Lack of rehab programs leaves cardiac patients underserved globally

Rehabilitation programs must become an integral part of cardiac care to significantly reduce the burden of living with heart disease, one of the most common chronic diseases and causes of death globally, according to York University Professor Sherry Grace.

“Cardiac rehabilitation is a cost-effective program offering heart patients exercise, education and risk reduction,” says Grace, noting that participation results in 25 per cent less death, lower re-hospitalization rates and better quality of life.

Despite these benefits, cardiac rehabilitation is vastly underused, particularly compared with costly revascularization and medical therapy, according to the review Grace conducted with Karam Turk-Adawi in the Cardiovascular Rehabilitation & Prevention Unit, University Health Network (UHN), and Dr. Nizal Sarrafzadegan, director of Isfahan Cardiovascular Research Center at Isfahan University of Medical Sciences in Iran.

“Cardiac rehabilitation services are insufficiently implemented, with only 39 per cent of countries providing any,” says Grace.

Heart disease has become an epidemic in low-income and middle-income countries (LMICs), and cardiac rehab can reduce the socio-economic impact of the disease by promoting return to work and reducing premature mortality, notes to Grace, who is also the director of research at the GoodLife Fitness Cardiovascular Rehabilitation Unit at the UHN.

“If supportive health policies, funding, physician referral strategies and alternative delivery modes are implemented, we could reduce the ratio from one cardiac rehab program per 6.4 million inhabitants in a middle income country like Paraguay, to the one program per 102,000 available in the US, a high income country,” adds Grace.

Low-income countries such as Afghanistan, Bangladesh and Kenya have one rehab program each for their entire population.

The article, Global availability of cardiac rehabilitation, published online at Nature Reviews Cardiology, indicates that while 68 per cent of high-income countries have cardiac rehabilitation, only 23 per cent of LMICs do, despite the fact that 80 per cent of deaths from heart disease occur in these countries.

http://www.medicalnewstoday.com/releases/279686.php

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Study links high cholesterol to increased risk of breast cancer

A new study recently presented at the Frontiers in Cardiovascular Biology meeting in Barcelona, Spain, suggests that women who have high cholesterol may be at higher risk of developing breast cancer.

The research team, led by Dr. Rahul Potluri of the Algorithm for Comorbidities, Associations, Length of Stay and Mortality (ACALM) Study Unit at Aston University School of Medicine in the UK, says their findings indicate that statins – drugs used to reduce levels of low-density lipoprotein, or “bad”cholesterol, in the blood – could be used to prevent breast cancer.

Past research has indicated a link between obesity – which can cause high cholesterol – and increased risk of breast cancer. A 2013 study reported by Medical News Today found that the obesity status of a woman may influence the rate of breast cancer cell growth and tumor size.

The researchers note that a more recent study suggested that cholesterol levels are what feeds this association. But the team wanted to investigate the link further.

Women with high cholesterol ‘1.64 times more likely to develop breast cancer’

To reach their findings, the investigators analyzed information from the ACALM clinical database between 2000 and 2013, which included more than 1 million patients.

Of the 664,159 women in the database, 22,938 had hyperlipidemia, or high cholesterol, and 9,312 had breast cancer. The team found that 530 of the women who had high cholesterol developed breast cancer.

Using a statistical model, the researchers estimated that women with high cholesterol were 1.64 times more likely to develop breast cancer than women with normal cholesterol levels.

The researchers say although their findings are purely observational at this point, they could have important long-term implications for women with high cholesterol.

Dr. Potluri says:

“We found a significant association between having high cholesterol and developing breast cancer that needs to be explored in more depth.

Caution is needed when interpreting our results because while we had a large study population, our analysis was retrospective and observational with inherent limitations. That said, the findings are exciting and further research in this field may have a big impact on patients several years down the line.”

According to the American Cancer Society, breast cancer is the second leading cause of death among women in the US. This year alone, approximately 232,670 American women will be diagnosed with invasive breast cancer.

The researchers point out that if their findings are validated through further research, they would like to see whether reducing cholesterol with statins could also lower the risk of breast cancer.

“Statins are cheap, widely available and relatively safe,” says Dr. Potluri. “We are potentially heading towards a clinical trial in 10-15 years to test the effect of statins on the incidence of breast cancer. If such a trial is successful, statins may have a role in the prevention of breast cancer especially in high risk groups, such as women with high cholesterol.”

Medical News Today recently reported on a study by researchers from University College London in the UK, which revealed the development of a simple blood test that could predict how likely a woman is to develop breast cancer.