COPD

Heart Health Month

February is Heart Health Month

Heart disease is the leading cause of death for both men and women in the United States. The good news? It is also one of the most preventable.  Making heart-healthy choices, knowing your family health history and the risk factors for heart disease, having regular check-ups and working with your physician to manage your health are all integral aspects of saving lives from this often silent killer.  FEBRUARY IS HEART HEALTH MONTH.  Make a difference in your community by spreading the word about strategies for preventing heart disease and encouraging those around you to have their hearts check and commit to heart-healthy lives. The following article is from www.theheartfoundation.org  and includes information on common risk factors of heart disease and how to reduce your risk. Share it with your friends and family and help spread awareness this heart health month!

 

How to Reduce Your Risk

  1. Choose a Heart Healthy Lifestyle.
    • Engage in regular moderate aerobic exercise for at least 30 minutes five days a week or more vigorous workouts at least 20 minutes three times a week.
    • Adopt a diet low in salt, saturated and transfats and high in unsaturated fats (fish, avocado, etc.) like the Mediterranean Diet.
    • Maintain a normal body weight with caloric adjustment.
    • Take fish oil supplements.
    • Avoid smoking and recreational drug use.
    • Imbibe no more than ½ to 1 alcoholic beverage per day.                                                                  

Know and review your risk factors with a trusted physician.

  1. Your physician may recommend medications to control cholesterol, hypertension and diabetes.
  2. High-risk individuals should consider taking a daily aspirin.
  3. Avoid hormone replacement unless you have severe menopausal symptoms.
  4. In selected cases, it may be necessary to conduct non-invasive or even invasive tests to determine the nature and severity of the heart disease.
  5. Sometimes angioplasty/stenting or even bypass surgery may be needed if you have severe and symptomatic arterial blockage.
  6. Learn CPR.
  7. And as Dr. P.K. Shah always recommends, CHOOSE YOUR PARENTS WISELY!

 

Common Risk Factors for Heart Disease

 

Age
Heart disease can occur at any age. However, four out of five people who die from coronary heart disease are aged 65 or older. The risk of stroke doubles with each decade after the age of 55.

 

Gender
Men and women are equally at risk for heart disease, but women tend to get coronary artery disease an average of 10 years later than men. The risk for women increases as they approach menopause and continues to rise as they get older. Death rates from heart disease and stroke for women are twice as high as those for all forms of cancer.

 

Family History (Heredity)
Presence of heart disease in a parent or sibling, especially at a young age, increases your risk of developing heart disease.

 

Smoking
Smokers are twice as likely to suffer heart attacks as non-smokers, and they are more likely to die as a result. Smoking is also linked to increased risk of stroke.  The nicotine and carbon monoxide in tobacco smoke damages the cardiovascular system. Passive smoking may also be a danger. 46 million Americans (25 million men and 21 million women) smoke.  Women who smoke and take the oral contraceptive pill are at particularly high risk of heart disease and stroke.

 

Cholesterol
The higher the blood cholesterol level, the higher the risk of coronary heart disease, particularly if it is combined with any of the other risk factors. Diet is one cause of high cholesterol – others are age, sex and family history. High levels (over 100 mg/dl) of LDL (low-density lipoprotein), or “bad cholesterol”, are dangerous, and low levels (under 40 mg/dl in men and under 55 mg/dl in women) of HDL (high-density lipoprotein), or “good cholesterol”, increase the risk of heart disease and stroke. High levels (over 150 mg/dl) of triglycerides (another type of fat), in some, may also increase the risk of heart attack and stroke.Nearly 40 million Americans have high cholesterol levels.

 

High Blood Pressure
High blood pressure (over 140/90 mmHg and over 130/80 mmHg in diabetics) increases the risk of heart attack, stroke, aneurysm, and kidney damage. When combined with obesity, smoking, high cholesterol or diabetes, the risk increases several times. High blood pressure can be a problem in women who are pregnant or are taking high-dose types of oral contraceptive pill. 72 million Americans over age 20 have high blood pressure.

 

Physical Inactivity
Failure to exercise (walking or doing other moderate activities for at least 30 minutes five days a week or more vigorous workouts at least 20 minutes three times a week) can contribute to an increased risk of coronary heart disease as physical activity helps control weight, cholesterol levels, diabetes and, in some cases, can help lower blood pressure.

 

Obesity
People who are overweight are more likely to develop heart disease and stroke, even if they have none of the other risk factors. Excess weight causes extra strain on the heart; influences blood pressure, cholesterol and levels of other blood fats – including triglycerides; and increases the risk of developing diabetes. 66% of Americans over age 20 are obese.

 

Alcohol
Small amount of regular alcohol consumption (1/2 to 1 drink per day for women and 1-2 drinks per day for men) can reduce risk of heart disease. However, drinking an average of more than one drink a day for women or more than two drinks a day for men increases the risk of heart disease and stroke because of the effect on blood pressure, weight and levels of triglycerides – a type of fat carried in the blood. Binge drinking is particularly dangerous.

 

Drug Abuse
The use of certain drugs, particularly cocaine and amphetamines, has been linked to heart disease and stroke.  Cocaine can cause abnormal heartbeat which can be fatal while heroin and opiates can cause lung failure. Injecting drugs can cause an infection of the heart or blood vessels.

 

Diabetes
The condition seriously increases the risk of developing cardiovascular disease, even if glucose levels are under control. More than 80% of diabetes sufferers die of some form of heart or blood vessel disease.

 

Previous Medical History
People who have had a previous heart attack or stroke are more likely than others to suffer further events.

 

Stress, Depression, Anger/Hostility
Stress, depression, and negative emotions have also been linked to an increased risk of heart disease.

Source: http://www.theheartfoundation.org/heart-disease-facts/reducing-your-risk

Bronchodilator Combo Works Best for COPD

Bronchodilator Combo Works Best for COPD

Bronchodilator Combo Works Best for COPD

 

Bronchodilator Combo Works Best for COPD

 

NBN Infusions delivers comprehensive services to patients of all ages, from pediatric to geriatric, providing a full range of care for Home Infusion Therapy. NBN Infusions on-site, licensed pharmacy can provide prescription medications, equipment, supplies and skilled nursing care needed for Home Infusion Therapy.

Home Infusion Therapy is a more convenient and cost-effective option than traditional inpatient therapy, with care administered in the comfortable surroundings of one’s own home. Home Infusion Therapy allows for a more active role in one’s own health care. It can also ease stress and anxiety that is sometimes associated with inpatient treatment, resulting in better patient outcomes.

 

CHICAGO — Combining bronchodilators formoterol (Foradil Aerolizer) and aclidinium (Tudorza Pressair) in a single twice-daily inhaler was better than either drug alone in chronic obstructive pulmonary disease (COPD), a randomized trial showed.

 

The combination of the long-acting beta2 agonist and long-acting muscarinic antagonist (LABA/LAMA) had a significantly stronger impact on lung function measured by forced expiratory volume in 1 s (FEV1) both at peak and trough time points compared with the single agent inhalers and compared with placebo.

 

The safety profile came out similar to either drug alone and to placebo, Anthony D’Urzo, MD, of the University of Toronto, and colleagues reported in the AUGMENT trial here at the CHEST meeting.

 

“For patients with moderate-to-severe COPD, a fixed-dose combination of two agents with different mechanisms of action is often recommended for improved bronchodilation, patient compliance, and cost-effectiveness,” D’Urzo noted at the late-breaking clinical trial session.

 

A variety of other fixed-dose combination inhalers are in development for COPD, noted Charles Powell, MD, chief of pulmonary, critical care, and sleep medicine at Mount Sinai Hospital in New York City.

 

“I think we can look for multiple drugs that combine LABA and LAMA medications into single device being introduced into clinical practice,” Powell said in an interview. “As of today, there are none yet available in the United States but I believe we can look forward to seeing multiple drugs with multiple actions available, these could include even a triplet of a LABA, LAMA, and a long-acting corticosteroid. I believe that’s the future.”

 

A once-daily LABA/LAMA combination of glycopyrronium/indacaterol showed promising results in cutting COPD exacerbations compared with either single agent in the SPARK trial last month.

 

While a single dose of a single inhaler would be convenient, some patients might benefit more from a twice-daily regimen, commented late-breaking session co-chair Andrew Berman, MD, director of pulmonology at Rutgers New Jersey Medical School in Newark.

 

“When you deliver that second dose at the 12-hour point, when they get an additional boost from the drug, some of our patients who are brittle really do benefit from that,” he told MedPage Today. “This group of patients is usually using rescue inhalers periodically through the day, so a b.i.d. drug is not really one that is inconvenient.”

 

The trial included 1,692 moderate-to-severe COPD patients randomized to aclidinium alone at 400 mcg, formoterol alone at 12 mcg, the combination at those doses, the combination with a lower 6-mcg dose of formoterol, or placebo for 24 weeks.

 

For one co-primary endpoint, FEV1 after the morning dose was 87 mL higher with the combination using the lower dose of formoterol and 108 mL higher with full dose combination than with aclidinium alone (both P<0.0001), showing the additive effect of formoterol.

 

For the other co-primary, change from baseline at the trough drug concentration before the morning dose was 45 mL greater with the full dose combination than with formoterol as monotherapy (P=0.0102).

 

The lower formoterol dose combination had a 26 mL advantage at trough over the formoterol monotherapy inhaler, but this didn’t reach statistical significance.

 

All four treatment arms came out significantly better than placebo on both measures, as expected.

 

The main point of the trial was to show that the combination wasn’t worse than monotherapy, which it did, Berman pointed out.

 

D’Urzo called the combination well-tolerated, with a rate of treatment-emergent adverse events of 61% to 64% compared with 57% and 62% in the monotherapy arms and 55% in the placebo group.

 

“Common treatment emergent adverse events were not different than in other trials looking at other compounds in same class,” he noted.

 

The most common were cough (4% to 5%), nasopharyngitis (5%), and headache (4% to 5%).

 

The trial included smokers and nonsmokers, which D’Urzo pointed to as supporting generalizability to clinical practice.

 

“The reality is there are still many patients with COPD out there who smoke,” he said.

 

Longer-term data is needed with the combination to see impact on COPD exacerbations, quality of life, and mortality, Powell noted.

 

Originally posted: MedPageToday.com 

 

 

Enhanced by Zemanta