April 2013 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for April 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

More Than One-Third of Stroke Patients Don't Utilize EMS

TUESDAY, April 30 (HealthDay News) -- More than one-third of stroke patients still do not use emergency medical services (EMS), despite the fact that EMS use is linked to significantly more rapid evaluation and treatment, according to a study published online April 29 in Circulation: Cardiovascular Quality and Outcomes.

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FDA Approves Kcentra to Reverse Anticoagulation

TUESDAY, April 30 (HealthDay News) -- Kcentra (prothrombin complex concentrate, human) has been approved by the U.S. Food and Drug Administration to treat severe acute bleeding in adults after administration of warfarin and similar products.

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Renewed Efforts From AAFP to Repeal OTC Provision in ACA

TUESDAY, April 30 (HealthDay News) -- Members of the American Academy of Family Physicians (AAFP) and other medical associations are urging further consideration of Section 9003 of the Patient Protection and Affordable Care Act (ACA) that requires holders of tax-preferred health care accounts to obtain a physician's prescription to use funds from those accounts to pay for over-the-counter (OTC) medications. The concerns have been laid out in a letter to the chair and the ranking member of the House Committee on Ways and Means.

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Mediterranean Diet Adherence Cuts Cognitive Impairment

MONDAY, April 29 (HealthDay News) -- Greater adherence to a Mediterranean diet (MeD) is associated with a lower likelihood of incident cognitive impairment (ICI), especially among those without diabetes, according to a study published in the April 30 issue of Neurology.

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FDA Announces New Network to Focus Exclusively on Patients

MONDAY, April 29 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new interactive tool for educating patients, their advocates, and consumers about the processes involved in medication development.

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Medical Interns Spending Less Time With Patients

FRIDAY, April 26 (HealthDay News) -- Medical interns are spending less time with patients and more time at a computer since new rules limiting total work hours were instituted in 2011, according to a study published online April 18 in the Journal of General Internal Medicine.

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L-Carnitine Found to Improve Heart Attack Outcomes

FRIDAY, April 26 (HealthDay News) -- L-carnitine significantly improves patient outcomes following heart attack, according to a review published online April 17 in the Mayo Clinic Proceedings.

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Saturday Marks Sixth Annual Rx Drug Take-Back Day

FRIDAY, April 26 (HealthDay News) -- United States residents across the nation will have an opportunity to safely and anonymously unload expired, unwanted prescription medications on Saturday, April 27, during the sixth annual National Prescription Drug Take-Back Day.

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Risk of Delay in Response to Patient E-Mails Up Over Weekend

THURSDAY, April 25 (HealthDay News) -- The risk of delays in opening and responding to primary care patient e-mail communication is significantly worse at the weekends, according to a study published in the April/June issue of Quality Management in Health Care.

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Physicians Less Empathetic in Talking to Heavy Patients

THURSDAY, April 25 (HealthDay News) -- Primary care physicians (PCPs) are less likely to bond with overweight and obese patients, according to research published online March 20 in Obesity.

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Air Pollution Linked to Marker of Atherosclerosis

THURSDAY, April 25 (HealthDay News) -- Greater exposure to air pollution is associated with greater progression of carotid artery thickness, a marker of atherosclerosis, according to a study published online April 23 in PLOS Medicine.

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One 12-Ounce Sweet Drink a Day Ups Risk of T2DM 22 Percent

THURSDAY, April 25 (HealthDay News) -- Consumption of sweetened soft drinks correlates with the incidence of type 2 diabetes in European adults, with one 12-ounce daily increase in sweetened soft drinks correlating with a 22 percent increase in risk of the disease, according to a study published online April 25 in Diabetologia.

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Prevalence, Costs of Heart Failure Estimated for 2030

THURSDAY, April 25 (HealthDay News) -- The impact of heart failure is likely to increase, with more than eight million U.S. adults anticipated to have heart failure by 2030, at an estimated total cost of $70 billion, according to a study published online April 24 in Circulation: Heart Failure.

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Analgesics in Endurance Events Can Have Serious Adverse Effects

THURSDAY, April 25 (HealthDay News) -- Analgesic use before endurance sports can cause serious medical events, according to a study published online April 19 in BMJ Open.

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Teens Targeting Strength, Cardio Fitness Battle Insulin Resistance

THURSDAY, April 25 (HealthDay News) -- Lower levels of abdominal muscle strength and cardiorespiratory fitness (CRF) in youth are independently associated with adverse levels of fasting insulin, insulin sensitivity, and β-cell function in young adulthood, according to a study published online April 11 in Diabetes Care.

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Diabetes Target Achievement Up From 1999 to 2010, More Needed

WEDNESDAY, April 24 (HealthDay News) -- For U.S. adults with diabetes there has been an improvement in achievement of targets from 1999 to 2010, but many still do not meet the recommended goals, according to research published in the April 25 issue of the New England Journal of Medicine.

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Intestinal Microbiota Tied to Proatherosclerotic Metabolite

WEDNESDAY, April 24 (HealthDay News) -- Production of the proatherosclerotic metabolite trimethylamine-N-oxide (TMAO) is dependent on intestinal microbiota metabolism, and increased TMAO levels correlate with the risk of major adverse cardiovascular events, according to a study published in the April 25 issue of the New England Journal of Medicine.

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AMA Reveals First Step Toward Improving Health Outcomes

WEDNESDAY, April 24 (HealthDay News) -- The American Medical Association (AMA) has announced the first stage of its improving health outcomes initiative, which aims to optimize the health of the nation with a focus on preventing cardiovascular disease and type 2 diabetes.

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Diagnostic Errors Are the Leading Type of Malpractice Claim

WEDNESDAY, April 24 (HealthDay News) -- In the past 25 years, diagnostic errors have been the leading type of malpractice claim and account for the highest proportion of total payments, according to a study published online April 22 in BMJ Quality & Safety.

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Peri-Noncardiac Op Exposure to β-Blockers Improves Outcome

TUESDAY, April 23 (HealthDay News) -- For patients undergoing major noncardiac surgery with two or more Revised Cardiac Risk Index factors, early exposure to β-blockers is associated with improved 30-day postoperative outcome, according to research published in the April 24 issue of the Journal of the American Medical Association.

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Patient Characteristics Impact CABG-PCI Treatment Effect

TUESDAY, April 23 (HealthDay News) -- In the community setting, coronary artery bypass graft (CABG) surgery is associated with reduced mortality versus percutaneous coronary intervention (PCI), with the association affected by patient-level characteristics, according to a study published in the April 23 issue of the Annals of Internal Medicine.

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Behaviors Indicative of More Trips to Buffet Table Identified

TUESDAY, April 23 (HealthDay News) -- Surveying the food options before eating and using a smaller plate could result in less trips to the buffet at all-you-can-eat restaurants and buffets, according to a research letter published in the April issue of the American Journal of Preventive Medicine.

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Pediatric HIV Antiretroviral Treatment Cardioprotective

TUESDAY, April 23 (HealthDay News) -- HIV-infected children treated with highly active antiretroviral therapy (HAART) have better cardiac function than untreated children, according to a study published online April 22 in JAMA Pediatrics.

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Alternative Approaches May Be Beneficial for Lowering BP

MONDAY, April 22 (HealthDay News) -- Non-dietary, non-drug, alternative approaches could be beneficial as adjuvant modalities for lowering blood pressure, according to a scientific statement published online April 22 in Hypertension.

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One-Year Survival Up for Critical Congenital Heart Defects

MONDAY, April 22 (HealthDay News) -- For infants with critical congenital heart defects (CCHDs), one-year survival has improved over time, with an increased risk of mortality associated with earlier diagnosis, low birth weight, and maternal age, according to a study published online April 22 in Pediatrics.

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Hair Analysis Can Show Elevated Cortisol Levels

FRIDAY, April 19 (HealthDay News) -- Elevated levels of the stress hormone cortisol, detectable in hair samples, is associated with increased risk of cardiovascular disease, according to a study published online April 17 in the Journal of Clinical Endocrinology & Metabolism.

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Community Gardening Programs Linked to Lower BMI

FRIDAY, April 19 (HealthDay News) -- Male and female participants in community gardening programs have significantly lower body mass indexes (BMIs) than their neighbors and siblings, according to a study published online April 18 in the American Journal of Public Health.

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Patient-Centered Decision Making Ups Health Outcomes

FRIDAY, April 19 (HealthDay News) -- Patient-centered decision making (PCDM) is associated with improved health care outcomes, according to a study published in the April 16 issue of the Annals of Internal Medicine.

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Pot Smoking Linked to Some Metabolic Changes

FRIDAY, April 19 (HealthDay News) -- Regularly smoking pot is associated with visceral adiposity and adipose tissue insulin resistance, but not other metabolic changes such as impaired β-cell function or hepatic steatosis, according to a study published online March 25 in Diabetes Care.

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NH-proBNP Strongly Predicts Cardiac Mortality in T2DM

THURSDAY, April 18 (HealthDay News) -- NH2-terminal probrain natriuretic peptide (NT-proBNP) predicts the risk of cardiovascular (CV) mortality in patients with type 2 diabetes without previous CV disease (CVD), according to a study published online April 5 in Diabetes Care.

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Family-Centered Teaching Rounds Good for Patients, Students

THURSDAY, April 18 (HealthDay News) -- Teaching and conducting rounds in the presence of patients and their families can be beneficial for patients and learners, according to research published online April 15 in Pediatrics.

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Guidelines Issued Relating to Online Medical Professionalism

THURSDAY, April 18 (HealthDay News) -- Physicians should be aware of the benefits on online media and should recognize the implications for patient confidentiality and public perception, according to a position paper published in the April 16 issue of the Annals of Internal Medicine.

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Relative Proportion of MRSA Increasing in S. aureus Isolates

THURSDAY, April 18 (HealthDay News) -- The relative proportion of methicillin-resistant Staphylococcus aureus (MRSA) is increasing in S. aureus isolates, and methicillin-sensitive S. aureus (MSSA) is becoming increasingly resistant to antibiotics, according to a study published in the April issue of JAMA Dermatology.

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Essay Questions Conventional Etiology of Obesity

THURSDAY, April 18 (HealthDay News) -- To progress in the fight against obesity it is necessary to accept that there may be alternative hypotheses underlying its etiology and be prepared to invest the necessary time and resources to understand the underlying causes, according to an essay published online April 16 in BMJ.

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Community Benefit Spending Varies for Tax-Exempt Hospitals

WEDNESDAY, April 17 (HealthDay News) -- There is considerable variation in the level of community benefit expenditure by tax-exempt hospitals, according to a study published in the April 18 issue of the New England Journal of Medicine.

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High Resting Heart Rate Linked to Increased Mortality in Men

WEDNESDAY, April 17 (HealthDay News) -- For healthy middle-aged men, resting heart rate (RHR) is associated with an increased risk of mortality, according to a study published online April 17 in Heart.

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Presenting Fee Data to Docs Cuts Number of Tests Ordered

WEDNESDAY, April 17 (HealthDay News) -- Presenting fee data to providers at the time of laboratory test orders is associated with a small reduction in the number of tests ordered, according to a study published online April 15 in JAMA Internal Medicine.

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Left Anterior Fascicular Block May Not Be a Benign Finding

WEDNESDAY, April 17 (HealthDay News) -- Left anterior fascicular block (LAFB) is associated with an increased risk of atrial fibrillation (AF), congestive heart failure (CHF), and death in older adults without apparent cardiovascular disease, according to research published in the April 17 issue of the Journal of the American Medical Association.

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Shock Waves Improve Coronary Stem Cell Treatment

TUESDAY, April 16 (HealthDay News) -- In patients with chronic heart failure, cardiac shock wave pretreatment before intracoronary infusion of bone marrow-derived mononuclear cells (BMCs) significantly but modestly improves heart function, according to a study published in the April 17 issue of the Journal of the American Medical Association.

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Overall Prevalence of Healthy Lifestyle Behaviors Is Low

TUESDAY, April 16 (HealthDay News) -- The prevalence of healthy lifestyle behaviors in patients with either a coronary heart disease (CHD) or stroke event is low in various countries with different income levels, but those living in poorer countries have the lowest prevalence, according to research published in the April 17 issue of the Journal of the American Medical Association.

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Some Triggered Fainting May Be Inherited

TUESDAY, April 16 (HealthDay News) -- Some inherited cases of vasovagal syncope, or fainting caused by particular triggers, are linked to a particular region of chromosome 15q26, according to a study in the April 16 issue of Neurology.

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Factors Weighing in on Long-Term Diabetes Survival Studied

MONDAY, April 15 (HealthDay News) -- Those able to survive with type 2 diabetes (T2DM) for more than 40 years are more likely to have better glycemic control, lower blood pressure, and more favorable lipid profiles, according to a study published online April 5 in Diabetes Care.

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Risk of New-Onset Diabetes Varies With Different Statins

THURSDAY, April 11 (HealthDay News) -- Different types and doses of statins seem to correlate with distinct risks of developing new-onset diabetes mellitus (DM), according to a meta-analysis published in the April 15 issue of The American Journal of Cardiology.

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Intensive Glucose Control Improves CVD Risk Factors

MONDAY, April 15 (HealthDay News) -- Intensive glucose-lowering therapy (INT) is associated with favorable changes in lipoprotein levels and inflammatory risk factors even though it does not lower the incidence of cardiovascular events, according to a study published online March 27 in Diabetes Care.

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FDA Warns Consumers of Dangers of the Stimulant DMAA

MONDAY, April 15 (HealthDay News) -- The U.S. Food and Drug Administration is attempting to halt distribution of dietary supplements that contain the stimulant dimethylamylamine (DMAA), following reports of illness and death associated with these supplements.

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Vitamin D Not Tied to Subclinical Atherosclerosis in T1DM

FRIDAY, April 12 (HealthDay News) -- For individuals with type 1 diabetes, low concentrations of vitamin D metabolites are not associated with an increased risk of subclinical atherosclerosis, according to a study published online March 25 in Diabetes Care.

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Cardiac Function Unaffected by Prior Intensive Insulin Therapy

FRIDAY, April 12 (HealthDay News) -- There was no effect of intensive versus conventional insulin therapy during the Diabetes Control and Complications Trial (DCCT) on cardiac parameters as assessed by cardiac magnetic resonance (CMR) in the Epidemiology of Diabetes Interventions and Complications (EDIC) cohort (follow-up to the DCCT), but prior glycemic exposure had an impact on cardiac parameters, according to research published online March 21 in Diabetes.

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Drug-Facilitated Weight Loss Benefits Cardiometabolic Status

FRIDAY, April 12 (HealthDay News) -- Obese and overweight patients with dyslipidemia or hypertension treated with phentermine and topiramate extended-release (PHEN/TPM ER) for weight loss had significant improvements in cardiovascular disease risk factors, according to research published in the April 15 issue of The American Journal of Cardiology.

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Speech Details Practices to Improve U.S. Health Systems

THURSDAY, April 11 (HealthDay News) -- There are specific steps health care providers and policymakers should take to create high-quality, patient-centered care at lower costs, according to remarks made in an April 9 speech to the National Press Club.

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Sales Representatives Provide Inadequate Safety Information

THURSDAY, April 11 (HealthDay News) -- Pharmaceutical sales representatives (PSRs) rarely inform primary care physicians about drug safety information during sales visits, according to research published online April 10 in the Journal of General Internal Medicine.

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Overweight Adults Back Weight-Loss Health Benefits

THURSDAY, April 11 (HealthDay News) -- Most overweight adults feel that specific weight-loss benefits offered by health plans would be helpful, but few are willing to pay extra for them, according to a study published online April 9 in the American Journal of Preventive Medicine.

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Population-Wide Weight Loss, Gain Linked to Diabetes Burden

WEDNESDAY, April 10 (HealthDay News) -- Based on the Cuban experience of 1980 to 2010, population-wide weight loss and regain seem to correlate with the burden of diabetes and heart disease, according to a study published online April 9 in BMJ.

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Patients Using Different Rx Strategies to Save Money

TUESDAY, April 9 (HealthDay News) -- Adults in the U.S. who are poor or uninsured are more likely to ask for lower-cost alternatives or not to take their prescribed medications, according to research published in the April NCHS Data Brief.

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Radiation-Linked Heart Disease Ups Death in Cardiothoracic Sx

TUESDAY, April 9 (HealthDay News) -- Radiation-associated heart disease (RAHD) correlates with an increased risk of death in patients undergoing cardiothoracic surgery (CTS), according to a study published online April 8 in Circulation.

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Amiodarone Treatment Is Linked to Higher Cancer Risk

MONDAY, April 8 (HealthDay News) -- Amiodarone treatment for arrhythmias is associated with a higher risk of developing cancer, particularly in males and with increasing dose, according to a study published online April 8 in Cancer.

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Less Sodium, More Potassium Can Have Major Health Impact

MONDAY, April 8 (HealthDay News) -- Lowering salt intake and increasing potassium intake are associated with cardiovascular risk improvements and could have a major impact on global health, according to three meta-analyses published April 4 in BMJ.

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Risk of Comorbidities Up With Hypoglycemia in T2DM

MONDAY, April 8 (HealthDay News) -- For patients with type 2 diabetes, hypoglycemia, regardless of its severity, correlates with a significantly increased risk of cardiovascular events, all-cause hospitalization, and mortality, according to research published in the April issue of Diabetes Care.

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Novel Digital Stethoscope Detects Coronary Artery Disease

FRIDAY, April 5 (HealthDay News) -- An advanced digital electronic stethoscope that detects coronary artery microbruits showed high sensitivity and specificity in detecting coronary artery disease (CAD) when compared to computed tomographic (CT) angiography, according to research published in March 15 issue in The American Journal of Cardiology.

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Statins Show Protective Effect Against Acute Kidney Injury

FRIDAY, April 5 (HealthDay News) --Initiating a statin prior to coronary artery bypass grafting (CABG) surgery may modestly reduce the risk of acute kidney injury (AKI) post-CABG, especially in patients less than 65 years old, according to research published March 15 in The American Journal of Cardiology.

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Walking Reduces CHD Risk Factors as Much as Running

FRIDAY, April 5 (HealthDay News) -- Equivalent energy expenditure by moderate- or vigorous-intensity exercise is associated with similar risk reductions in coronary heart disease risk factors, according to a study published online April 4 in Arteriosclerosis, Thrombosis, and Vascular Biology.

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Prevalence of Self-Reported Hypertension Rises in U.S.

THURSDAY, April 4 (HealthDay News) -- The prevalence of self-reported hypertension among U.S. adults increased slightly, but significantly from 2005 to 2009, and the proportion of adults using anti-hypertensive medications also increased, according to research published April 4 in Morbidity and Mortality Weekly.

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Mortality Predictors in CV Implantable Device Infection ID'd

THURSDAY, April 4 (HealthDay News) -- Infective endocarditis related to a cardiovascular implantable electronic device (CIED), corticosteroid therapy, and other comorbidities are tied to reduced short- and long-term survival, according to a study published in The American Journal of Cardiology.

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Male Vertex Baldness Linked to Coronary Heart Disease

THURSDAY, April 4 (HealthDay News) -- Male vertex baldness is associated with an increased risk of coronary heart disease (CHD), with the association depending on the severity of baldness, according to a meta-analysis published online April 3 in BMJ Open.

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Low Risk With Normal Coronary Arteries, Nonobstructive CAD

THURSDAY, April 4 (HealthDay News) -- Patients who experience acute chest pain, and have nonobstructive coronary artery disease (CAD), as determined by coronary computed tomographic angiography, have similarly benign outcomes as those with normal coronary arteries, according to a study published in the April 1 issue of The American Journal of Cardiology.

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Cardiac Autonomic Dysfunction Is Linked to Arterial Stiffness

WEDNESDAY, April 3 (HealthDay News) -- Cardiac autonomic dysfunction as measured by lower heart rate variability (HRV) is associated with increases in both central and vascular vascular stiffness among youths with type 1 diabetes regardless of underlying cardiovascular disease (CVD) risk factors, according to research published online Feb. 22 in Diabetes Care.

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Fitness, Obesity Independently Affect Cardiometabolic Risk

WEDNESDAY, April 3 (HealthDay News) -- Fitness and obesity are independently associated with cardiometabolic (CM) risk, according to a study published in the April 1 issue of The American Journal of Cardiology.

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Patients Taken Off Statins Can Be Re-Challenged With Success

TUESDAY, April 2 (HealthDay News) -- Most patients who reported statin-related clinical events that resulted in statins being discontinued can often be re-challenged, and they can often tolerate the same or different statins long-term, according to research published in the April 2 issue of the Annals of Internal Medicine.

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Higher Plasma Fatty Acid Levels Tied to Reduced Mortality

TUESDAY, April 2 (HealthDay News) -- Higher circulating long-chain ω-3 polyunsaturated fatty acid (ω3-PUFA) levels are tied to lower mortality later in life among cardiovascularly healthy adults, according to a study published in the April 2 issue of the Annals of Internal Medicine.

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After Chest Pain, Outcomes Are Better With Cardiologist's Care

TUESDAY, April 2 (HealthDay News) -- Patients with high cardiovascular risk seen for chest pain have better outcomes if they receive follow-up from a cardiologist rather than a primary care physician or no physician follow-up, according to a study published online April 1 issue of Circulation.

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U.S. Adolescents Are in Poor Heart Health, Survey Finds

TUESDAY, April 2 (HealthDay News) -- Adolescents in the United States are in poor cardiovascular health, with poor diets and insufficient physical activity, according to a study published online April 1 in Circulation.

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Group-Based Weight Loss Incentives Are More Effective

TUESDAY, April 2 (HealthDay News) -- Group-based financial incentives for weight loss are more effective than individual incentives, according to a study published online April 1 in the Annals of Internal Medicine.

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Most Partners of U.S. Docs Satisfied in Their Relationships

MONDAY, April 1 (HealthDay News) -- Most spouses/partners of U.S. physicians report being satisfied with their relationships, with satisfaction linked to time spent together each day, according to research published in the March issue of the Mayo Clinic Proceedings.

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Runners Achieve Greater Weight Loss Than Walkers

MONDAY, April 1 (HealthDay News) -- Runners lose more weight than walkers, according to a large study published in the April issue of Medicine & Science in Sports & Exercise.

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