Idea #316 for December 31st, 2009: Out In The Cold or Winter Weather Can Increase Heart Attack Risk

In colder regions of the country, winter weather poses more than just risks of hypothermia. Many people are unaware that risk of heart attack also increases when the temperature drops. In the cold, blood vessels tend to constrict in an effort to conserve body heat. As a result, blood pressure increases and the amount of oxygen that can get to the heart decreases. Couple that with strenuous winter activity — like shoveling snow — and you have a recipe for heart attack in susceptible people. For people at increased risk of of heart disease, experts recommend avoiding strenuous cold-weather activity, and they should be aware of heart attack symptoms to ensure immediate response if one occurs.

Read more about this here.

Idea #313 for December 28th, 2009: Unpleasantly Plump or Obesity Is Always Dangerous

There’s a bit of an urban myth that some obese people are able to remain quite healthy despite their weight. But it appears to be just that — a myth. A report from cardiologists in Sweden found that overweight men were significantly more likely to develop cardiovascular disease, regardless of whether they showed symptoms of metabolic syndrome. In some circles, people who are obese yet don’t show signs of metabolic syndrome (i.e. high blood sugar, hypertension, high cholesterol) were believed to be healthy, but this report indicates otherwise.

Unlike previous studies on the matter, this one from Sweden followed patients over a thirty year period. The results underscore the notion that being overweight is always unhealthy. Having low cholesterol or good blood sugar levels will not change the fact that if you are obese, your risk of cardiovascular disease is significantly higher. Overweight individuals should not feel complacent about their health status even if their blood work looks healthy.

Read more about the study here.

Idea #181 for August 18th, 2009: Raising Awareness or The Plunging Heart Attack Death Rate in Hospitals

Between 1995 and 2006, the rate of in-hospital deaths among Medicare patients suffering from heart attacks dropped from 14.5% to 10%, says a report in the Journal of the American Medical Association. At the same time, the 30-day death rate was reduced from 18.9% to 16.1%. The authors of the study credit CMS with sparking the changes the have led to these improvements in patient outcomes.

In the mid-90s, CMS changed their strategy related to quality improvement. Before then, qaulity improvement was effected by focusing only on the hospitals that had the worst outcomes. Then in the mid-90s, CMS changed course and decided to improve outcomes at hospitals across the board rather than just the outliers. CMS brought about the lower death rates, say the authors, not by forcing new standards on hospitals, but by making them aware of their own results. Legislation at the time made reporting of some data mandatory, and hospitals were made aware of stats. At the time, 39 hospitals had heart attack death rates over 24%, but by 2006, zero hospitals had death rates even as high as 20%.

Of course, other factors were at play too, like advances in cardiology, and the fact that an increasing percentage of heart attack patients were being discharged to nursing facilities instead of straight home. Yet it was the CMS strategy of sharing information and statistics to all hospitals, not just the worst offenders, that likely led to the adoption of safer practices across the board. If this strategy has been this successful among heart attack patients, hopefully CMS will use similar tactics in other areas of healthcare.

See the story about this here.

Idea #101 for May 30th, 2009: Just a Few Minutes of Your Time or Online Cardiovascular Health Assessment

A hospital near Chicago has a simple online tool that it hopes will lower the incidence of preventable heart disease. It’s a risk assessment calculator that takes only a couple minutes to complete. A staggering number of heart disease cases are preventable, and health workers’ are trying to make potential victims more aware of their risk. In fact, a physician at that hospital estimates that 90-95% of their cases of heart disease are preventable. With almost a million deaths a year in the US related to heart disease, there is clearly a need to catch early warning signs and risks of cardiovascular issues before they become deadly.

The tool asks for some basic information like age, weight, blood pressure, and family history, as well as checkboxes for a number of symptoms. Then, your estimated risk level is displayed and if the risk is determined to be high, a free cardiac screening is offered. In those cases, users enter their contact information and a nurse will follow-up by telephone.

Of the 7,000 people who’ve taken the test this year, more than a third have been deemed high-risk. Similar tools are available on other hospital websites as well. It’s a pretty low-cost way to reach out to patients who may otherwise be unable or unwilling to see a doctor. This is an example of a simple tool that should be publicized more and, hopefully, will compel potential heart disease patients to take the necessary steps to thwart the problem.

Read the story about this in the Chicago Tribune and try the test yourself here