Wednesday, November 16, 2011

Women more likely to have 'broken heart syndrome' (AP)

ORLANDO, Fla. � A woman's heart breaks more easily than a man's.

Females are seven to nine times more likely to suffer "broken heart syndrome," when sudden or prolonged stress like an emotional breakup or death causes overwhelming heart failure or heart attack-like symptoms, the first nationwide study of this finds. Usually patients recover with no lasting damage.

The classic case is "a woman who has just lost her husband," said Dr. Mariell Jessup, a University of Pennsylvania heart failure specialist who has treated many such cases.

Cyndy Bizon feared that was happening when her husband, Joel, suffered a massive heart attack in 2005. "May God work through your hands," the Maine woman told the surgeon as her husband was wheeled past her into the operating room. She later collapsed at a nurse's station from "broken heart syndrome" and wound up in coronary care with him. Both survived.

Japanese doctors first recognized this syndrome around 1990 and named it Takotsubo cardiomyopathy; tako tsubo are octopus traps that resemble the unusual pot-like shape of the stricken heart.

It happens when a big shock, even a good one like winning the lottery, triggers a rush of adrenaline and other stress hormones that cause the heart's main pumping chamber to balloon suddenly and not work right. Tests show dramatic changes in rhythm and blood substances typical of a heart attack, but no artery blockages that typically cause one. Most victims recover within weeks, but in rare cases it proves fatal.

Dr. Abhishek Deshmukh of the University of Arkansas had treated some of these cases.

"I was very curious why only women were having this," he said, so he did the first large study of the problem and reported results Wednesday at an American Heart Association conference in Florida.

Using a federal database with about 1,000 hospitals, Deshmukh found 6,229 cases in 2007. Only 671 involved men. After adjusting for high blood pressure, smoking and other factors that can affect heart problems, women seemed 7.5 times more likely to suffer the syndrome than men.

It was three times more common in women over 55 than in younger women. And women younger than 55 were 9.5 times more likely to suffer it than men of that age.

No one knows why, said Dr. Abhiram Prasad, a Mayo Clinic cardiologist who presented other research on this syndrome at the conference.

"It's the only cardiac condition where there's such a female preponderance," he said.

One theory is that hormones play a role. Another is that men have more adrenaline receptors on cells in their hearts than women do, "so maybe men are able to handle stress better" and the chemical surge it releases, Deshmukh said.

Bizon was 57 when her attack occurred; she's now 63. She and her husband are pharmacists and live in Scarborough, Maine.

"I remember grabbing the counter and a black curtain coming down before my eyes," she said in a telephone interview. Her attack was so severe that she went into full cardiac arrest and had to have her heart shocked back into a normal rhythm. Although most such attacks resolve without permanent damage, she later needed to have a defibrillator implanted.

About 1 percent of such cases prove fatal, the new study shows.

"In the old days, we'd say someone was scared to death," said Prasad.

About 10 percent of victims will have a second episode sometime in their lives. And although heart attacks happen more in winter, broken heart syndrome is more common in summer.

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Online:

Heart Association, http://www.americanheart.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP



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Blood type may affect stroke risk, study finds (AP)

ORLANDO, Fla. � Your blood type might affect your risk for stroke. People with AB and women with B were a little more likely to suffer one than people with O blood � the most common type, a study found.

The research can't prove such a link. But it fits with other work tying A, B and AB to more risk of blood clots in the legs and heart attacks. Blood type O also has been tied to an increased risk of bleeding, which implies less chance of clots, the cause of most strokes.

"There's increasing evidence that blood type might influence risk of chronic disease," said one of the study leaders, Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital.

"It's not at the level where we want to alarm people and we want to make that clear. But it's one more element of risk that people would want to know about," and it could give them one more reason to keep blood pressure and cholesterol in line, she said.

The study, led by Brigham's Dr. Lu Qi, was presented Wednesday at an American Heart Association conference. It involved 90,000 men and women in two observational health studies that have gone on for more than 20 years.

Looking at the 2,901 strokes that have occurred and taking into account other things that can cause them, such as high blood pressure, researchers found:

_Men and women with AB had a 26 percent increased risk of stroke compared to those with type O.

_Women but not men with B blood had a 15 percent greater risk compared to those with O.

What's the explanation?

Blood type depends on proteins on the surface of red blood cells. A pattern of immune system responses forms early in life based on them. Certain blood types may make red cells more likely to clump together and stick to the lining of blood vessels, setting the stage for a blood clot, Manson said.

"You can't change it, and we don't know if it's the blood type per se or other genes that track with it" that actually confers risk, said Dr. Larry Goldstein, director of Duke University's stroke center.

"There are other things that are more important" than blood type for stroke risk, such as smoking, drinking too much and exercising too little, he said.

About 45 percent of whites, 51 percent of blacks, 57 percent of Hispanics and 40 percent of Asians have blood type O, according to the American Red Cross. Such people are called "universal donors" because their blood can safely be used for transfusions to any other blood type.

AB blood type is the least common type, present in 4 percent of whites and blacks, 2 percent of Hispanics and 7 percent of Asians.

B is second least common overall, in 11 percent of whites, 19 percent of blacks, 10 percent of Hispanics and 25 percent of Asians.

A is in 40 percent of whites, 26 percent of blacks, 31 percent of Hispanics and 28 percent of Asians.

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Online:

Heart Association: http://www.americanheart.org

Blood types: http://www.redcrossblood.org/learn-about-blood/blood-types

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP



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UK doctors call for ban on smoking in cars (AP)

LONDON � The British Medical Association is calling on the government to ban smoking at all times in cars, a step that would go beyond regulations elsewhere.

In research released on Wednesday, the group that represents U.K. doctors said the confined environment in cars exposes drivers and passengers to 23 times more toxins than a smoky bar. Children are particularly vulnerable to second-hand smoke since they absorb more pollutants. Smoke can linger in cars long after cigarettes have been smoked.

In countries including Australia, Canada, and parts of the U.S., smoking in cars is banned when children are present. In the U.K., smoking in public vehicles like buses and trains is banned but there is no law against smoking in private cars.

Dr. Vivienne Nathanson of the association said Wednesday that the government should now take a "bold and courageous step."



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