Men who are on the blood-thinning drug warfarin have more difficulty taking the medication if they live alone, but the same is not true for women, a new study finds. Warfarin (brand-name Coumadin) is a common anti-clotting treatment to prevent stroke in people with atrial fibrillation, the most common type of heart rhythm disorder. Continuous blood-monitoring is required for warfarin to be safe and effective. Too little of the drug may allow a blood clot to form and cause a stroke. Too much causes bleeding. Having ideal warfarin concentrations in the blood to prevent stroke and avoid bleeding is called time in therapeutic range (TTR). European Society of Cardiology (ESC) guidelines say patients should be in TTR at least 70% of the time. In this study, researchers assessed nearly 4,800 patients in Denmark with six months of continuous warfarin use and monitoring. Median TTR in men living alone was 57% — 3.6% lower than in men who lived with partners. (Median means half had longer times, half shorter.) Women who lived alone had a 0.2% lower TTR than those who lived with partners, but the difference wasn’t significant, according to the study authors. The findings were presented Monday at the annual meeting of the ESC in Paris. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal. “Men living alone had…  read on >

Teen boys who are overweight or obese may be more likely to have a heart attack before they’re old enough to retire, according to a new study. Researchers analyzed data from nearly 1.7 million men in Sweden born between 1950 and 1987 who had extensive physical exams when they entered mandatory military service at age 18. They were tracked for up to 46 years, or to age 64. During that time, more than 22,000 fatal and non-fatal heart attacks were reported in this group, which occurred at an average age of 50. A higher body mass index (BMI) at age 18 was associated with an increased risk of heart attack before age 65, even after the researchers adjusted for other factors. BMI is an estimate of body fat based on height and weight. A BMI of 30 or more is considered obese (for example, someone who’s 5 feet, 10 inches tall and weighs 209 pounds has a BMI of 30). The increased heart attack risk started at BMI 20, which is considered normal, then rose gradually. Men who had been severely obese at age 18 (BMI 35 or higher) had more than triple the risk of heart attack later in life, according to the study presented Tuesday at the European Society of Cardiology’s annual meeting, in Paris. “We show that BMI in the young is…  read on >

For people who are obese and have type 2 diabetes, weight-loss surgery leads to more than a slimmer figure. It also reduces the risk of heart complications and premature death by about 40% compared to standard medical care, new research says. The Cleveland Clinic researchers compared the impact of various types of weight-loss (bariatric) surgery to usual medical care for people with type 2 diabetes treated between 1998 and 2017. Specifically, they looked at a composite of six components, including death from any cause, heart failure, heart disease, stroke, kidney problems and an irregular heartbeat called atrial fibrillation. “When we looked at the components individually, we saw a reduction in all of those six, including the death rate,” said study lead author Dr. Ali Aminian, a bariatric surgeon at the Cleveland Clinic. Dr. Steven Nissen — chief academic officer of the Heart and Vascular Institute at Cleveland Clinic and senior author of the study — called the findings “striking.” “As a cardiologist, these findings tell me that if we can find a way to get people to lose weight, we can save a lot of lives,” Nissen said. Aminian added that primary care doctors, endocrinologists and cardiologists should regard weight-loss surgery as a tool. “Instead of adding more medications, have a conversation with a bariatric surgeon [about whether surgery would be an appropriate treatment option],”…  read on >

Men who are on the blood-thinning drug warfarin have more difficulty taking the medication if they live alone, but the same is not true for women, a new study finds. Warfarin (brand-name Coumadin) is a common anti-clotting treatment to prevent stroke in people with atrial fibrillation, the most common type of heart rhythm disorder. Continuous blood-monitoring is required for warfarin to be safe and effective. Too little of the drug may allow a blood clot to form and cause a stroke. Too much causes bleeding. Having ideal warfarin concentrations in the blood to prevent stroke and avoid bleeding is called time in therapeutic range (TTR). European Society of Cardiology (ESC) guidelines say patients should be in TTR at least 70% of the time. In this study, researchers assessed nearly 4,800 patients in Denmark with six months of continuous warfarin use and monitoring. Median TTR in men living alone was 57% — 3.6% lower than in men who lived with partners. (Median means half had longer times, half shorter.) Women who lived alone had a 0.2% lower TTR than those who lived with partners, but the difference wasn’t significant, according to the study authors. The findings were presented Monday at the annual meeting of the ESC in Paris. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal. “Men living alone had…  read on >