heart attacks


Dropping Co-Pays Boosts Adherence, Health After Heart Attack

Can free medications help solve the problem of poor adherence among heart attack patients?

A new study by researchers at Brigham & Women’s Hospital (and funded, in part, by the insurer Aetna) concludes that eliminating co-pays for drugs prescribed after a heart attack improves patients’ medication adherence rates and health outcomes without increasing overall costs.

The research, published online in The New England Journal of Medicine, split heart attack patients into two groups: one with full insurance coverage — including all prescription drugs routinely prescribed after a heart attack, including statins, beta-blockers, angiotensin-converting-enzyme (ACE) inhibitors, and angiotensin-receptor blockers — and another with usual insurance coverage, including co-pays.

While adherence rates were incredibly low in both groups, study authors write: “Rates of adherence ranged from 35.9 to 49.0% in the usual-coverage group and were 4 to 6 percentage points higher in the full-coverage group.” Continue reading

High Heat: How It Works, And Why Being Fat Adds To Risk

With a heat wave sweeping much of the nation, including a heat advisory now out for Boston, today’s excellent Los Angeles Times story on what extreme heat does to the body should be required reading.

It includes some fascinating physiological facts: Heat makes your heart beat faster to increase blood flow to the skin. For every Centigrade degree that your body’s “core temperature” rises, your heart has to beat 30 more times per minute. And once your core temperature hits 103 degrees, organs may begin to fail — in other words, I can’t resist saying, you’re cooked.

I knew that old people were particularly at risk, but the LA Times reports that obese and diabetic people are as well:

People over age 60 are most vulnerable to suffocatingly hot conditions. But if you’re not fit, if you’re overweight or if you suffer heart disease, diabetes or respiratory problems, you’re also at high risk because these conditions can hamper the body’s ability to regulate its core temperatures in extreme heat.

Fatal heatstroke occurs 3.5 times more frequently in overweight or obese adults than those of average body weight, according to research published last year in the Canadian Medical Association Journal.

Are You ‘Type D’ (For Distressed)?

A new term has just entered my vocabulary: ‘Type D’ — defined as people “marked by chronic negative emotions, pessimism and social inhibition” who “tend to experience increased levels of anxiety, irritation and depressed mood across situations and time.”

It’s been so useful to have the label “Type A” for the hard-runners who tend to take out their stress on others. Now we have “Type D” for people who direct their stress inward instead — and who, like their Type A counterparts, may run heart risks as a result.

Health journalist Karen Weintraub just tweeted this release on a new paper in an American Heart Association journal. Researchers found that Type D patients had triple the normal risk for cardiovascular problems and triple the normal risk for depression, anxiety and other psychological problems.
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