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August 2008 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for August 2008. 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.

Systolic Blood Pressure After Exercise Linked to Mortality

FRIDAY, Aug. 29 (HealthDay News) -- Individuals with paradoxical systolic blood pressure increase after treadmill testing face an elevated risk of cardiovascular disease mortality, according to research published in the September issue of the American Journal of Cardiology.

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Lancet Supports WHO Report on Health Inequality

FRIDAY, Aug. 29 (HealthDay News) -- The final report by the World Health Organization's Commission on Social Determinants of Health contains a strong mandate for reducing global inequalities in health care, according to an editorial published in the Aug. 30 issue of The Lancet.

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Cardiovascular Screening Has Pros and Cons

FRIDAY, Aug. 29 (HealthDay News) -- Cardiovascular screening targeted at high-risk segments of the population is a cost-effective way to get treatment to those who need it most, according to a Head to Head article published online Aug. 28 in BMJ, but a companion article argues that it is costly, too focused on treatment instead of prevention, and lulls physicians and policy-makers into a false sense of security about tackling cardiovascular disease.

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Low-Dose Radiation Seen As Possible Heart Risk

FRIDAY, Aug. 29 (HealthDay News) -- Low-dose radiation may increase the risk of cardiovascular disease, but further study is needed to determine whether or not the risk is significant, according to a comment published in the Aug. 30 issue of The Lancet.

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Atrial Fibrillation Patients Not Adequately Anticoagulated

FRIDAY, Aug. 29 (HealthDay News) -- Most patients with known atrial fibrillation who are admitted with an ischemic stroke either do not take warfarin or have sub-therapeutic levels of the drug, according to a study published online ahead of print Aug. 28 in Stroke.

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Higher Dose Addresses Lack of Response to Clopidogrel

THURSDAY, Aug. 28 (HealthDay News) -- In patients with acute myocardial infarction who fail to respond to clopidogrel, reloading with the drug and using a higher maintenance dosage can overcome patients' non-responsiveness, according to research published in the September issue of the American Journal of Cardiology.

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Mayo Clinic Risk Score Accurately Predicts Mortality

THURSDAY, Aug. 28 (HealthDay News) -- The Mayo Clinic Risk Score -- which consists of seven simple clinical and non-invasive variables that are assessed before coronary angiography -- is a valid tool for predicting in-hospital mortality after percutaneous coronary intervention (PCI), according to an article published in the August debut issue of Circulation: Cardiovascular Interventions.

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New Test to Help Manage Heart Transplants Approved

THURSDAY, Aug. 28 (HealthDay News) -- The U.S. Food and Drug Administration has approved AlloMap, a non-invasive test based on molecular expression techniques, to help doctors manage heart transplant patients during the post-transplant phase.

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Telmisartan Fails to Reduce Risk of Recurrent Stroke

WEDNESDAY, Aug. 27 (HealthDay News) -- In the prevention of recurrent stroke, telmisartan is no more effective than placebo, and aspirin plus extended-release dipyridamole is similar to clopidogrel, according to the results of two studies published online Aug. 27 in the New England Journal of Medicine.

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Modest Troponin I Elevation in ICU Points to Mortality

WEDNESDAY, Aug. 27 (HealthDay News) -- In intensive care patients without acute coronary syndrome, even small increases in troponin I levels were associated with increased in-hospital mortality, according to research published in the Sept. 1 issue of the American Journal of Cardiology.

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Allopurinol Shows Promise As Hypertension Treatment

TUESDAY, Aug. 26 (HealthDay News) -- The blood pressure of teens newly diagnosed with hypertension can be reduced with allopurinol, but the potential for the drug to become a new treatment depends on the outcome of larger clinical trials to better understand the potential side effects of the drug, according to a report published in the Aug. 27 issue of the Journal of the American Medical Association.

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Anemia in Heart Failure Raises Risk of Mortality

TUESDAY, Aug. 26 (HealthDay News) -- In patients with chronic heart failure, anemia significantly increases the risk of death, according to a report published in the Sept. 2 issue of the Journal of the American College of Cardiology.

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Large Aortic Plaques Increase Future Stroke Risk

TUESDAY, Aug. 26 (HealthDay News) -- Large aortic plaques combined with a hypercoagulable state following an acute ischemic stroke is associated with an increased risk of recurrent stroke and death, according to a report published in the Sept. 2 issue of the Journal of the American College of Cardiology.

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Low-Risk Group May Safely Discontinue Anticoagulation

TUESDAY, Aug. 26 (HealthDay News) -- Women taking oral anticoagulants for five to seven months after an unprovoked venous thromboembolism may discontinue therapy if they have one or fewer risk factors for recurrent venous thromboembolism, according to a report published in the Aug. 26 issue of CMAJ, the journal of the Canadian Medical Association.

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Bivalirudin Monotherapy Studied in Acute Coronary Syndrome

TUESDAY, Aug. 26 (HealthDay News) -- Among patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome, bivalirudin is associated with significantly less bleeding at 30 days and monotherapy is associated with similar ischemic and mortality rates compared with unfractionated heparin or enoxaparin plus a glycoprotein (GP) IIb/IIIa inhibitor, according to a report in the Sept. 2 issue of the Journal of the American College of Cardiology.

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Artery Grafting and Stent Have Similar Outcomes

TUESDAY, Aug. 26 (HealthDay News) -- Outcomes for stenting and left internal mammary artery grafting are similar except for the need for additional early revascularization following stenting, according to research published in the Sept. 2 issue of the Journal of the American College of Cardiology.

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Continuous Warfarin Safe During Angiography

MONDAY, Aug. 25 (HealthDay News) -- Uninterrupted warfarin therapy does not increase the risk of excessive bleeding or site complications during coronary angiography and may be reasonable in clinical practice, according to a report in the August issue of the American Journal of Cardiology.

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Swedish Stroke Incidence Shows Favorable Trends

FRIDAY, Aug. 22 (HealthDay News) -- Stroke incidence in northern Sweden declined during a recent 19-year period, with rates falling for first and recurrent strokes in women with diabetes and men without diabetes, according to research published online Aug. 21 in the journal Stroke.

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Even 'Little' Strokes Can Lead to Major Problems

THURSDAY, Aug. 21 (HealthDay News) -- The theme for the upcoming World Stroke Day -- which will be observed on Oct. 29 -- is "Little strokes, big trouble," according to an editorial in the September issue of Stroke.

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Obesity, Gastroesophageal Reflux Disease Link Reviewed

THURSDAY, Aug. 21 (HealthDay News) -- Obesity is clearly associated with the development of gastroesophageal reflux disease (GERD), which may be alleviated by weight loss through caloric restriction or surgery, according to a review in the August issue of the American Journal of Gastroenterology.

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Statin Therapy Not Associated with Incident Cancer

THURSDAY, Aug. 21 (HealthDay News) -- Although there is an inverse association between low levels of on-treatment low-density lipoprotein cholesterol (LDL-C) and incident cancer, it is not driven by statin therapy, but the issue needs further study with a longer duration of follow-up, according to a report published online Aug. 20 in the Journal of the American College of Cardiology.

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Outlook Mixed on US Presidential Candidates' Health Plans

WEDNESDAY, Aug. 20 (HealthDay News) -- The health care plans proposed by John McCain and Barack Obama would have uncertain effects on health care coverage in America, but potential problems with each plan are evident, according to a perspective piece in the Aug. 21 issue of the New England Journal of Medicine.

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Carotid Ultrasound May Identify Cardiac Risk

WEDNESDAY, Aug. 20 (HealthDay News) -- Carotid artery lesions identified by ultrasound and demonstrating increasing echolucency may indicate increased risk for major adverse cardiovascular events, and repeat testing may identify patients at particularly high risk for near-future events, according to an article published in the September issue of Radiology.

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Low-Dose Aspirin Therapy Inadequate in Some Patients

WEDNESDAY, Aug. 20 (HealthDay News) -- In patients with diabetes mellitus and coronary artery disease, low-dose aspirin may not adequately inhibit platelet function, researchers report in the August issue of the American Journal of Cardiology.

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Seniors Likely to Find Medicare Health Web Site Unusable

TUESDAY, Aug. 19 (HealthDay News) -- Even older adults with computer skills may have difficulty using the Medicare.gov Web site to determine eligibility for services and enroll in a drug plan, according to a research letter published in the Aug. 20 issue of the Journal of the American Medical Association.

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Vitamins Do Not Reduce Deaths in Coronary Artery Disease

TUESDAY, Aug. 19 (HealthDay News) -- Although B vitamins can lower plasma homocysteine levels, they do not reduce the number of deaths or cardiovascular events in patients with coronary artery disease or aortic valve stenosis, according to study findings published in the Aug. 20 issue of the Journal of the American Medical Association.

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Seldom-Performed Heart Procedure Has Advantages

TUESDAY, Aug. 19 (HealthDay News) -- Although radial percutaneous coronary intervention (PCI) is rarely performed, it has a similar procedural success rate as femoral PCI and significantly lower rates of bleeding and vascular complications, according to research published in the August issue of the Journal of the American College of Cardiology -- Cardiovascular Interventions.

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Gender and Advanced Heart Failure Outcome Not Related

TUESDAY, Aug. 19 (HealthDay News) -- Overall, outcomes for men and women with advanced decompensated heart failure (ADHF) are similar with some differences based on heart failure etiology, according to an article published in the Aug. 15 issue of the American Journal of Cardiology.

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Sleep Quality Linked to Hypertension in Healthy Teens

MONDAY, Aug. 18 (HealthDay News) -- Healthy adolescents with poor quality of sleep are more likely to have prehypertension, according to research published online Aug. 18 in Circulation: Journal of the American Heart Association.

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Physical Activity Decreases Mortality in Coronary Disease

MONDAY, Aug. 18 (HealthDay News) -- Leisure-time physical activity predicts long-term survival in men and women with chronic stable coronary heart disease, researchers report in the Aug. 15 issue of the American Journal of Cardiology.

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Study Sheds Light on Air Pollution-Related Health Risks

FRIDAY, Aug. 15 (HealthDay News) -- Reducing the levels of air pollution is one strategy for decreasing its harmful effects, but identifying and regulating specific causal agents linked to air pollution-related health problems could lead to less cardiovascular morbidity and mortality, according to a report in the Aug. 26 issue of the Journal of the American College of Cardiology.

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In England, Health Care Quality Suffers from Gaps

FRIDAY, Aug. 15 (HealthDay News) -- The quality of health care in England could be greatly improved, particularly for some chronic conditions in older people, according to research published online Aug. 14 in BMJ.

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Quick Tirofiban Use Beneficial in Myocardial Infarction

FRIDAY, Aug. 15 (HealthDay News) -- The early use of tirofiban, a glycoprotein IIb/IIIa blocker, following some myocardial infarctions is associated with improved ST-segment resolution before and after primary coronary angioplasty, according to research published in the Aug. 16 issue of The Lancet.

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Studies Show Stroke Risk from Abdominal Fat, Smoking

FRIDAY, Aug. 15 (HealthDay News) -- Abdominal fat and smoking are strongly associated with an increased risk of stroke, according to the results of two case-control studies published online Aug. 14 in the journal Stroke.

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ACE Inhibitor/ARB Combination Worsens Major Renal Outcomes

FRIDAY, Aug. 15 (HealthDay News) -- The combined use of the angiotensin converting enzyme (ACE) inhibitor ramipril and the angiotensin receptor blocker (ARB) telmisartan in patients with high cardiovascular risk is associated with worsened major renal outcomes compared to these drugs as monotherapy, researchers report in the Aug. 16 issue of The Lancet.

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Low-Risk Lifestyle Linked to Stroke Prevention

THURSDAY, Aug. 14 (HealthDay News) -- A low-risk lifestyle is associated not only with a reduced risk of several chronic diseases -- such as coronary heart disease, diabetes and total cardiovascular disease -- but also with the prevention of stroke, according to the results of a study published online Aug. 12 in Circulation: Journal of the American Heart Association.

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Treatments to Prevent Contrast Nephropathy Compared

THURSDAY, Aug. 14 (HealthDay News) -- Hydration with saline or sodium bicarbonate is similarly effective in preventing contrast-induced nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention, researchers report in the Aug. 19 issue of the Journal of the American College of Cardiology.

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Distance Runners Adapt to Physiological Strain

THURSDAY, Aug. 14 (HealthDay News) -- During long-distance runs, most athletes actively regulate their relative physiologic strain, but those who experience competitive failure show evidence of poor regulation, according to a report published in the August issue of PLoS ONE.

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Resynchronization Use Varies from Published Guidelines

THURSDAY, Aug. 14 (HealthDay News) -- The use of cardiac resynchronization therapy (CRT) varied by hospital site and geographic region, with a significant proportion of patients receiving new CRT placement outside current guidelines, according to research published online Aug. 12 in Circulation: Journal of the American Heart Association.

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Report on Infant Heart Transplants Sparks Debate

WEDNESDAY, Aug. 13 (HealthDay News) -- A Brief Report by Mark M. Boucek, M.D., and colleagues from the Denver Children's Hospital Pediatric Heart Transplant Team published in the Aug. 14 issue of the New England Journal of Medicine is the basis for an extended discussion of the ethics of organ procurement in three accompanying Perspective articles, an editorial, and an online roundtable discussion.

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PCI May Only Improve Short-Term Quality of Life

WEDNESDAY, Aug. 13 (HealthDay News) -- Among patients with chronic coronary artery disease, percutaneous coronary intervention (PCI) is associated with short-term, but not long-term, improvements in quality of life compared to optimal medical therapy alone, according to a report published in the Aug. 14 issue of the New England Journal of Medicine. A study in the same issue found that post-PCI treatment with bivalirudin is not associated with a net clinical benefit compared to treatment with unfractionated heparin.

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Secondary CVD Prevention Varies by Health Care System

WEDNESDAY, Aug. 13 (HealthDay News) -- In patients receiving care for secondary prevention of cardiovascular disease (CVD), those enrolled in pay-for-performance practices are more likely to have better control of blood pressure and cholesterol, but those enrolled in non-pay-for-performance practices are more likely to report healthy lifestyle behaviors and a higher quality of life, according to a report published online Aug. 13 in Heart.

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Running Linked to Reduced Disability and Mortality

WEDNESDAY, Aug. 13 (HealthDay News) -- People who are vigorous runners in middle and older age are likely to enjoy reduced disability and prolonged survival in later life, according to a report published in the Aug. 11/25 issue of the Archives of Internal Medicine.

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Low Vitamin D Levels Linked to All-Cause Mortality

WEDNESDAY, Aug. 13 (HealthDay News) -- In the general population, a low serum level of 25-hydroxyvitamin D -- less than 17.8 ng/mL -- is independently associated with a significantly increased risk of all-cause mortality, researchers report in the Aug. 11/25 issue of the Archives of Internal Medicine.

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Retinopathy Linked to Heart Disease Mortality

TUESDAY, Aug. 12 (HealthDay News) -- Retinopathy independently predicts coronary heart disease mortality in people with and without diabetes, according to study findings published online Aug. 12 in Heart.

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Statins Change Cholesterol Control Requirements

TUESDAY, Aug. 12 (HealthDay News) -- Statin treatment in patients at high risk of heart disease requires that non-high-density lipoprotein cholesterol (non-HDL-C) be reduced further to achieve the same apolipoprotein B (apoB) goal, researchers report in the Aug. 19 issue of the Journal of the American College of Cardiology.

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Russians Would Like More Tobacco Control

TUESDAY, Aug. 12 (HealthDay News) -- Many Russians would like to see more tobacco control and think that tobacco companies probably unduly influence politicians, but many also underestimate the dangers of smoking, according to the results of a study published in the August issue of Tobacco Control.

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Epirubicin Has Mixed Results in Metastatic Breast Cancer

FRIDAY, Aug. 8 (HealthDay News) -- In women with metastatic breast cancer, the risk of cardiotoxicity from epirubicin treatment is higher than previously expected, but an increasing dose is also associated with improved overall survival, according to a report published in the Aug. 6 issue of the Journal of the National Cancer Institute.

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Thromboembolism Prophylaxis Urged for Caesarean Deliveries

FRIDAY, Aug. 8 (HealthDay News) -- The maternal death rate in the United States could be systematically reduced if all women undergoing Caesarean delivery received thromboembolism prophylaxis, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.

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Over 1 Billion U.S. Doctor, Hospital Visits Logged in 2006

THURSDAY, Aug. 7 (HealthDay News) -- In 2006, patients made an estimated 1.1 billion visits to physician offices and hospital emergency and outpatient departments in the United States, which was an average of four visits per person, according to health care statistics released Aug. 6 by the U.S. Centers for Disease Control and Prevention.

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Coronary Spasms in Heart Attack Point to Poor Outcomes

THURSDAY, Aug. 7 (HealthDay News) -- Provoked coronary spasms in patients with acute myocardial infarction are associated with adverse outcomes, and coronary spasms are frequently the cause of acute coronary syndrome, according to two studies published in the Aug. 12 issue of the Journal of the American College of Cardiology.

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Exercise Link to Depression and Anxiety Examined

WEDNESDAY, Aug. 6 (HealthDay News) -- Although there is an association between regular exercise and reduced symptoms of anxiety and depression, exercise is not a causal factor, according to study findings published in the August issue of the Archives of General Psychiatry.

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Delayed Peptide Measure Linked to Heart Failure Treatment Delay

WEDNESDAY, Aug. 6 (HealthDay News) -- A longer delay in measuring immunoreactive B-type natriuretic peptide (iBNP) in patients with acutely decompensated heart failure after they arrived in emergency departments was associated with a delay in treatment, according to research published in the Aug. 12 issue of the Journal of the American College of Cardiology.

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More Data Needed on Blood Pressure in Children

TUESDAY, Aug. 5 (HealthDay News) -- Ambulatory, rather than clinic blood pressure, is a more accurate measure of changes in blood pressure throughout the day, and more data are needed on blood pressure changes in children and young people, according to an American Heart Association scientific statement published online Aug. 4 in Hypertension.

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In U.S., 11 Million Chronically Ill Lack Health Insurance

TUESDAY, Aug. 5 (HealthDay News) -- About 11.4 million adults in the United States with chronic conditions do not have health insurance, and they are less likely to visit a health professional and more likely to use the emergency department for care, according to an article in the Aug. 5 issue of the Annals of Internal Medicine.

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Exercise Lowers Atrial Fibrillation Risk

TUESDAY, Aug. 5 (HealthDay News) -- Older adults who engage in light to moderate physical activity are at lower risk of atrial fibrillation than their counterparts who do not exercise, according to research published online Aug. 4 in Circulation: Journal of the American Heart Association.

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Smoking Enhances Platelet Inhibition By Plavix

TUESDAY, Aug. 5 (HealthDay News) -- Cigarette smoking enhances platelet inhibition by clopidogrel (Plavix), which may explain some variability in patient response to the drug, according to a report in the Aug. 12 issue of the Journal of the American College of Cardiology.

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Sleep Apnea Linked to Higher Death Risk

MONDAY, Aug. 4 (HealthDay News) -- Patients with moderate-to-severe sleep apnea or severe sleep-disordered breathing have a higher risk of death than those without sleeping problems, according to two studies published in the Aug. 1 issue of Sleep.

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Adiponectin Linked to Higher Risk of Heart Disease

MONDAY, Aug. 4 (HealthDay News) -- Higher levels of adiponectin are associated with an increased risk of new coronary heart disease in older adults, according to research published online July 1 in the Journal of Clinical Endocrinology & Metabolism.

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International Issue of Torture Complicity Analyzed

FRIDAY, Aug. 1 (HealthDay News) -- More than 100 countries condone the use of torture and have often recruited the medical community as participants without consequence, according to an editorial published online July 31 in BMJ.

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