Heart Disease

December 4, 2019

As life expectancy and fertility rates decline, health politics more key than ever

Ohio, Pennsylvania, Kentucky, and Indiana — if you’re obsessed with national politics, these states might register in your mind as key partisan battlegrounds. But if you’re focused on Americans’ health and well-being, these states — along with New Hampshire, Maine, Vermont, and West Virginia — may be causes for different and considerable concern: the nation’s plummeting life expectancy.

These states are flashing warning signs, racking up the greatest relative increases in death rates among young and middle-aged adults (New Hampshire, Maine, Vermont, West Virginia, and Ohio).

Excess deaths among Americans in their prime, that is individuals in the 25 to 64 age group who would live longer if mortality rates improved, also were highly concentrated geographically, with fully a third of them in just four states: Ohio, Pennsylvania, Kentucky and Indiana, experts say.

November 17, 2019

Drugs are better for heart patients than surgery (except in mid-heart attack), study finds

by Patrick A. Malone

Tens of thousands of patients with serious but stable heart disease soon may see themselves treated more with prescription drugs and less with rushed surgeries, especially bypass procedures or operations that seek to open clogged blood vessels with wire cages called stents.

A possible shift away from stents — which have come under question for some time now — may be accelerated by the just-announced findings of a $100 million, multi-year study of more than 5,000 heart patients at 320 sites and in 37 countries. The research, the New York Times reported, sought to provide rigorous and more incontrovertible evidence on procedures that now are a bulwark of heart care:

“[The study dubbed] Ischemia is the largest trial to address the effect of opening blocked arteries in non-emergency situations and the first to include today’s powerful drug regimens, which doctors refer to as medical therapy. All the patients had moderate to severe blockages in coronary arteries. Most had some history of chest pain, although one in three had no chest pain in the month before enrollment in the study. One in five experienced chest pain at least once a week. All participants were regularly counseled to adhere to medical therapy. Depending on the patient’s condition, the therapy variously included high doses of statins and other cholesterol-lowering drugs, blood pressure medications, aspirin and, for those with heart damage, a drug to slow the heart rate. Those who got stents also took powerful anti-clotting drugs for six months to a year. Patients were randomly assigned to have medical therapy alone or an intervention and medical therapy. Of those in the intervention group, three-quarters received stents; the others received bypass surgery. The number of deaths among those who had stents or bypass was 145, compared to 144 among the patients who received medication alone. The number of patients who had heart attacks was 276 in the stent and bypass group, compared with 314 in the medication group, an insignificant difference.”

November 6, 2019

Heart failure deaths spike as nation ages and diabetes and obesity abound

by Patrick A. Malone

Although many Americans fret that old age will afflict them with cognitive impairment, from Alzheimer’s or another form of dementia, it may be that their hearts will give way first.

Experts have expressed growing concern about increasing issues with rises in heart disease, especially in the elderly, and a new study appearing in the online medical journal “JAMA Cardiology” provides explanation why these fears are well-founded: After a period of decline, deaths due to heart failure are spiking.

As the Wall Street Journal reported: “The death rate from the chronic, debilitating condition [of heart failure] rose 20.7% between 2011 and 2017 and is likely to keep climbing sharply.”

November 1, 2019

Too many spoons full of sugar going down in kids’ drinks

by Patrick A. Malone

Grownups shouldn’t be surprised that child obesity is a major and rising concern for 1 in 5 of the nation’s young, putting their short- and long-term health at serious peril: That’s because Big Sugar and major food makers persist in a costly, relentless barrage on kids and adults for unhealthful products, notably sweet drinks that hook children into hard-to-break habits for a lifetime.

Although pediatricians and nutrition experts keep warning that babies and tots, especially, should get much lower amounts of sugar in various forms in their daily diet, almost “two-thirds of the $2.2 billion in beverages marketed to children contained added sweeteners, according to a report released last week by the Rudd Center for Food Policy & Obesity at the University of Connecticut,” the New York Times reported.

Rudd researchers found that just three food industry titans sprinkled $21 million in advertising for sugary liquids.

September 8, 2019

As deaths and lung damage cases rise, isn’t it clear that vaping is unhealthy?

by Patrick A. Malone

How well does Scott Gottlieb, the former federal Food and Drug Commissioner, sleep at night? Or does he even pause to think much about his role in opening the door to what has become a widening and lethal health menace: vaping and e-cigarettes?

The federal Centers for Disease Control and Prevention has joined with respected specialists in public health and lung disorders to urge the public, most especially young Americans, to stop vaping and using e-cigarettes at least until authorities can sort out an outbreak of serious problems connected with the trendy practices involving inhaling of substances catalyzed by electric devices.

Vaping suddenly has been implicated in 450 cases in 33 states and it has been tied to at least five deaths. Dozens of young people have been hospitalized, some with significant and sustained lung damage requiring extensive medical treatment.

September 3, 2019

Transplant patient’s nightmares illustrate why patients fear and loathe medical bills

by Patrick A. Malone

It may be bad for the blood pressure. But to understand a key reason why Americans seethe when talking about medical bills and medical costs, just start perusing a timely new magazine report on hospitals and debt collection.

The Atlantic article — “What Happens When You Don’t Pay a Hospital Bill” — details the horrors and frustrations experienced by Joclyn Krevat, an occupational therapist in New York. She sought medical care for what she thought was a nasty case of flu. She, instead, suffered from a severe heart inflammation — and ended up undergoing a costly and physically draining heart transplant.

Weak, sick, and on the brink, Krevat still was hounded by out-of-control debt collectors — cruel men and women who not only lack hearts of their own but who engage in relentless, often ridiculous tactics (like trying to connect on social media, just to harp on patients there about their bills) to wring pennies out of those with illness and injury, reported writer Olga Khazan.

July 28, 2019

Can lives be saved with lessons learned from a space pioneer’s botched care?

by Patrick A. Malone

Neil Armstrong served as a naval aviator, test pilot, federal administrator, and a university professor. He earned his place in history as space pioneer — the first astronaut to walk on the moon. The American hero, who spoke the legendary phrase about “one small step for man and one giant leap for mankind,” also now offers a textbook case about nightmares in health care. Can others avoid these by learning about what happened to him?

As the nation celebrates the 50^th anniversary of Armstrong’s Apollo 11 flight, an anonymous tipster has disclosed information to two news organizations that his death was due to botched care. His family, which included a lawyer who represented their interests, reached a $6 million settlement with the community hospital involved.

Armstrong was known for keeping out of the media and public glare. His family kept that tradition in keeping private how he died in 2012, why, and the tense negotiations that resulted in the sizable payment to them by the hospital. Full information about his case may never be fully disclosed. But it already provides a possible series of check points for patients to protect themselves and their loved ones in dealing with doctors and hospitals:

June 3, 2019

As doctors warned UNC about heart surgery program, kids kept dying

by Patrick A. Malone

Although big hospitals may love to pat themselves on the back and boost their profits and professional standings by claiming to offer “comprehensive” services, children may suffer and die due to the reality versus the hubris of institutions’ excessive initiatives with specialized care.

Officials at the University of North Carolina blew past anguished warnings from their own pediatric cardiology staff of significant problems in the pediatric heart surgery program at the medical center’s children’s hospital, the New York Times reported. Brushing aside their concerns about a lack of resources within and to support the program, UNC declined to make public, as most similar specialty efforts do, key performance measures. They would show that the UNC pediatric heart surgery program had a higher death rate than “nearly all 82 institutions that do publicly report” this and other measures of patient care.

The newspaper, in a rare move, has internal tape recordings of doctors disputing among themselves whether dwindling resources, staff departures, and other problems meant that UNC should do what many of the specialists demanded — take a long hard look at what was going wrong, and, in the meantime, refer sick kids to other institutions to safeguard their care.

May 31, 2019

FDA’s dubious oversight of heart devices: hidden complaints and shaky tests

by Patrick A. Malone

Cardiac patients may wish to take to heart how news reports have undercut federal regulators’ claims that they provide the most rigorous oversight to medical devices that treat complex conditions in ways that pose the greatest risk. With certain heart pumps and defibrillator units, both implanted in patients, the Federal Food and Drug Administration deserves criticism for putting the interests of device makers ahead of patients, excellent stories by the Kaiser Health News Service and Axios show.

KHN reporter Christina Jewett followed up her investigation into how FDA bureaucrats let device makers file 1.1 million reports of injuries or malfunctions with their products to a little-known internal agency database, discovering how this practice contributed to what one cardiologist described as “the worst cardiac device problem” he has seen in a quarter-century of practice.

The incidents involved the Sprint Fidelis, a small device surgically installed in hundreds of thousands of patients to monitor and supposedly to administer small shocks to deal with their irregular heartbeat. Instead, the device — especially due to problems with its corroding and cracking electrical leads — gave patients random jolts, failed to perform in genuine emergencies, and led to a torrent of complaints and deaths. Doctors, medical researchers, and patients forced into wide public view the substantial defects of the defibrillator, including in congressional hearings.

May 7, 2019

Did FDA just let Big Tobacco put another burn on Americans’ health?

by Patrick A. Malone

Federal regulators appear to be getting caught flat-footed yet again as Big Tobacco’s harms metastasize before their very eyes. The federal Food and Drug Administration has given a qualified go-ahead to Philip Morris International to sell a device that heats but does not burn tobacco, a process that appears to expose users to fewer harmful toxins.

Still, the iQOS gadget packs the same wallop of highly addictive nicotine as does a standard, tobacco-burning cigarette. And the FDA decided it would be regulated just as cigarettes are, thereby restricting its sales and marketing to young people.

Big Tobacco executives talked up iQOS (eye-kos) as yet another way for smokers of their proven and deadly burned tobacco cigarettes to get unhooked from them and to lessen their health harms.