Strict Diet, Exercise Regimen May Normalize Blood Sugar In Some T2D Patients.

Reuters  (12/19, Pittman) reports that according to a 4,503-patient study  published Dec. 19 in the Journal of the American Medical Association, one in nine people with type 2 diabetes (T2D) may return to having normal blood sugar levels after following a strict program of exercise and diet for a year. An accompanying editorial  pointed out that lifestyle interventions such as diet and exercise may help lower the risk for long-term health problems.

        HealthDay  (12/19, Gordon) points out, however, that "less than two percent of the people who tried" the intervention "were able to achieve a complete remission, and if they don't maintain the changes, it's likely that their diabetes will quickly return."

Dialysis, Kidney-Care Providers Take Issues With GAO Report.

Modern Healthcare  (12/17, Kutscher, Subscription Publication) reports, "Dialysis and kidney-care providers are taking issue with a Government Accountability Office report released this month that found the government may be over-paying for end-stage renal disease treatment. The report  [pdf] called on the CMS to re-examine the amount it's paying for dialysis care, arguing that the agency bases its bundled payment rates on five-year-old drug utilization trends that are no longer current." The report "added that if the payments accurately reflected current prescribing trends for end-stage renal disease, Medicare would have saved at least $650 million in 2011, up to as much as $880 million -- and that those savings are only forecasted to grow." Modern Healthcare adds, "Dr. Thomas Hostetter, chairman of the public policy board at the American Society of Nephrology, noted that he agreed with the 'raw findings' of the report concerning decreased utilization. But, he noted, 'I think the biggest concern is that this is such a widely fluctuating area right now.'"

Report Finds Poor Diet, Lack Of Exercise Obstacles To Better Heart Health In US.

HealthDay  (12/13, Gordon) reports that a new report from the American Heart Association that warns "cardiovascular disease -- including heart disease and stroke -- still causes the death of one American every 40 seconds. The report," published in the journal Circulation, "emphasizes that two big factors stand in the way of improving US heart health: poor eating habits and a lack of physical activity." Although the AHA "previously set a goal of reducing heart disease and stroke deaths by 20 percent by 2020," if the current trends continue, America's heart health "may only improve by six percent by 2020, according to the report."

        Heartwire  (12/13, O'Riordan) notes that AHA report estimates that the "total direct and indirect costs of cardiovascular disease and stroke are more than $310 billion in the US. Although the relative rate of deaths attributable to cardiovascular disease declined from 1999 to 2009, cardiovascular disease still accounts for one in every three US deaths."

        Fainting May Be First Sign Of Heart Trouble. HealthDay  (12/13, Gray) reports that according to a study published in the Journal of the American College of Cardiology, first-time fainters "were 74 percent more likely to eventually be admitted to the hospital for heart attack or stroke and five times more likely to need a pacemaker or implantable cardioverter-defibrillator at some point in the future." The study "suggests that fainting in seemingly healthy people may be a first symptom of a more severe underlying cardiovascular disease, the researchers found."

Study: Smoking Raises Women's Sudden Cardiac Death Risk Significantly.

Forbes  (12/11, Husten) reports that a new study  "from the Nurses' Health Study" published online Dec. 11 in Circulation: Arrhythmia & Electrophysiology, an American Heart Association journal, "provides new clarity about the relationship between smoking" and sudden cardiac death (SCD). Lead investigator Roopinder Sandhu and colleagues examined data from over 100,000 women who had no known cancer or cardiovascular disease. The article details that "during 30 years of followup there were 351 incident SCDs." Forbes adds that "compared to women who never smoked, the risk of SCD was significantly elevated in current smokers (relative risk 2.44) and former smokers (RR 1.40)."

        HealthDay  (12/12, Doheny) reports that the study suggests that "women who are light or moderate cigarette smokers -- lighting up as little as once a day -- still have an increased risk of sudden cardiac death." Lead researcher Dr. Roopinder Sandhu stated, "In our study we found small-to-moderate quantities, one to 14 cigarettes per day, were associated with almost a twofold higher risk of sudden cardiac death compared to women who never smoked." Further, the researchers found that "those who smoked 25 or more a day had more than triple the risk of sudden cardiac death."

        Heartwire  (12/12, Nainggolan) reports that "with respect to the total number of years smoking, Sandhu notes that 'every five years of continued smoking was associated with an almost 10% increase in SCD.'" Further, Dr. Sandhu adds that "importantly, SCD risk reduced over time with smoking cessation, equaling that of a never smoker after 20 years." She observes, "These are data supporting the fact that smoking cessation is an important modifiable risk factor and that women shouldn't wait until they develop heart disease to quit."

        MedPage Today  (12/12, Neale) reports that the study team "acknowledged some limitations of the study, including possible misclassification of cigarette consumption based on self-report, possible error in determining sudden cardiac death, the lack of information about the severity of coronary heart disease events during follow-up, and potential residual or unmeasured confounding." Additionally, the article notes that "the study population was mostly white, female nurses, and the findings may not apply to other groups." MedPage Today mentions that "the study was supported by research grants from the NIH and an Established Investigator Award from the American Heart Association to one of the authors." Also covering the story are BBC News  (12/12, Roberts),WebMD  (12/12, Warner), and the Daily Mail (UK)  (12/12, Hope).

Some Hypertension Medications May Be Sensitive To A Person's Weight.

MedPage Today  (12/7, Kaiser) reports, "Some hypertension medications appear to be sensitive to a person's weight, a subanalysis of the ACCOMPLISH trial found." Investigators found that "the single-pill combination of benazepril (ACE inhibitor) plus the diuretic hydrochlorothiazide was associated with increasingly fewer cardiovascular events as patients' body mass index (BMI) rose." But, "BMI did not influence efficacy in patients taking benazepril plus amlodipine (calcium channel blocker)." The findings  were published online in The Lancet.

        HealthDay  (12/7, Reinberg) reports that, according to lead researcher Dr. Michael Weber, a professor of medicine at Downstate Medical Center of the State University of New York in New York City, "Unexpectedly, people who have high blood pressure and are fat actually have a better prognosis than people who have high blood pressure and are thin." Dr. Weber added, "You can now choose blood pressure medication as a means of compensating for this difference between obese and thin people, so that it's possible to treat everybody with a medicine that maximizes the outcome regardless of how much you weigh."

Acute Kidney Injuries Have More Than Doubled Since 2000.

USA Today  (12/7, Weintraub) reports, "Acute kidney injuries have more than doubled since 2000, causing nearly 39,000 deaths in 2009 alone," according to a study published Dec. 6 in the Journal of the American Society of Nephrology. Researchers came to this conclusion after reviewing "1.9 million US hospitalizations due to acute kidney injuries. Only the most serious injuries, which required patients to go on dialysis, were counted." The study authors are not sure what is behind the increase in acute kidney injuries. Currently, "there are no drugs to reduce the incidence or severity of acute kidney injuries, though several are under development, says Bruce Molitoris, president of the American Society of Nephrology."

Study Deems Aspirin Resistance As False Diagnosis.

Bloomberg News  (12/6, Nussbaum) reports that "there's no such thing as aspirin resistance, according to a study  that suggests a false diagnosis may be unnecessarily raising the number of people given costlier prescription drugs with more side effects to lower their risk of heart attack and stroke." According to the article, "the report, by University of Pennsylvania researchers, found the coatings put on aspirin by makers such as Bayer AG (BAYN) mask uptake of the medicine in the blood, leading to false diagnoses that it's not working, said the study published in the journal Circulation." The article adds that "one in five Americans take a low-dose aspirin tablet daily to reduce heart risks, with most taking coated versions sold as less harsh on the stomach, the university said in a statement." Lead researcher Garret FitzGerald stated that there is no evidence proving that the coatings make aspirin more tolerable.

        MedPage Today  (12/6, Kaiser) details that "healthy volunteers undergoing various tests exhibited characteristics of aspirin 'response' in some phases of the study and of 'nonresponse' in other phases, reported Garret A. FitzGerald, MD, and colleagues." According to the article, "the lack of a consistent mechanism of action to ascribe to aspirin resistance suggests there is no genetic basis and, in fact, that 'pseudoresistance' is caused by delayed and reduced absorption of coated aspirins, they concluded in the study." Notably, the researchers found that "the 'pseudoresistance' seems to reflect delayed and reduced drug absorption from the coated drugs, which calls into question the use of point-of-care diagnostic tests for aspirin resistance."