Narrowed Leg Arteries Disable Women Faster Than Men: Study

Women coping with peripheral arterial disease (PAD) in the legs appear to lose mobility faster than men, new research reveals. PAD is marked by narrowing and blockages of the peripheral arteries, usually those in the legs and pelvis. The most common symptoms are pain, cramping and tiredness in the leg or hip muscles when walking or climbing stairs symptoms that go away during rest. "The bottom line is that among those with lower extremity PAD, women have faster declines in mobility and functional performance compared to men," said study author Mary M. McDermott, a professor of medicine.

"This may be related to gender differences in calf muscle, as women tend to have less calf muscle compared to men," McDermott added. She and her colleagues report their findinsg in the Feb. 8 issue of the Journal of the American College of Cardiology. Both the researchers and the American Heart Association note that an estimated 8 million American men and women are affected by lower extremity PAD, with disease prevalence being split about equally across genders. To examine whether disease progression differs among men and women, between 2002 and 2009 McDermott and her team tracked the progress of 380 male and female patients with PAD of the legs in the Chicago area.

All the participants were 59 and older. Over a four-year period, annual mobility assessments were conducted during which each patient was asked to complete a quarter mile, six-minute walk, as well as a four-minute speed test, to observe the development of disability. Changes in calf muscle measurements and characteristics were also noted, alongside knee extension strength. Overall, the research team determined that after adjusting for age, women fared more poorly than men over the course of the study. As the study period unfolded, they noted that women ended up walking less per week and had more difficulty walking the quarter-mile.

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Omega-3 Supplements Won't Fight Irregular Heartbeat

Omega-3 fatty acid supplements don't cut back on recurrences of atrial fibrillation, a type of irregular heartbeat that can cause stroke, new research suggests. "We now have definitive data that they don't work for most patients with AF," said Dr. Peter R. Kowey, lead author of a study appearing in the Dec. 1 issue of the Journal of the American Medical Association that is also scheduled to be presented Monday at the American Heart Association's annual meeting in Chicago. "Although we can't exclude the possibility of efficacy in sicker AF patients, it would be hard to believe that it would work in that population and not in healthier patients. So for practical purposes, yes, the end of the line in AF."

This study, the largest of its kind, looked at patients with AF who were otherwise healthy. "We cannot say there is any convincing evidence of a role for omega-3 in the prevention of atrial fibrillation," added Dr. Ranjit Suri, director of the Electrophysiology Service and Cardiac Arrhythmia Center at Lenox Hill Hospital in New York City, who was not involved with the trial. The study was funded by GlaxoSmithKline. Omega-3 fatty acids, which are found in fatty fish such as salmon and albacore tuna, had showed some promise in preventing heart disease in earlier trials. Of the total 663 outpatient participants, 542 had paroxysmal atrial fibrillation, which appears suddenly and resolves on its own, and 121 had persistent atrial fibrillation, which needs treatment.

Participants were randomized to receive either a placebo or 8 grams of omega-3 supplements daily for the first week, followed by 4 grams a day for the remaining 23 weeks of the trial. The doses used in the study are available only by prescription and are "higher than doses previously published in studies," said Dr. Robert Block, a cardiologist and assistant professor of community and preventive medicine at the University of Rochester Medical Center. At the end of six months, 46 percent of those in the placebo group and 52 percent of those taking omega-3 supplements experienced recurrences. The numbers of paroxysmal AF patients in the placebo and treatment groups who had AF recurrences were about equal, the investigators found.

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CPR Guidelines May Lower Out-of-Hospital Death Rate

When implemented, the American Heart Association's 2005 guidelines on cardiopulmonary resuscitation (CPR) can dramatically boost survival rates among people being treated outside a hospital setting, according to an expert report. A case report on the effectiveness of the new guidelines is scheduled to be presented Saturday at the AHA's annual meeting in Chicago by Dr. Michael Dailey, an associate professor of emergency medicine at Albany Medical College. Dailey also serves as medical director of emergency medical services (EMS) for the town of Colonie, N.Y., population 80,000. He said that local implementation of the AHA directives beginning in 2006 translated into a quadrupling of survival rates in his community over a three-year period.

Adoption of the guidelines took many forms, including the expansion of CPR training along the lines of the AHA's "CPR Anytime" format. Since 2005, about 200 Colonie residents a year have been trained in CPR, Dailey said. In addition, the town has embraced other AHA suggestions, such as the use of impedance threshold devices, faster deployment of mechanical CPR devices, bringing down emergency response times by upwards of a full minute, a commitment to performing two minutes of CPR before applying defibrillation, and favoring a period of high quality CPR prior to application of advanced airway placement and IV access. Also, as of 2009, once in the hospital, resuscitated patients in comas have received therapeutic hypothermia, he added. Since 2005, Colonie has also opened three Level One cardiac arrest centers.

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Fish Oil Might Help Fight Gum Disease

Eating even moderate amounts of omega-3 fatty acids, typically found in foods such as salmon and other fatty fish, may help ward off gum disease, new research suggests. Researchers divided nearly 9,200 adults aged 20 and up participating in the National Health and Nutrition Examination Survey between 1999 and 2004 into three groups based on their consumption of omega-3 fatty acids. Consumption was assessed by asking participants to recall exactly what they'd eaten during the prior 24 hours. Dental exams showed participants in the middle and upper third for omega-3 fatty acid consumption were between 23 percent and 30 percent less likely to have gum disease than those who consumed the least amount of omega-3 fatty acids.

Specifically, the researchers found that the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) were associated with less gum disease. The association with linolenic acid (LNA) was not statistically significant. "Eating a very feasible amount of fatty fish seems to have a lot of benefit," said senior study author Dr. Kenneth Mukamal, an associate professor of medicine at Harvard Medical School. "But we found no benefits to eating tons of this stuff." Since the study was a snapshot of a single day's diet, Mukamal said researchers could not determine exactly how much fish oil people should consume regularly.

The following guidelines from major organizations such as the American Heart Association, which recommends eating fatty fish at least twice a week, is probably a good idea, not just for gum disease but for overall health, they noted. "There are a lot of benefits of omega-3 fatty acids. We have good evidence they prevent sudden death caused by heart rhythm disturbances. We have some evidence omega-3 fatty acids can reduce the risk of heart attacks and stroke," Mukamal said. "This is a great example of another potential benefit." In the study, researchers took into account other factors that could affect the likelihood of having gum disease, such as age, income, education and other health and socioeconomic factors.

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New CPR Guidelines Emphasize Compressions First

Don't fret about mouth-to-mouth. The average, untrained person can still save a life by focusing on chest compressions first, say new guidelines from the American Heart Association. The simplified form of cardiopulmonary resuscitation, or CPR, focuses on giving chest compressions to keep the blood and the oxygen in the blood flowing to the heart and brain. The group's advice comes on the heels of studies in the past year trumpeting that a compression-only approach is as good or better than compression plus mouth-to-mouth. It updates guidelines from 2005.

"For a variety of reasons, when someone suddenly collapses in cardiac arrest, people often don't start any type of CPR, and one of the barriers, we believe, is that people think it's fairly complicated to do CPR," explained Dr. Michael Sayre, co-author of the new guidelines and chairman of the American Heart Association's emergency cardiovascular care committee. "But chest compressions alone are easy, and anyone can do it," he said. "Chest compressions actually act like an artificial heart, pumping blood to the heart and brain," Sayre noted. "And, that blood often will have a reserve of oxygen."

The American Heart Association recommends that if an adult is unresponsive and not breathing or is having occasional unusual breaths that sound like gasping, any bystander should first call 911 and then begin chest compressions. If someone else is nearby, send that person in search of an automatic external defibrillator, a device that can shock the heart back into normal rhythm. "To give the victim the best chance of survival, three actions must occur within the first moments of a cardiac arrest: activation of the EMS system, provision of CPR and operation of a defibrillator," the new guidelines state.

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