Princess Health and Painkillers appear to increase risk of deaths other than overdoses, according to new study of Medicaid patients in Tennessee. Princessiccia

Princess Health and Painkillers appear to increase risk of deaths other than overdoses, according to new study of Medicaid patients in Tennessee. Princessiccia

cardiac care cardiovascular disease heart health narcotics pain pain management prescription drug abuse research

Gusty 07:28 Add Comment

"Accidental overdoses aren't the only deadly risk from using powerful prescription painkillers," The Associated Press reports. "The drugs may also contribute to heart-related deaths and other fatalities, new research suggests."

A study of of more than 45,000 Medicaid patients in Tennessee from 1999 to 2012 found that "those using opioid painkillers had a 64 percent higher risk of dying within six months of starting treatment compared to patients taking other prescription pain medicine," AP reports. "Unintentional overdoses accounted for about 18 percent of the deaths among opioid users, versus 8 percent of the other patients."

"As bad as people think the problem of opioid use is, it's probably worse," said Vanderbilt University professor Wayne Ray, the lead author of the study report. "They should be a last resort and particular care should be exercised for patients who are at cardiovascular risk."

The report in the Journal of the American Medical Association noted that opioids can slow breathing and worsen the disrupted breathing associated with sleep apnea, which could lead to irregular heartbeats, heart attacks or sudden death.

The patients in the study "were prescribed drugs for chronic pain not caused by cancer but from other ailments including persistent backaches and arthritis," AP reports. "Half received long-acting opioids including controlled-release oxycodone, methadone and fentanyl skin patches. . . . There were 185 deaths among opioid users, versus 87 among other patients. The researchers calculated that for every 145 patients on an opioid drug, there was one excess death versus deaths among those on other painkillers. The two groups were similar in age, medical conditions, risks for heart problems and other characteristics that could have contributed to the outcomes."

Princess Health and CDC boss Tom Frieden, at SOAR, gives examples of how communities can improve health, such as smoking bans. Princessiccia

Princess Health and CDC boss Tom Frieden, at SOAR, gives examples of how communities can improve health, such as smoking bans. Princessiccia

blood pressure cardiovascular disease heart disease hypertension obesity physical activity pregnancy smoking smoking ban smoking bans teenagers teens tobacco tobacco prevention walking

Gusty 13:08 Add Comment

By Al Cross
Kentucky Health News

PIKEVILLE, Ky. -- Speaking to a region with some of the nation's poorest health, the top federal public-health official gave examples of how individual communities and states have made themselves healthier.

"Health is not just about health, it's about society," Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, told more than 1,000 people at the Shaping Our Applalachian Region Innovation Summit in Pikeville. "Healthy societies are more productive, and productive societies are more healthy."

Referring to Kentucky's high rates of disease and factors that cause them, Frieden said bringing Eastern Kentucky's health statistics up to the national average would save more than 1,000 lives a year.

Frieden cited six communities that have tackled specific health issues, such as obesity, lack of physical activity, heart health, smoking and teen pregnancy.

Obesity is one of SOAR's three main health targets, but it's not an easy one, Frieden said. He said Somerville, Mass., reduced obesity in children under 6 by 21 percent by making it a community issue, with creation of farmers' markets for local produce, construction of walking paths and the mayor leading community walks.

"Physical activity is the closest thing to a wonder drug," Frieden said, because it helps prevent heart disease, strokes, diabetes and cancer, improved mood and lengthens life.

The leading preventable cause of death is smoking, Frieden said, calling for ordinances and laws making workplaces smoke-free. "Nobody should have to risk getting cancer to come to their job," he said.

Heart disease is the most preventable major cause of death, Frieden said, explaining how Minnesota and Grace Community Health Centers in Knox, Clay, Leslie and Bell counties have improved heart health by improving treatment of high blood pressure, or hypertension. "It's the single most important thing" to do for heart health, and it's simple, Frieden said, because the medicine is inexpensive and taken once a day with few if any side effects.

Frieden said the CDC thinks a lot about teen pregnancy because "Teen pregnancy perpetuates a cycle of poverty." He said Spartanburg, S.C., reduced teen pregnancy by 61 percent from 2001 to 2014 partly because South Carolina's Medicaid program paid for long-acting, reversible contraception immediately after delivery, and was the first state to give full reimbursement for post-partum insertion of intrauterine devices for birth control. Kentucky Medicaid doesn't cover such services.

Princess Health and Co-workers with CPR and AED training save Lexington man from 'widow maker' heart attack; now he's fine and cheering Wildcats. Princessiccia

Princess Health and Co-workers with CPR and AED training save Lexington man from 'widow maker' heart attack; now he's fine and cheering Wildcats. Princessiccia

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Gusty 07:41 Add Comment

Tim Hayden (UK photo)

This time last year, co-workers' quick actions saved a Kentucky man who suffered from a usually fatal type of heart attack because they knew how to do cardiopulmonary resuscitation and how to use an automatic external defibrillator (AED). They were able to keep him alive until he could get medical help, according to a University of Kentucky news release.

Tim Hayden, a big UK basketball fan who works at Lexington's Southern Wine and Spirits, was at a work meeting last March, hoping it would end before the Southeastern Conference Tournament games started that day, when he had the heart attack.

His doctor, Adrian Messerli, director of the heart catheterization laboratory at the UK Gill Heart Institute, said it was the type of heart attack that is often called the "widow-maker" because fewer than half of its victims survive.

"Dr. Messerli told us if Tim had been at home, or if the meeting had been scheduled later, or if he'd been in his car, this type of heart attack isn't something that people typically survive," said Harold Nikirk, Southern Wine and Spirits' field sales manager and Tim's boss.

Upon realizing that Hayden wasn't just goofing off and pretending to be snoring so they would wrap up the meeting, two of the co-workers trained in CPR immediately began it. One who was trained on the AED, a portable device that checks heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm, used it.

Everyone in the office pitched in, Nikirk said, calling 911, waving down the ambulance and moving cars and furniture out of the way to make room for the paramedics.

"I think Tim was fortunate for many reasons," Messerli said. "He was surrounded by co-workers who knew how to perform CPR and knew how to use an AED. Those critical first steps sustained Tim until we could get him the treatment he needed."

Paramedics took him to UK, where his wife Catherine works and where Dr. Messerli was waiting for him in the catheterization lab.

"With a heart attack, especially one like Tim's, every minute literally counts," Messerli said. "We were the first hospital in Lexington to allow paramedics to bypass the emergency room and go directly to the cath lab, which buys us precious time and hugely increases the patient's chances for survival."

Hayden's co-workers created
a Heart Walk team. (UK photo)

Messerli restored blood flow by inserting two stents with a catheter and placing him in a type of medically induced coma to cool his body temperature, which is "thought to protect the vital organs from damage and improves healing," Messerli said. Tim spent three weeks in the hospital.

"What's so gratifying about Tim's case is that the healing has really been complete and absolute," he said. "When I see him in the office, he's in wonderful spirits, minimal complaints, and he's doing really well."

Since then, about a dozen of SWS's 40 staffers have received CPR certification and AED training, says the release.

They have also been honored by the Lexington Fire Department for their bravery, quick thinking and knowledge of CPR and have participated in the American Heart Association's 2015 Heart Walk on #TimsTeam and raised $3,500 on his behalf.

Princess Health and Know the signs of a heart attack and don't ignore or dismiss them; quick action can be the difference between life and death.Princessiccia

Princess Health and Know the signs of a heart attack and don't ignore or dismiss them; quick action can be the difference between life and death.Princessiccia

cardiac care cardiovascular disease heart disease heart health

Gusty 10:00 Add Comment

Many people who have a heart attack initially ignore the symptoms or dismiss them. For the best chance of survival and preserving heart function, you should not ignore these symptoms, and should get help quickly.

Heart disease is the leading cause of death in the U.S. and Kentucky. Nationwide, it causes about one in four deaths. The age-adjusted death rate from heart disease in Kentucky is 208.2 per 100,000 per year, according to the federal Centers for Disease Control and Prevention.

Below are some questions and answers about the symptoms and treatment of heart attacks and narrowed aortic valves, as reported by Gina Kolata for the New York Times.

How do you know if you are having a heart attack? Most people feel pain, pressure or squeezing in their chest and about one-third of people have symptoms in addition to or instead of chest pain that include abdominal pain, heavy sweating, back pain, neck and jaw pain, nausea and vomiting, Kolata reports. WebMD adds pain that radiates down one arm, indigestion or a choking feeling, extreme weakness, anxiety or shortness of breath, and rapid or irregular heartbeats to the list.

How can you decide if symptoms other than chest pain are actually from a heart attack? If your symptoms come on suddenly, or if they worsen over a period of hours or days, call 911 and get to an emergency room. "The best time to treat a heart attack is within one to two hours of the first onset of symptoms," says WebMD. "Waiting longer increases the damage to your heart and reduces your chances of survival."

Do women have different symptoms than men? "Probably not," Dr. Mary Norine Walsh, vice president of the American College of Cardiology, told Kolata. Walsh noted that women, however, are more likely to delay seeking treatment and doctors are more likely to dismiss their symptoms, especially if the woman is younger.

The American Heart Association says women often attribute signs of a heart attack to the flu, acid reflux or the normal aging process, even though it is the number one killer of women. It also noted that symptoms in women can be subtler, like shortness of breath, upper back pressure that feels like squeezing, lightheadedness or actually fainting.

What should you do if you are having heart attack symptoms? Call 911 for an ambulance to take you to the emergency room immediately. Do not drive yourself and do not have a friend or family member drive you unless you have no other choice. Kolata notes that paramedics are trained to treat heart attacks and are less likely to get stuck in traffic.

How can you find out if your local hospital is able to treat heart attacks quickly? Don't waste time fighting with your paramedic when you are having a heart attack, they will know the best place to take you, Kolata writes.

That being said, some hospitals are faster than others in treating heart attacks, but the time to research this information is before you are in the throws of a heart attack, Kolata writes. To find out this information, she suggest you ask each hospital what its "door to balloon time" is, which will tell you how long it takes the hospital to open a blocked coronary artery with a balloon after you arrive at the emergency room. If they don't have this information, ask if they take certain steps to speed up treatment. For example ask: Do paramedics transmit a patient's electrocardiogram to the hospital en route?; Does the ER doctor read the EKG and send out a single call to summon the cardiology team?; And are the team members on call required to be within 30 minutes of the hospital?

What are the symptoms of a severely narrowed aortic valve? There are three classic symptoms of this disease of aging: shortness of breath, a feeling of heaviness and pain in the chest, and fainting, according to cardiologists. They also noted that these symptoms are often mistakenly attributed to the normal process of aging.

How can a doctor know if symptoms are caused by a narrowed aortic valve? The doctor will listen  for a heart murmur in the patient�s chest and can order an echocardiogram, which will reveal the narrowed artery and the extent of the damage.

Should everyone with a severely narrowed artery have it replaced? Not everyone should undergo treatment, Kolata reports, so ask your doctor if you are a good candidate. The latest treatment is a transcatheter aortic valve replacement, or TAVR, which allows doctors to replace valves without doing open-heart surgery. High risk patients who would have been considered at too great a risk of dying from open-heart surgery have a chance to have a valve replacement, but sometimes elderly patients whose health is compromised are not good candidates.

Princess Health and Insulin Resistance Predicts a Variety of Age-related Diseases. Princessiccia

Princess Health and Insulin Resistance Predicts a Variety of Age-related Diseases. Princessiccia

cardiovascular disease diabetes metabolic syndrome

Gusty 09:57 Add Comment

In the last post, I reviewed a study by Gerald Reaven's group showing that insulin resistance strongly predicts the risk of cardiovascular disease over a 5-year period. In 2001, Reaven's group published an even more striking follow-up result from the same cohort (1). This study shows that not only does insulin resistance predict cardiovascular disease risk, it also predicts a variety of age-related diseases, including hypertension, coronary heart disease, stroke, cancer, type 2 diabetes, and even overall mortality risk.

Read more �

Princess Health and New Study Strengthens the Case that LDL Causes Heart Disease. Princessiccia

Princess Health and New Study Strengthens the Case that LDL Causes Heart Disease. Princessiccia

cardiovascular disease

Gusty 14:00 Add Comment

There is little remaining doubt in the scientific/medical community that high levels of LDL, so-called "bad cholesterol", cause heart disease. Yet in some alternative health circles, the debate continues. A new study adds substantially to the evidence that LDL plays a causal role in heart disease.

Read more �

Princess Health andHeart attacks are leading cause of death while on the job in Kentucky; being struck by objects is No. 2, and falling is No. 3.Princessiccia

Princess Health andHeart attacks are leading cause of death while on the job in Kentucky; being struck by objects is No. 2, and falling is No. 3.Princessiccia

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Gusty 15:03 Add Comment

Heart attacks are the number one killer of Kentuckians who die on the job, according to a study conducted by the state Labor Cabinet.

The study found that in the last three years, 87 Kentuckians had fatal heart attacks while on the job. Their average age was 52. Ten of them were truck drivers, seven were machine operators and six were maintenance workers.

The study found that 28 of the victims were struck by an object, 19 fell, 17 had transportation crashes, 13 were being caught in or between objects, seven were electrocuted, and one each suffered hyperthermia or suffocation. Eight deaths in the workplace were from natural causes, such as stroke, brain aneurysm and failure of the pancreas.

Kentucky ranks 48th in the nation in cardiovascular deaths, with more than 12,000 per year, a state press release said. �Employers should do everything they can to raise awareness about cardiovascular health, and everyone needs to keep an eye on their blood pressure and cholesterol levels while paying close attention to diet and exercise,� Labor Secretary Larry Roberts said.

The study includes workplaces under the jurisdiction of the Kentucky Occupational Safety and Health Program, and do not include those monitored under federal agencies, such as the Mine Safety and Health Administration or the Federal Railroad Administration.