with their program that allows for the visualization of the interaction of plasma, red blood cells and even micro-particles. \"We can evaluate all of the elements and how they interact with each other; move, stagnate and whirl and turn over each other,\" Melchionna adds.

This precision will allow for the detection of the first signs of arteriosclerosis when the plaques begin to form on the artery\'s walls and disturb blood flow. This condition, which creates dangerous rigidity and blockage of these vital vessels, is the main cause of heart attacks-responsible for 12% of deaths in the world. This mortality rate increases to 16% in richer countries, where greasy and cholesterol rich foods are more common. Early detection of the forces leading to arteriosclerosis is one element in the strategy developed by EPFL and the universities of Geneva and Lausanne to rationalize the investment in a supercomputer of 16,000 microprocessors-the equivalent of 8,000 PCs.

Heart failure: Avoiding medicines that make symptoms worse

Mon, Sep 20,2010

Introduction



If you have heart failure, you need to be extra careful with medicines. Some can make your heart failure worse. Other medicines may not mix well with your heart failure drugs.
This Actionset will help you learn which medicines you may need to avoid and what questions to ask your doctor or pharmacist.
Key points
  • Each time you see a doctor, make sure he or she knows that you take medicines for heart failure.
  • Before you fill any new prescription, tell the pharmacist that you have heart failure. Ask if it’s okay to take the new prescription medicine.
  • Before you take any over-the-counter medicine, such as a cold or flu remedy, ask your doctor or a pharmacist if it is safe to take it with your heart failure medicines.
  • Tell each doctor about all the other medicines you take. This includes over-the-counter medicines, such as cold and flu remedies, herbal products, and natural supplements and vitamins. Take a list of your medicines or bring your medicines to each doctor\'s appointment.
  • Whether or not some medicines will make your heart failure worse depends on how severe your heart failure is. It also depends on what type of heart failure you have.

What medicines can make heart failure worse?


There are many medicines that you\'ll need to avoid when you have heart failure. Some are over-the-counter drugs that you can buy without a prescription. Others are drugs that a doctor may prescribe.
Do not start taking any of the medicines listed in the table below unless your doctor says it is okay and he or she knows that you have heart failure. If your heart failure is mild, you may be able to use some of the medicines for a short time, but it’s very important to ask your doctor first.
If you are already taking a medicine on the list below, be sure to ask your doctor or pharmacist if it is okay to take it.
Medicines you may need to avoid

Over-the-counter medicines you may need to avoid (talk to your doctor or pharmacist)

Prescription medicines you may need to avoid (talk to your doctor or pharmacist)

Pain relievers called NSAIDs
  • Ibuprofen, such as Advil and Motrin
  • Naproxen, such as Aleve
  • Aspirin, such as Bayer
    • If your doctor has told you to take a low-dose aspirin every day for your heart problems, it’s probably okay to take it. Low-dose aspirin can help prevent blood clots and may prevent a stroke or a heart attack.
    • Higher doses of aspirin may make your heart failure worse. Do not take aspirin for pain, such as from headaches or arthritis. Use acetaminophen, such as Tylenol, instead.

Prescription NSAIDs
  • Celecoxib (Celebrex)
  • Etodolac (Lodine)
  • Ibuprofen (prescription-strength Motrin)
  • Indomethacin (Indocin)
  • Ketoprofen
  • Nabumetone (Relafen)
  • Naproxen sodium (Anaprox)
  • Piroxicam (Feldene)
  • Salsalate (Disalcid, Salsitab)
  • Sulindac (Clinoril)

Cold, cough, flu, or sinus medicines
  • Be sure to check the label. Do not take medicines that contain pseudoephedrine, ephedrine, phenylephrine, or oxymetazoline, such as:
    • Sudafed.
    • Nose sprays (decongestants), such as Afrin and Dristan.
    • Herbal remedies, such as ma huang and Herbalife.
  • Make sure your cough and cold medicines don\'t contain aspirin or ibuprofen.

Antiarrhythmics
  • These are drugs used to treat a fast or uneven heart rhythm. You may need to avoid the following:
    • Quinidine (Quinaglute, Quinidex Extentabs)
    • Disopyramide (Norpace)
    • Procainamide
    • Flecainide (Tambocor)
    • Sotalol (Betapace AF)
    • Propafenone (Rythmol)
    • Dofetilide (Tikosyn)

Antacids or stool softeners
  • Do not take ones that contain sodium, such as Alka-Seltzer or Dulcolax.

Calcium channel blockers
  • People with a certain kind of heart failure may need to avoid the following medicines:
    • Diltiazem (Cardizem, Dilacor XR, Taztia, Tiazac)
    • Verapamil (Calan SR, Isoptin SR)
  • If you need to take a calcium channel blocker for another health problem, such as high blood pressure, your doctor will watch your health carefully.
 
Certain diabetes medicines
  • Most diabetes drugs are safe to take, but you may need to avoid the following:
    • Thiazolidinediones—rosiglitazone (Avandia) and pioglitazone (Actos)
    • Metformin (Glucophage)
 
Certain antibiotics
  • Some antibiotics may interfere with how your body uses the medicine digoxin. If you take digoxin, talk with your doctor before taking antibiotics.

Test Your Knowledge

  1. You have headaches a lot. Instead of taking aspirin or ibuprofen, you need to take acetaminophen.
    1. True
      The answer is correct
      Aspirin and ibuprofen are types of over-the-counter medicines that can make your heart failure worse. But if your heart doctor has told you to take a low-dose aspirin for your heart, this is probably okay. Make sure to talk with your doctor about this.
    2. False
      The answer is incorrect
      Aspirin and ibuprofen are types of over-the-counter medicines that can make your heart failure worse. But if your heart doctor has told you to take a low-dose aspirin for your heart, this is probably okay. Make sure to talk with your doctor about this.

Why may you need to avoid certain medicines?


Some drugs or herbal remedies could interfere with your heart failure medicines. This is called a drug interaction. It happens when different medicines work against each other and cause problems.
Other drugs may make your heart failure worse by speeding up your heart or making it beat in a way that’s not normal. Other medicines can cause your body to hold onto fluid or increase your blood pressure.
Some drugs have too much sodium in them. Sodium causes your body to hold on to extra water, making it harder for your heart to pump. Too much sodium makes it harder for your already-weakened heart to pump and can lead to sudden heart failure. Fluid may build up in your lungs—making it harder for you to breathe—and in your feet, ankles, legs, and belly.
Your doctor may have told you to limit your sodium intake to less than 2,000 milligrams (mg) a day. That is less than 1 teaspoon of salt a day, including all the salt you eat in cooked or packaged foods.
If you take a medicine that contains sodium, it counts as part of your total sodium intake each day. It could cause you to go over your 2,000 mg limit. Look for sodium in the list of ingredients on each medicine you take.

Test Your Knowledge

  1. Your doctor told you that you need to limit how much sodium (salt) you have each day. This includes any sodium in your medicines.
    1. True
      The answer is correct
      Your doctor may have told you to limit your sodium intake to less than 2,000 milligrams (mg) a day. If you take a medicine that contains sodium, that counts as part of your total sodium intake each day.
    2. False
      The answer is incorrect
      Your doctor may have told you to limit your sodium intake to less than 2,000 milligrams (mg) a day. If you take a medicine that contains sodium, that counts as part of your total sodium intake each day.

How do you know if your other medicines are safe to take with your heart failure medicines?


Talk to your doctor or a pharmacist. Show him or her a list of all the medicines you take.

Be organized


It’s important to keep an up-to-date list of your medicines. Here are some tips:
  • Make a list of everything you take. Keep a copy in your purse or wallet, and take it to each doctor or hospital visit. Anytime you see a new doctor, show him or her your list.
  • Remember to include herbs, vitamins, and over-the-counter medicines on your list.
  • Have each doctor keep a copy of your list of medicines in your file.
  • Make sure your spouse, a family member, your caregiver, or a friend has an extra copy of your list of medicines.
  • Use the same pharmacy or drugstore for all of your prescriptions.
  • Update your list if you start a new medicine or stop taking one.

Ask questions


What if you need to take a medicine that can make heart failure worse? Here are some things you can do:
  • Ask your doctor or a pharmacist if it is safe to take the medicine.
    • For example, if you have a cold or the flu, ask which medicine is safe to take.
    • Ask how long you should take the medicine and how much you should take. It may be safe to take it for a short time.

Watch for problems


Call your doctor if you have symptoms that your heart failure is getting worse, including the following:
  • You gain weight suddenly, such as 3 lb (1.4 kg) or more in 2 to 3 days.
  • You have new shortness of breath, a cough, or problems eating.
  • Your ankles are more swollen than usual, and you have to get up more often in the night to urinate.
  • You need to use more pillows to sleep at night.

Test Your Knowledge

  1. You\'ve suddenly gained a few pounds. This may be a sign that your heart failure is getting worse, so you need to call your doctor.
    1. True
      The answer is correct
      If you gain weight suddenly, such as 3 lb (1.4 kg) or more in 2 to 3 days, call your doctor. Call if you have new shortness of breath, a cough, or problems eating. Call if your ankles are more swollen than usual, if you have to urinate in the night more often, or if you need to use more pillows to sleep at night.
    2. False
      The answer is incorrect
      If you gain weight suddenly, such as 3 lb (1.4 kg) or more in 2 to 3 days, call your doctor. Call if you have new shortness of breath, a cough, or problems eating. Call if your ankles are more swollen than usual, if you have to urinate in the night more often, or if you need to use more pillows to sleep at night.

Where to go from here



Now that you have read this information, you can avoid medicines that may make your heart failure worse.

Frequently Asked Questions About Heart Disease

Mon, Sep 20,2010
  • What is atherosclerosis?
  • Answer:



    Atherosclerosis, often described as a hardening of the arteries, occurs when the normal lining of the arteries deteriorates, the walls of arteries thicken, and deposits of fat and plaque build up, causing narrowing (or even blockage) of the arteries.
    coronary artery disease is a form of atherosclerosis. In coronary artery disease, the arteries that supply blood to the heart become severely narrowed, decreasing the supply of oxygen-rich blood to the heart -- especially during times of increased activity. Extra strain on the heart may result in chest pain (angina) and other symptoms.
  • What\'s the link between smoking and heart disease?
  • Answer:



    About 30% of all deaths from heart disease in the U.S. are directly related to cigarette smoking. Smoking is a major cause of atherosclerosis.
    Among other things, the nicotine present in smoke causes:
    • Decreased oxygen to the heart.
    • Increased blood pressure and heart rate.
    • Increase in blood clotting.
    • Damage to cells that line coronary arteries and other blood vessels, triggering atherosclerosis and heart disease.
  • What are the risk factors for coronary artery disease?
  • Answer:



    Conditions that increase a person\'s risk for heart disease, also called coronary artery disease, are called risk factors. There are some risk factors that you can\'t do anything about. These include:
    • Male sex.
    • Older age.
    • Family history of heart attack or coronary artery disease.
    • Being post-menopausal.

    Other risk factors, fortunately, can be changed (modifiable risk factors). These include:
    • Smoking.
    • High cholesterol.
    • Hypertension (high blood pressure).
    • Lack of exercise.
    • Obesity.

    By improving modifiable risk factors, you can reduce your risk of heart attack or angina.
  • What should I do if I have risk factors for coronary artery disease?
  • Answer:



    There are many things you can do to decrease your risk of developing heart disease. If the artery-clogging process has already begun, you can slow the rate at which it progresses by improving your diet, exercising, quitting smoking, and reducing stress. With very careful lifestyle modification, you can stop or even reverse the narrowing of arteries. While this is very important for everyone with risk factors for the disease, it is even more important if you have had a heart attack and/or procedure to restore blood flow to your heart or other areas of your body.
  • What dietary changes can I make to reduce my heart disease risk?
  • Answer:



    Eating right is a powerful way to reduce or even eliminate some heart disease risk factors. Adopting a heart-healthy nutrition strategy can help reduce total and LDL (\"bad\") cholesterol, lower blood pressure, lower blood sugar, and reduce body weight.
    To reduce your risk of heart disease, try these tips.
    • Increase your intake of vegetables, fruits, whole grains, and legumes.
    • Limit fat intake. When you use added fat, use fats high in mono- and polyunsaturates only.
    • Eat a variety -- and just the right amount -- of foods high in protein. Commonly eaten protein foods (red meat, dairy products) are among the main culprits in increasing heart disease risk. By balancing animal, fish, and vegetable sources of protein, you can reduce your risk.
    • Limit intake of cholesterol.
    • Eat complex carbohydrates (such as whole-grain bread, rice, pasta) and limit simple carbohydrates (such as regular soda, sugar, sweets).
    • Eat small but more meals throughout the day (for example, eating five to six mini-meals).
    • Reduce salt intake.
    • Exercise regularly.
    • Drink 32 to 64 ounces of water daily (unless you are fluid restricted).
  • What is cholesterol?
  • Answer:



    Cholesterol is a soft waxy like material that is made in the liver of animals. Animal foods such as egg yolks, milk fat, organ meats, and shellfish, contain cholesterol too.
    In many people, an elevated blood cholesterol level (hypercholesterolemia) is caused by excessive intake of foods high in saturated fats, cholesterol, and calories. Reducing intake of these products can reduce cholesterol levels. Limit intake to 300 milligrams of cholesterol per day.
  • How common is heart disease among women?
  • Answer:



    Heart disease is the leading cause of death in women over 40 years old, especially after menopause. Once a woman reaches the age of 50, (about the age of natural menopause), the risk for heart disease increases dramatically. In young women who have undergone early or surgical menopause, the risk for heart disease is also higher, especially when combined with other risk factors such as:
  • Diabetes.
  • Smoking.
  • High blood pressure.
  • High blood cholesterol, especially high LDL or \"bad\" cholesterol.
  • Obesity.
  • Lack of exercise.
  • Family history of heart disease.

What's Your Heart Disease Risk? Ask Mom

Mon, Sep 20,2010
You may already know that your risk for some diseases goes up if a first-degree relative (parent, brother, sister, or child) has had the condition.
We know, for example, that your risk for coronary heart disease (CHD) goes up significantly if a first-degree male relative developed it before age 55 or a first-degree female relative developed it before age 65. This is known as premature or early coronary heart disease.
I had considered early CHD in either parent as having the same risk, but several recent studies report that premature CHD is a greater risk when it occurs in a mother than in a father.
For example, in a study from Sweden the risk of developing CHD was raised by 55 percent in men whose mothers had premature CHD, compared with 41 percent in those whose fathers had premature disease. The risks for women were increased by 43 percent and 17 percent for maternal and paternal premature CHD, respectively. When both parents had premature CHD, the risk more than doubled in men and increased by 82 percent in women. The impact of a bad family history was greatest in both men and women younger than 40 years.
The authors suggest that mothers pass on the greater risk because children spend more time with their mothers and may develop some of the environmental risk factors, such as cigarette smoking, that lead to premature CHD in the mothers. A better explanation, in my opinion, is that children may inherit specific genetic factors that can be transmitted only by the mother.
I haven\'t seen a report on the risks of having siblings versus parents with premature CHD, but it\'s quite clear that premature CHD in a brother or sister is a significant risk factor. It wouldn\'t surprise me if the risk associated with premature CHD in siblings is higher than the risk imparted by either parent. After all, children may inherit a combination of bad genetic traits from both parents.