Importance of Uninterrupted Chest Compressions in Sudden Cardiac Arrest

(Note: The disco tune "Stayin' Alive) is about 100 beats per minute)

Gasping Helps Cardiac Arrest Victims Survive, New Research Shows
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ScienceDaily (Nov. 26, 2008) — People who witness an individual collapse suddenly and unexpectedly should perform uninterrupted chest compressions even if the patient gasps or breathes in a funny way, research from the Resuscitation Research Group at The University of Arizona Sarver Heart Center shows.
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When an individual breathes abnormally or gasps after collapsing from sudden cardiac arrest there is a greater chance of surviving, the researchers report. Gasping can be thought of as a survival reflex triggered by the brain. .
Each day, about 500 Americans collapse because their hearts suddenly stop beating. Data collected by Sarver Heart Center researchers show that in more than half of witnessed cardiac arrest cases, the patient gasped.
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"Gasping is an indication that the brain is still alive, and it tells you that if you start and continue uninterrupted chest compressions, the person has a high chance of surviving," said Gordon A. Ewy, MD, corresponding author of the study, professor and chief of cardiology at the UA and director of its Sarver Heart Center. "We need people to promptly recognize sudden cardiac arrest, to call 9-1-1 and to start chest compressions right away."
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Gasping has been described as snoring, gurgling, moaning, snorting or agonal or labored breathing. However, bystanders often misinterpret gasping and other unusual vocal sounds as normal breathing and don't call 9-1-1 or begin lifesaving chest compressions quickly enough, Dr. Ewy said.
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The authors hope their findings lead to greater willingness of untrained bystanders to jump in and perform continuous chest compressions. Bystander-initiated CPR has been shown to be a cardiac arrest victim's only chance of survival until an automated external defibrillator or the paramedics get to the scene.
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Many bystanders are hesitant to perform mouth-to-mouth ventilation, and in a case of a witnessed (seen or heard) collapse, so-called rescue breathing is not necessary and may be harmful, Dr. Ewy said. "When the patient gasps, there is a negative pressure in the chest, which not only sucks air into the lungs but also draws blood back to the heart. In contrast, mouth-to-mouth breathing creates overpressure in the chest and actually inhibits blood flow back to the heart. Gasping during cardiac arrest is much better than mouth-to-mouth breathing."
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But what about choking? "That's very different," Dr. Ewy said. "Someone who is choking will be seen to grasp their throat and struggle to breathe, which means they're responsive. These individuals need the Heimlich maneuver." A primary cardiac arrest is the witnessed unexpected collapse of an individual who is not responsive, Dr. Ewy said. "Cardiac arrest will cause the stricken individual to pass out and collapse to the ground within seconds."
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The Arizona researchers examined data from two sources. Transcripts from the Phoenix Fire Department Regional Dispatch Center included information on gasping in patients found by bystanders, whether their collapse was witnessed or not. The department's first-care reports on 1,218 witnessed patients provided the incidence of gasping upon or after the arrival of emergency medical service (EMS) personnel. Among the 481 patients who received bystander CPR, 39 percent of gaspers survived, but only 9.4 percent of those who didn't gasp survived.
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Performing uninterrupted chest compressions (a technique developed at the UA Sarver Heart Center and endorsed by the American Heart Association as "Hands-Only CPR" for lay individuals) may cause a person who has stopped gasping to resume gasping. "This scares many people and they stop pressing on the chest," Dr. Ewy said, "This is bad because gasping is an indication that you're doing a good job."
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The study is set to publish in the Nov. 24 online issue of Circulation, the official journal of the American Heart Association.
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The authors of the study are: Bentley J. Bobrow, MD; Mathias Zuercher, MD; Gordon A. Ewy, MD; Lani Clark, BS; Vatsal Chikani, MPH,; Dan Donahue BS, NREMT-P, Arthur B. Sanders, MD; Ronald W. Hilwig, DVM; Robert A. Berg, MD; and Karl B. Kern, MD.
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Experts continue to promote a combination of rescue breathing and chest compressions for victims of cardiac arrest due to non-cardiac causes, like near drowning or electrocution, and all victims of pediatric cardiac arrest.
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The study was funded in part by a grant from the Arizona Department of Health Services Bureau of Emergency Medical Services.
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http://www.sciencedaily.com/releases/2008/11/081124165125.htm

Gratitude is a vaccine

The sign for "thank you" is made by touching your lips with the front of the fingers of your right hand.

Your hand should be an "open-b."
Move your hand away from your face, palms upward.
Smile.

Note: If you use two hands with this sign it means you are "very" grateful.

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“Gratitude is a vaccine, an antitoxin,and an antiseptic.”— John Henry Jowett

If you start practicing now, you could be grateful by Thanksgiving. Not only that, your marriage could improve, you might be exercising more, feel less depressed, sleep better, have a healthier heart, more life satisfaction, and increase your chances of living longer.

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This may sound like a late-night ad that comes with a free set of steak knives (…and that’s not all!), but a growing body of research shows that gratitude is truly amazing in its physical and psychosocial benefits. The benefits are so great, in fact, that it’s a wonder “gratitude gyms” aren’t already being franchised.

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Robert A. Emmons, PhD, a professor of psychology at University of California, Davis, pioneer in the research on gratitude and one of the leading scholars in positive psychology, has written a new book on the impressive findings in the field.

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Thanks: How the New Science of Gratitude Can Make You Happier is the perfect text for Gratitude 101, a course that could justifiably be part of the core curriculum to leading a happy life. What makes gratitude the “magic ingredient” is that it takes us outside ourselves so that we can see how we are part of the larger, intricate network of sustaining relationships -- relationships that are mutually reciprocal.

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Research on gratitude.

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In one of his first studies on gratitude, conducted with colleague Mike McCullough at the University of Miami, Emmons randomly assigned participants one of three tasks. Some were encouraged to feel gratitude indirectly, others to be indirectly negative and complaining, and a third group to be neutral.

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Every week, participants kept a short journal. They briefly described either five things they were grateful for that had occurred in the past week, or the opposite, five daily hassles from the previous week that displeased them.

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The neutral group was asked to list five events or circumstances that affected them, but they were not told to accentuate the positive or negative.

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The results of this study at the end of 10 weeks:
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Participants in the gratitude group felt better about their lives as a whole and were more optimistic about the future than participants in either of the other control conditions -- a full 25 percent happier.
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They reported fewer health complaints and even spent more time exercising than control participants.
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They had fewer symptoms of physical illness than the other two groups.
The gratitude group exercised 1.5 hours more than the hassled group.
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In a second study by Emmons, people were asked to write with daily frequency about things for which they were grateful or when they experienced gratitude. There was evidence that the daily intervention led to greater increases in gratitude than did the weekly practice in the first study.

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The results showed another benefit:
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Participants in the gratitude condition also reported offering others more emotional support or help with a personal problem, indicating that the gratitude condition increased “pro-social” motivation.
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A third study on gratitude was conducted with adults having congenital and adult-onset neuromuscular disorders (NMDs), with the majority having post-polio disease (PPS).
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Compared to those who were not jotting down their blessings nightly, participants in the gratitude condition reported more hours of sleep each night, spending less time awake before falling asleep, and feeling more refreshed upon awakening.
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The gratitude group also reported more satisfaction with their lives as a whole, felt more optimism about the upcoming week, and felt considerably more connected with others than did participants in the control condition.
The participants weren’t the only ones believing life was better. According to the researchers, “Spouses of the participants in the gratitude condition reported that the participants appeared to have higher subjective well-being than did the spouses of the participants in the control condition.”
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Several studies have shown depression to be strongly inversely related to gratitude. The more grateful a person is, the less depressed they are. The more depressed, the less likely one is to feel thankful for life. One researcher, Philip Watkins, clinical psychologist at Eastern Washington University, found that clinically depressed individuals showed significantly lower gratitude (nearly 50 percent less) than non-depressed controls.
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One reason may be that people who are grateful tend to show a positive recall bias (conjuring up many more pleasant memories than unpleasant ones) when asked about past life events, just as depressed individuals show a negative recall bias when asked about past life events. Watkins suggests that gratitude may help alleviate depression for three other reasons:

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Gratitude might increase a person’s potential for enjoyment of benefits and “the benevolence of the event.”
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A grateful attitude may provide useful coping skills for dealing with losses and other stressful events, such as appreciating important things that we have previously taken for granted.
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A grateful approach to life can increase one’s focus on their benefits in life.
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Marriage: the 5 to 1 ratio
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Dr. John Gottman at the University of Washington has been researching marriages for two decades. The bottom line of all that research, he concludes, is that unless a couple is able to maintain a high ratio of positive to negative encounters (5:1 or greater), it is likely the marriage will end.
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With 90 percent accuracy, Gottman can predict, often after only three minutes of observation, which marriages are likely to flourish and which will probably flounder. The formula is that for every negative expression (a complaint, frown, put-down, expression of anger) there needs to be about five positive ones (smiles, compliments, laughter).

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So, what’s the best way to create a positivity ratio? No surprises here. Gottman suggests practicing gratitude in marriage and having a goal of counting at least five blessings for every one complaint.
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Gratitude and heart health
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How about the healthy heart benefit? University of Connecticut psychologist Glen Affleck’s research showed that the explanation a person fashions for why he or she has had a heart attack has implications for future cardiac health. He and colleagues at the Department of Community Medicine and Health Care found that cardiac patients who blamed their heart attacks on others were more likely to suffer another heart attack within the next eight years. On the other hand, perceiving benefits and gains from an initial heart attack, including becoming more appreciative of life, was related to a reduced risk for subsequent attack.

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In a study at Duke University Medical Center, 3,000 patients with significant blockage who were more socially isolated were substantially less likely to say they count their blessings by comparing themselves to less fortunate others. The benefit of gratitude extended even to people who had heart transplants. At the University of Pittsburgh, a study of 119 heart transplant patients found “thankfulness and appreciation as an aspect of religious faith was positively related to their perceived physical and mental health at one year post-transplant. Thankfulness also was predictive of greater compliance with the medical regimen and of fewer difficulties with diet and medications.”
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10 steps to gratitude

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So, what’s the best way to make all these great things happen? In his book Thanks, Emmons recommends these 10 steps:

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Keep a gratitude journal daily, recording in writing what you are grateful for.
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Remember the bad. A mental comparison of how bad it was and how much better it is now really helps.
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Three questions to ask yourself:
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What have I received from ______?

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What have I given to ________?

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What troubles and difficulty have I caused ____?
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Learn prayers or meditations of gratitude.
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Come to your “senses.” Count bodily related blessings: being able to see, hear, walk, eat, etc.
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Use visual reminders, like pictures of loved ones or scenes of nature.
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Make a vow to practice gratitude.
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Watch your language. Negative talk undermines the gratitude practice.
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Go through the motions. Feelings follow words and actions.
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Think outside the box. Think of the non-obvious things to be grateful for.
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Gratitude, with practice, can become not only a habit, but a way of viewing the world. “Ain’t it Awful” is as much learned as “Ain’t it Grand,” and not nearly so much fun. No doctor’s appointment needs to be scheduled to practice gratitude, no deductible on your insurance, no personal trainer required. This amazing health remedy is yours for the taking, right now. So, say, “Thank you!”
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You are more than welcome.
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http://www.healthleader.uthouston.edu/archive/Mind_Body_Soul/2007/gratitude-1121.html
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Change in Heart Rate over Time Predicts Mortality

Change in heart rate over time predicts mortality

November 21, 2008

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Lisa Nainggolan

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Paris, France - In the first study to ever assess the prognostic value of a change in heart rate (HR) over a number of years, French doctors have found that there is a relation between this variable and mortality [1]. Dr Xavier Jouven (Hôpital Européen Georges Pompidou, Paris, France) and colleagues report their findings in a study published online November 7, 2008 in the American Journal of Cardiology.

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They found that in a cohort of healthy policemen, HR at rest and its change over five years were both predictors of death, independent of the standard cardiovascular risk factors. Those whose HR rose by more than three beats per minute (bpm) over this time period had an almost 20% increased mortality risk compared with men whose HR remained unchanged.

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Jouven told heartwire that this is "an important paper and the second step" in a jigsaw. "We knew before that a person with a high heart rate has a high mortality. Now this article shows we are advancing in the research concerning the potential association between HR and mortality."

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Change in HR over a five-year period conferred additional information beyond HR at rest and the usual risk factors.

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Dr Franz Messerli (St Luke's-Roosevelt Hospital, New York) commented to heartwire: "The present study is unique in that it shows that patients whose heart rate increased during a five-year period had an . . . increased mortality risk. Of note, the policemen who did best were the ones who had a low heart rate at the beginning of the Paris Prospective Study 1 and whose heart rate remained unchanged."Reduced HR associated with 14% lower risk of death

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The observational, although prospective, study followed 5139 asymptomatic men (aged 42 to 53 years) who were recruited from 1967 to 1972 and had their HRs measured at rest in standardized conditions every year for five consecutive years. HR change was defined as the difference between HR at examination 5 and HR at inclusion. Subjects were divided into the following tertiles: decrease >4 bpm; unchanged (from -4 to +3 bpm); or increase >3 bpm.

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After adjustments were made for confounding factors, including baseline HR at rest, compared with subjects with unchanged HRs, those with decreased HRs during the five years had a 14% decreased mortality risk (RR 0.86, 95% CI 0.74-1.00; p=0.05), whereas men with increased HRs during the five years had a 19% increased mortality risk (RR 1.19, 95% CI 1.04-1.37; p<0.012).>

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"We found that change in HR over a five-year period conferred additional information beyond HR at rest and the usual risk factors [and] was an independent predictor of mortality in middle-aged men," they observe. Exercise keeps heart rate low Messerli told heartwire that "the most common reason for a slow heart rate in young to middle-aged subjects, such as in the present study, is regular conditioning. Conceivably, therefore, subjects in this group were the ones who exercised regularly and continued to exercise regularly throughout the five-year period, thereby keeping heart rate slow.

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As expected, [body-mass index] BMI was lowest in this group. "It is of little surprise, then, that these slow-heart-rate policemen had a drastically lower mortality than those who started out with an increased heart rate [that] accelerated . . . even more during the five-year period," he added. Jouven told heartwire that the next step to prove an association will be with some kind of interventional trial aimed at investigating whether an induced HR decrease—with, for example regular exercise—is associated with a decrease in mortality risk. "If we change HR, do we change mortality?" he wondered.

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Source

.Jouven X, Empana JP, Escolano S, et al. Relation of heart rate at rest and long-term (>20 years) death rate in initially healthy middle-aged men. Am J Cardiol 2008; DOI:10.1016/j.amjcard.2008.08.071. Available at: http://www.ajconline.org/.

http://www.theheart.org/article/923023.do

What the News Media Did Not Reveal About Bill Clinton's Heart Problem

BILL CLINTON’S CHOLESTEROL, LDL, AND BLOOD PRESSURE

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One of the unique aspects of being president of the United States is that details of your medical history are made public every year. According to the results of the last exam performed before he left the White House, Bill Clinton’s total cholesterol was 233 mg/dL, which is not outrageously high. Since optimal cholesterol levels are now considered below 200 mg/dL,1 the news media made a big deal over the fact that Clinton’s cholesterol was too high.

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A more significant problem that the news media only touched on was that the former president’s LDL level was a dangerous 177 mg/dL. New guidelines call for LDL to be below 100 mg/dL, and some doctors want LDL to be below 70 mg/dL in those suffering from coronary artery disease.

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The Life Extension Foundation was first to advocate that LDL levels should be below 100 mg/dL. Until recently, most mainstream doctors believed that an LDL of 130 mg/dL was all right.

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Clinton’s blood pressure of 136/84 used to be considered acceptable, but conventional medicine has finally realized that blood pressure over 119/79 exposes one to greater risks of coronary artery disease, stroke, kidney failure, and other diseases.

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One of the drawbacks of being president is that you get free health care provided by government doctors who are not always up to date on new disease risk factors.

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Interestingly, Clinton was prescribed cholesterol-lowering medication before he left the White House, but decided on his own to stop taking the drug after losing some weight. Without first verifying that LDL and cholesterol levels are in safe ranges using a simple blood test, discontinuing any lipid-lowering therapy is a risky strategy. Regrettably, side effects from cholesterol-lowering drugs cause some patients to stop taking them without informing their doctors.

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(This is only an excerpt from the comprehensive and well-written article)

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http://www.lef.org/magazine/mag2004/nov2004_awsi_01.htm

Using Stem Cells for Heart Failure

Symptoms of Heart Failure




University of Utah researchers to use patient's own stem cells to treat heart failure

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Bone marrow cells may prove effective in regenerating heart muscle, improving function
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SALT LAKE CITY – Nov. 17, 2008 – Researchers at the University of Utah are enrolling people in a new clinical trial that uses a patient's own stem cells to treat ischemic and non-ischemic heart failure.
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The one-year Cardiac Repair Cell Treatment of Patients with Dilated Cardiomyopathy (IMPACT-DCM) study will look at the safety of injecting Cardiac Repair Cells (CRC) and their ability to improve heart function.
Patients enrolled in IMPACT-DCM will have their own bone marrow cells drawn (about 3 tablespoons worth), which will then be grown in a culture to expand the number of cells that will help the heart muscle and improve blood flow. Two weeks later, the patient's stem cells will be injected directly into the left ventricle of the heart during a minimally invasive surgery developed by Amit N. Patel, M.D., national principal investigator for the IMPACT-DCM trial and director of cardiovascular regenerative medicine at the University of Utah School of Medicine.
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"Heart failure affects about 5 million Americans, with more than half a million new cases diagnosed each year. A subset of these patients has dilated cardiomyopathy (DCM), a condition that leaves the heart weakened, enlarged and unable to pump blood efficiently. For most of these patients, the only option has been a heart transplant," said David A. Bull, M.D., professor and division chief of Cardiothoracic Surgery in the U's medical school and site principal investigator for the trial.
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"This is the first trial of its kind in the United States, providing patients who have limited to no other options with a viable treatment," said Patel, professor of surgery. "By using a patient's own cells, we eliminate the concern of rejection and the need for potentially harmful immunosuppressive drugs. We hope these cells will help with new blood vessels and support the heart muscle in order to improve the heart's function, thereby greatly improving the patient's quality of life."
Patients who have been diagnosed with congestive heart failure (NYHA Class 3 or 4) and are between the ages of 18 and 86 may be eligible to participate in the trial. The University of Utah is one of five nationwide sites conducting the IMPACT-DCM study, sponsored by Aastrom Biosciences, Inc., a company specializing in autologous cell products. IMPACT-DCM is a randomized, controlled, Phase II study that will enroll 40 patients nationwide: 20 patients with ischemic DCM and 20 patients with nonischemic DCM.

http://www.eurekalert.org/pub_releases/2008-11/uouh-uou111708.php
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Heart Failure Symptoms

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Heart failure symptoms are not always apparent. Some people in the very early stages of heart failure may have no symptoms at all. And others dismiss feeling tired and experiencing shortness of breath as signs of growing older.

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But some heart disease symptoms are more obvious. When the heart is not pumping properly or efficiently, daily activity can cause shortness of breath or difficulty in breathing when lying down. The legs and ankles may swell because the body is retaining water. Feeling weak and tired is common. Ordinary daily activities like going to the grocery store or even walking up a flight of stairs can be exhausting.

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Because of the heart’s inability to efficiently pump blood and supply your organs, such as the kidneys and the brain, you may experience a number of symptoms including:

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Shortness of breath
Swelling of the feet and legs
Lack of energy, feeling tired
Difficulty sleeping at night due to breathing problems
Swollen or tender abdomen, loss of appetite
Cough with "frothy" sputum
Increased urination at night
Confusion, impaired memory

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Your heart failure symptoms will help your doctor classify the severity of your heart failure and monitor the effects of drug and/or device therapy.
Are you at risk for heart failure? Take the Heart Failure Assessment.

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http://www.hearthelp.com/heartfailure/symptoms-heart-failure.html

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New Test to Predict Imminent Heart Attack

Test for Imminent Heart Attacks Cardiologists Discover New Enzyme that Predicts Risk of Heart Attack

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August 1, 2005 — MPO, or myeloperoxidase,is an enzyme produced by white blood cells. High levels of MPO predict a heart attack, the need for invasive intervention, or cardiac death within the next six months with 95-percent accuracy. The FDA has recently approved a simple blood test for MPO.
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CLEVELAND--For many people the first sign of heart disease is a heart attack ... And one out of three people who have a heart attack die. The problem? Current blood tests only tell doctors if a heart attack has already happened. Now a new blood test could let doctors know who needs aggressive heart help, before a heart attack happens.

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Fifty-four year old David Lesesky exercises every day with his young family. He has a lot to live for, but not too long ago, his family nearly lost him. "I thought I was running out of wind," he says. "I couldn't catch my breath."

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Lesesky was having a heart attack He knows he is lucky to be alive. He says, "I worked out. I tried to do all the right things. So I thought, if anything, I'm in great shape." This former triathlete's doctors thought so, too. Heart and stress tests didn't pick up a thing, but a dangerous blockage was forming.

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MPO, or myeloperoxidase is produced by white blood cells, the body's defense system. When there's a dangerous blockage, MPO levels in the blood increase.

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Cardiologist Stanley Hazen, of Cleveland Clinic, says, "We were able to show that this enzyme called MPO ... that elevated levels of it are seen in patients who are at risk not only for having a heart attack when they present, but also a heart attack or needing bypass surgery or needing angioplasty or dying in the next one-month to six-month period."
A simple blood test -- when performed on patients with the highest MPO levels -- predicted a heart attack, the need for invasive intervention, or cardiac death within the next six months with 95-percent accuracy.
The cardiac MPO test was recently approved by the FDA. It's not widely available yet, but it should start appearing in hospitals across the country soon.
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BACKGROUND: Doctors at the Cleveland Clinic in Ohio have developed a new test to identify those who are in imminent danger of a heart attack by measuring the level of a disease-fighting enzyme in the bloodstream. A start-up company called PrognostiX has received FDA approval to sell the diagnostic test.
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HOW IT WORKS: Enzymes are proteins in the body that control metabolism: they convert nutrients into energy and new cell tissue. Enzymes can speed up chemical processes that would otherwise take longer. They are also very specific: each type of enzyme only reacts with one specific compound. High levels of an enzyme called myeloperoxidase (MPO) in the bloodstream can signal a person's near-term risk for heaving a heart attack within months.

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WHAT CAUSES HEART ATTACKS: Heart attack is the leading cause of death in North and South America and in Europe. It is usually the result of prolonged hardening and narrowing of the arteries that direct blood into the heart. When blood vessels are healthy, oxygen-rich blood flows easily to all the muscles and organs of the body. But if they become clogged by the buildup of fatty deposits on vessel walls, blood can be cut off, killing heart muscle cells. This is called coronary heart disease, and it can lead to heart attacks or strokes.
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SIGNS OF A HEART ATTACK:
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Pressure, tightness, or burning chest pain. May extend into the jaw, shoulders, back, or arms
Nausea or vomiting
Sweating
Shortness of breath
Dizziness

http://www.sciencedaily.com/videos/2005/0812-test_for_imminent_heart_attacks.htm

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Blood Protein Offers Clues To Heart Attack In Seemingly Healthy People

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ScienceDaily (July 9, 2007) — We've all wondered how a seemingly healthy person can actually be at high risk for heart disease or a heart attack. Now researchers have uncovered a new clue to this mystery. The culprit: myeloperoxidase (MPO), a protein secreted by white blood cells that both signals inflammation and releases a bleach-like substance that damages the cardiovascular system.
See also:
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Although MPO is intended to kill harmful bacteria, it may instead inflame the body's arteries and cripple protective substances in the blood, according to a study published in the July 10, 2007, issue of the Journal of the American College of Cardiology (JACC). As a result, long before conventional risk factors set off alarms, elevated MPO levels signal that harmful plaque has been building up.

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"We were surprised to find that many years before a cardiovascular event actually occurs, MPO is increased," said Matthijs Boekholdt, M.D., Ph.D., a resident in cardiology at Academic Medical Center in Amsterdam, the Netherlands. "This could open up completely new areas of research and diagnosis. As we learn more about these processes, we hope to be able to identify 'vulnerable blood' as a reliable tool for detecting vulnerable patients."

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Not only does MPO change low-density-lipoprotein (LDL) cholesterol into a harmful oxidized form that can cause atherosclerosis, the "bleach" produced by MPO damages the arteries directly, causing cell death and erosion of the arterial lining, a process that can create unstable plaques. MPO also hampers the protective effects of high-density-lipoprotein (HDL) cholesterol and reduces the availability of nitric oxide, a natural chemical that relaxes the blood vessels.
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Earlier studies in patients with chest pain and heart disease have shown that elevated levels of MPO identify those at highest risk for a heart attack. "The novelty of the present study is that it is the first large-scale study to examine the relationship of MPO to cardiovascular risk in apparently healthy individuals," Dr. Boekholdt said.
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For the study Dr. Boekholdt and colleagues recruited healthy people living in Norfolk, United Kingdom, between 1993 and 1997, as part of a larger community-based research program known as the European Prospective Investigation Into Cancer and Nutrition (EPIC). They took baseline blood samples from each participant and froze the samples for future analysis.

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After an average of eight years, 1,138 EPIC-Norfolk participants had been admitted to the hospital or died from the effects of coronary artery disease (CAD), including heart attack. The researchers matched these patients with study participants who remained healthy throughout the follow-up period, selecting those of the same gender and similar ages and enrollment times.

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The average blood levels of MPO were significantly higher in those who developed heart disease than in those who remained healthy. In fact, when MPO levels were divided into four groups, patients in the highest fourth were 1.49 times as likely as those in the lowest fourth to develop CAD or have a heart attack. When traditional risk factors--blood pressure, LDL and HDL cholesterol levels, body mass index, smoking and diabetes--were taken into account, an MPO level in the highest fourth increased the risk of heart disease by 1.36 times.
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Equally important, elevated MPO levels signaled increased risk even in those with acceptable levels of LDL cholesterol, HDL cholesterol or C-reactive protein, a widely acknowledged marker of inflammation.
"MPO levels help to identify individuals at increased risk for CAD when traditional risk screening fails," Dr. Boekholdt said.
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The search for blood tests to help identify patients at risk for heart attack is a very important one, said Christopher Cannon, M.D., F.A.C.C., who did not participate in the study and is an associate professor of medicine at Harvard Medical School, Boston, MA. "One fascinating aspect of this study is that this marker of inflammation precedes by nearly a decade the development of clinical coronary disease," he said. "This suggests MPO could be used to catch the disease in a very early stage and help in true prevention of CAD.
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"Another interesting aspect of MPO is that it may be a marker for unstable plaque. Even more than the number or severity of coronary plaques, we want to know the risk of plaque rupture, and this evolving new marker may help in that regard. More study is needed, but among the hundreds of markers tested to date, MPO looks like a "keeper" that will one day become part of clinical care," Dr. Cannon said.

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Researchers are continuing to assess the value of MPO in different patient groups as well as in relation to other biomarkers, Dr. Boekholdt said. Key questions include whether, and under what circumstances, MPO should be added to the laboratory tests used to screen for cardiovascular disease, and whether blocking MPO could prevent cardiovascular disease.
The EPIC-Norfolk study is supported by program grants from the Medical Research Council UK and Cancer Research UK, with additional support from the European Union, Stroke Association, British Heart Foundation, and the Wellcome Trust. Some of the measurements in this study were supported by Wyeth. One of the study's authors, Stanley L. Hazen, M.D., Ph.D., is named as a co-inventor on pending patents filed by the Cleveland Clinic Foundation relating to the use of myeloperoxidase as a biomarker for cardiovascular disease.
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http://www.sciencedaily.com/releases/2007/07/070703172506.htm

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CardioMPO

http://www.prognostix.com/

Longevity Runs in Families

Children Of Centenarians Live Longer, Have Lower Risk Of Heart Disease, Stroke, Diabetes

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ScienceDaily (Nov. 21, 2008) — A recent study appearing in the November issue of Journal of American Geriatrics Society revealed that centenarian offspring (children of parents who lived to be at least 97 years old) retain important cardiovascular advantages from their parents compared to a similarly-aged cohort. The study is the first to assess the health of centenarian offspring over time and could be important for future research, as the subjects may be used as a model of healthy aging.
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The findings show that centenarian offspring have a 78 percent lower risk for heart attacks, 83 percent lower likelihood of stroke and an 86 percent lower risk of developing diabetes mellitus.

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Additionally, the study found that centenarian offspring who were followed in the study were 81 percent less likely to die than the reference group of similarly-aged patients during the follow-up period. The survival rate is evidence that longevity runs in families, and the results reinforce the notion that there may be physiological and genetic reasons that longevity runs in families.
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The results are consistent with previous research, which suggested that the avoidance or delay of cardiovascular disease and cardiovascular risk factors, including high blood pressure and diabetes, runs strongly in the families of centenarians, particularly amongst their children.
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Dellara F. Terry, co-author of the study, points out that offspring of centenarians maintain these cardiovascular advantages throughout their lives. "These advantages persisted over the several years of the study when they are compared to a similarly-aged group whose parents did not survive to very old age," Terry said.

http://www.sciencedaily.com/releases/2008/11/081120122159.htm

The word from the world's oldest person

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December 11, 2005
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Maria Capovilla was born in 1889.Photo: Reuters
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A 116-YEAR-OLD Ecuadorean woman has been declared the oldest person in the world, lifting the title from a US woman previously thought to be the oldest.
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Maria Esther Capovilla was confirmed as the oldest living person after her family sent details of her birth and marriage certificates to Guinness World Records. "We hadn't heard of her before," Kate White, brand manager at the book's publisher, said. "She's in very good health, she's got good sight … and doesn't walk with a stick."
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Ms Capovilla was born in Guayaqull in western Ecuador on September 14, 1889.
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She had five children, and has four grandchildren, nine great-grandchildren and two great-great-grandchildren.
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Asked what she thought about the changes she had seen, Ms Capovilla said "she disliked the fact that presently it's acceptable for women to pursue men", White said.
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REUTERS

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http://www.theage.com.au/articles/2005/12/10/1134086848291.html