Recovering from Sudden Cardiac Arrest

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Dr. Chuck Bush-Joseph from Midwest Orthopaedics at Rush and Steve Kashul talk with Jacob Holler about his cardiac event, what he learned from that experience and his remarkable recovery. Jacob Holler is a Physical Therapist and Clinical Director at ATI Physical Therapy in Abingdon, MD.

Sports Medicine Weekly on 670 The Score

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Study: A Daily Baby Aspirin Has No Benefit For Healthy Older People

Daily low-dose aspirin can be of help to older people with an elevated risk for a heart attack. But for healthy older people, the risk outweighs the benefit.

Many healthy Americans take a baby aspirin every day to reduce their risk of having a heart attack, getting cancer and even possibly dementia. But is itreally a good idea?

Results released Sunday from a major study of low-dose aspirin contain a disappointing answer for older, otherwise healthy people.

“We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly,” says Anne Murray, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis, who helped lead the study.

The study involved more than 19,000 people ages 65 and older in the United States and Australia. The results were published in three papers in the New England Journal of Medicine.

There is still strong evidence that a daily baby aspirin can reduce the risk that many people who have already suffered a heart attack or stroke will suffer another attack.

And there is some evidence that daily low-dose aspirin may help people younger than 70 who have at least a 10 percent risk of having a heart attack avoid a heart attack or stroke, according to the latest recommendations from the U.S. Preventive Services Task Force.

But for older, healthy people, “the risks outweigh the benefits for taking low-dose aspirin,” Murray says.

The primary risk is bleeding. The study confirmed that a daily baby aspirin increases the risk for serious, potentially life-threatening bleeding.

Surprisingly, those who took daily aspirin also appeared to be more likely to die overall, apparently from an increased risk of succumbing to cancer. That was especially unexpected given previous evidence that aspirin might reduce the risk for colorectal cancer.


Related: Panel Says Aspirin Lowers Heart Attack Risk For Some


The researchers stressed, however, that the cancer finding might have been a fluke. There’s also a possibility that any colorectal cancer benefit wasn’t seen because the subjects had only been followed for about five years.

Regardless, the findings raise serious questions as to whether otherwise healthy older people should routinely take low-dose aspirin.

“A lot of people read, ‘Well, aspirin is good for people who have heart problems. Maybe I should take it, even if they haven’t really had a heart attack,’ ” Murray says. But “for a long time there’s been a need to establish appropriate criteria for when healthy people — elderly people — need aspirin.”

That’s why the researchers launched their study, called ASPREE, in 2010. It involved 19,114 older people, with 16,703 in Australia and 2,411 in the United States. The U.S. portion included white volunteers ages 70 and older, and African-Americans and Hispanics subjects ages 65 and older.

Participants took either 100 milligrams of aspirin every day or a placebo. People in the study were followed for an average of 4.7 years.

“We were hoping that an inexpensive, very accessible medication might be something that we could recommend to elderly to maintain their independence but also decrease their risk of cardiovascular disease,” Murray says.

But based on the findings, Dr. Evan Hadley of the National Institute on Aging, which helped fund the study, says any elderly people taking aspirin or thinking about it should think twice.

“This gives pause and a reason for older people and their physician to think carefully about the decision whether to take low-dose aspirin regularly or not,” Hadley says. “And in many cases the right answer may be: Not.”

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Cardiac rehabilitation: Getting more fit may mean easing into HIT!

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Globally, heart disease still is the number one killer among chronic diseases. Exercise-based cardiac rehabilitation (CR) programs are an effective strategy for helping heart patients improve their health and reduce their risk for heart-related deaths. CR programs currently have patients perform moderate-intensity continuous exercise (MICE).

This traditionally involves walking, jogging, or stationary cycling at a comfortable pace for 30-60 minutes. In this study, the investigators measured fitness levels in heart patients performing a progression of higher-intensity interval training (HIT).

This HIT approach involved short bouts of exercise performed at near maximal effort, followed by recovery periods of slower exercise. HIT outcomes were compared to those from traditional MICE. A total of 772 patients participated and were assigned to HIT or MICE groups for 26 weeks of training; group assignment was balanced according to age and sex.

Results showed that progressive HIT improved fitness levels significantly more than did MICE in patients participating in CR. In addition, HIT improved several other risk factors for heart disease, including depression, more than did MICE. These findings may enhance how exercise training is provided in health care to improve the lives of heart patients.

For more information, view the abstract

American College of Sports Medicine

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Heart Health

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You don’t have to spend a lot of money or take medication to maintain a healthy heart, just follow these guidelines:

  1. Quit smoking.  Smoking causes high blood pressure, decreases exercise tolerance, increases blood clotting, and double the odds of a heart attack.
  2. If you drink alcohol, do so in moderation. Alcohol can increase the blood pressure and in higher doses can significantly weaken heart muscle.
  3. Exercise the heart as much as you would do for any other muscle to help strengthen it and keep it healthy. 30 minutes a day of moderate intensity exercise, such as brisk walking five days a week, or 20 minutes of vigorous activity, such as jogging three days a week.  Try to make your exercise enjoyable (bring a friend or listen to music) and be persistent.
  4. Eat plenty of fiber such as fruits, nuts, whole grains and vegetables. Avoid saturated fats such as those found in most meats, chicken skin and many dairy products.  Instead, eat good fats such as olive oil, nuts, avocados and olives.
  5. Maintain a normal blood pressure. High blood pressure increases the work load on the heart and eventually will cause it to become thicker, stiffer and weaker.  This can lead to heart attacks and heart failure.
  6. Maintain as normal a weight as possible. As with hypertension, excess weight also increases the workload of the heart leading to the same end result of heart damage. Recent research shows that people who carry most of their weight around their middle (apple shaped as opposed to pear shaped), are at an even greater risk of heart disease.
  7. Controlling diabetes is important because up to three quarters of people with diabetes will die of some form of heart disease.
  8. Keep calm. Stress triggers the release of certain hormones that have an adverse effect on the heart muscle.  Studies have shown that clam and happy people have fewer heart attacks than those who are angry and discontent.  “Don’t worry – be happy”.
  9. Avoid salt as much as possible especially if you have high blood pressure. The recommended daily limit of salt is 2,300 mg. (one teaspoon). Try to avoid processed food and read food labels to steer clear of the worst offenders.
  10. Maintain levels of vitamin D. Research shows that people with low levels of vitamin D were twice as likely to have a heart attack as those who have adequate levels. The new 2010 recommended daily allowance (RDA) is 600 IU for those 1-70 years of age, and pregnant or breastfeeding women, and 800 IU for those over 71 years of age.

The above guidelines are tried and true methods of significantly improving your odds of decreasing heart disease and thereby promoting a healthier, happier, and longer life.

Valley Doctor

Health Related Articles by Terry Hollenbeck, M.D.

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