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AHA: Excessive Screen Time for Kids May be Marker of Future Heart Disease Risk
Kids' 'Screen Time' Linked to Early Markers for Cardiovascular Disease
Study Highlights:
Children who had the most hours of screen time, particularly in front of the television, had narrower arteries in the eyes — a possible indicator for future heart disease risk.
Children with the highest levels of physical activity had wider retinal arterioles.
The magnitude of vessel narrowing for each hour of screen time was similar to a 10 millimeter of mercury rise in systolic blood pressure.
DALLAS, April 20, 2011 /PRNewswire-USNewswire/ -- Six-year-olds who spent the most time watching television, using a computer or playing video games had narrower arteries in the back of their eyes — a marker of future cardiovascular risk, in a first-of-its-kind study reported in Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association.
Australian researchers found that more sedentary behavior such as "screen time" was associated with an average narrowing of 2.3 microns in the retinal arteriolar caliber. A micron is one thousandth of a millimeter or one-25th of a thousandth of an inch.
In the study, 6- to 7-year-olds who regularly participated in outdoor physical activity had 2.2 microns wider average retinal arteriolar compared to those children with the lowest level of activity.
The magnitude of the narrowing associated with each hour of television/computer viewing was similar to that associated with 10 millimeters of mercury (mm HG) increase in systolic blood pressure in children, researchers said.
"We found that children with a high level of physical activity had a more beneficial microvascular profile compared to those with the lowest levels of physical activity," said Bamini Gopinath, Ph.D., lead author and senior research fellow at the Center for Vision Research at the University of Sydney. "This suggests that unhealthy lifestyle factors may influence microcirculation early in life and increase the risk of cardiovascular disease and hypertension later in life."
Retinal microvascular caliber is a marker for cardiovascular disease and high blood pressure in adults. But this is the first time that a sedentary lifestyle in childhood showed a narrowing of the vessels in the retina that could be a subclinical marker for cardiovascular disease in the future.
The study included 1,492 children in 34 primary schools in Sydney, Australia. Parents answered a 193-item questionnaire, providing the number of hours spent each week in indoor and outdoor physical activity and sedentary activity such as watching television, videogames, computer time and reading. Researchers took digital photographs of the vasculature in the back of each child's eye, then calculated average retinal vascular calibers. Height, weight, body mass index (BMI) and three separate blood pressure measurements were taken and averaged.
On average, the children spent 1.9 hours per day in screen time and 36 minutes a day in total physical activity. Children in the highest levels of physical activity at just over an hour or more had significantly wider average retinal arteriolar caliber than those spending just under half an hour or less per day.
Increased screen time was associated with narrower average retinal arteriolar diameter after adjusting for age, sex, ethnicity, iris color, length of the eyeball, BMI, birth weight and blood pressure. Each hour per day of TV viewing time was associated on average with 1.53 microns narrower retinal arteriolar caliber.
"Excessive screen time leads to less physical activity, unhealthy dietary habits and weight gain," Gopinath said. "Replacing one hour a day of screen time with physical activity could be effective in buffering the effects of sedentariness on the retinal microvasculature in children. Free play should be promoted and schools should have a mandatory two hours a week in physical activity for children."
Physical activity enhances endothelial function and increases blood flow resulting in enhanced nitric oxide production, which has a positive effect on the linings of blood vessels.
The researchers said their findings might not be applicable to other regions of the world because of the temperate climate in Australia, where children are more apt to play outdoors. Study limitations included the use of parental rather than objective measurement of the children's time spent in physical and sedentary activities.
"Parents need to get their children up and moving and off the couch," Gopinath said. "Parents can also lead the way by being more physically active themselves."
Co-authors are: Louise A. Baur, Ph.D.; Jie Jin Wang, Ph.D.; Louise Hardy, Ph.D.; Erdahl Teber, Ph.D.; Annette Kifley, M.B.B.S.; Tien Y. Wong, M.D., Ph.D.; and Paul Mitchell, M.D., Ph.D. Author disclosures are on the manuscript.
Australian National Health and Medical Research Council, Westmead Millennium Institute and Vision Co-operative Research Centre funded the research.
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.
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Highlights of Article by Dr. Erik Hess et of Mayo Clinic ;CIRCOUTCOMES 2012
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Chest pain is the 2nd most common reason patients come to EDs across the United States
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Initial testing – including information obtained from the history, physical exam, electrocardiogram, and cardiac troponin – identifies > 98% of heart attacks
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To avoid missing a diagnosis of heart attack or pre-heart attack symptoms, emergency physicians often admit patients to observation units or to the hospital for extensive diagnostic testing, including stress testing
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This results in false positive test results, unnecessary exposure to radiation, and unnecessary downstream procedures such as stent placement in arteries of the heart
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Decision aids are evidence-based tools designed to educate and engage patients in decisions regarding their care
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We hypothesized that patients who were educated regarding their future risk for a heart attack and engaged in the decision of whether to be admitted to the observation unit for stress testing or to follow-up with a Mayo Clinic heart doctor in the next 72 hours would have greater knowledge about their short-term risk for heart attack, be more aware of the management options, and choose less intensive approaches to evaluation
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We randomly assigned 204 patients who came to the ED with chest pain and were being considered for observation unit admission to the decision aid or to usual care
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Decision aid patients:
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Had greater knowledge regarding their short-term risk for a heart attack
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Less frequently decided to be admitted to the observation unit for stress testing
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Had 4 times greater engagement in the decision making process
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Had no adverse events within 30 days of the ED visit
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Take home points
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Patients want to be educated and engaged in decisions regarding their care
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Once properly informed and engaged in treatment decisions, patients often choose less intensive treatment options
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Integrated health systems like the Mayo Clinic in which physicians collaboratively work together to provide ER patients ready access to outpatient follow-up have potential to improve the value of Emergency care
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Glucose, Insulin and Potassium (“GIK”) TO MINIMIZE IMPACT OF HEART ATTACKS BEFORE PATIENTS GET TO THE HOSPITAL
Study puts life-saving drugs in the hands of paramedics, decreasing rate of cardiac arrest and death from heart attacks
CHICAGO (March 27, 2012) — Paramedics can potentially reduce someone’s chances of having a cardiac arrest or dying by 50 percent by immediately administering a mixture of glucose, insulin and potassium (“GIK”) to people having a heart attack, according to research presented today at the American College of Cardiology’s 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.
The study showed that patients who received GIK immediately after being diagnosed with acute coronary syndrome — which indicates a possible heart attack is either in progress or on the way — were 50 percent less likely to have cardiac arrest (a condition in which the heart suddenly stops beating) or die than those who received a placebo, although the treatment did not prevent the heart attack from occurring. The reduction in in-hospital cardiac arrest or death was a “secondary endpoint”, so statistically was not definitive, but was consistent with how GIK seems to work in experimental models of heart attack.
The effect was also present for patients with ST-elevation heart attacks, which require immediate treatment. For those patients, immediate GIK was associated with a 60 percent reduction in in-hospital cardiac arrest or death.
“When started immediately in the home or on the way to the hospital — even before the diagnosis is completely established — GIK appears not completely prevent any heart attack from occurring, but appeared in this trial to reduce the size of heart attacks and to reduce by half the risk of having a cardiac arrest or dying,” said Harry P. Selker, MD, MSPH, executive director of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, who led the study with Joni Beshansky, RN, MPH, co-principal investigator and project director. “Acute coronary syndromes represent the largest cause of death in this country. GIK is a very inexpensive treatment that appears to have promise in reducing those deaths and morbidity.”
The cost of the treatment is about $50.
“Because the trial is the first to show GIK could be effective when used by paramedics in real-world community settings, it could have important implications for the treatment of heart attacks,” Dr. Selker said. Previous clinical trials have shown no consistent effect, likely because the GIK was given too late to help. This study, the “IMMEDIATE Trial,” was the first to test the effectiveness of administering GIK at the very first signs of a threatening heart attack, in the community, rather than waiting hours until the diagnosis was well-established at a hospital, as done in previous clinical trials.
“We wanted to do something that is effective and can be used anywhere,” said Dr. Selker. “We’ve done a lot of studies of acute cardiac care in emergency departments and hospitals, but more people die of heart attacks outside the hospital than inside the hospital. Hundreds of thousands of people per year are dying out in the community; we wanted to direct our attention to those patients.”
The researchers trained paramedics in 36 Emergency Medical Services systems in 13 cities across the country to administer GIK after determining that a patient was likely having a threatened or already established heart attack using electrocardiograph-based ACI-TIPI (acute cardiac ischemia time-insensitive predictive instrument) and thrombolytic predictive instrument decision support that prints patient-specific predictions on the top of an electrocardiogram. The paramedics used these predictions to decide if a patient would likely benefit from treatment. There were 911 patients randomized to receive either the GIK treatment or a placebo.
Administering GIK immediately also reduced the severity of the damage to the heart tissue from the heart attack. On average, 2 percent of the heart tissue was destroyed by the heart attack in people receiving GIK, compared with 10 percent in those who received the placebo. Although a significant proportion of suspected heart attacks are later determined to be false alarms (23 percent in this study), administering GIK does not appear to cause any harmful effects in such patients.
The research team will follow up with study participants at six and 12 months to evaluate the longer-term benefit of the GIK treatment.
This study was funded by the NIH’s National Heart, Lung and Blood Institute.
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Amazon.com 's Editorial Reviews
Angina: New Ways to Treat
Chronic Chest Pain
Part of the award winning public television series Healthy head
/Healthy Mind. It's one of the scariest medical symptoms for people who are generally healthy: a tightening, painful feeling in the chest known as Angina. In some cases this chest pain can be a serious warning that requires immediate treatment. But for the millions of people with chronic, stable angina the discomfort is something that can be readily managed with a variety of treatments. In this program we take a look at what generally causes angina, what can be done to prevent it and how it can be effectively treated with lifestyle changes, innovative drug therapies and medical procedures.
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Amazon.com Editorial Review:
Philips HeartStart Home Defibrillator (AED)
Be prepared for the unexpected.
When sudden cardiac arrest (SCA) strikes, the electrical system of the heart short circuits, causing the heart to quiver rather than pump in a normal rhythm. It typically results in the abnormal heart rhythm know as ventricular fibrillation (VF). It usually happens without warning and the majority of people have no previously recognized symptoms of heart disease. And it most often happens at home. For the best chance of survival from SCA caused by VF, a defibrillator should be used within 5 minutes. Yet, less than 1 in 20 people survive largely because a defibrillator does not arrive in time.
Just as seat belts or airbags do not save every life in a traffic accident, a defibrillator will not save every person who suffers a sudden cardiac arrest. Yet many lives could be saved if more people could be reached more quickly.
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