Quick Look at Cardiology
Summary
More than a billion people worldwide are affected by the consequences of high blood pressure and many more suffer without diagnosis, due to a lack of ubiquitous symptoms...
... Yet according to new research acquired from the Eastern Region Public Health Observatory and UK Quality Framework Prevalence statistics, the good news is that the overall levels of undiagnosed and untreated conditions in the UK are falling. For where the number of people diagnosed with high blood pressure in the UK rose by 2.7 per cent between 2004/2005 and 2007/2008, statistics from UK Quality Framework Prevalence also show that during the same period, GPs discovered and diagnosed an additional nearly 1 million people with high blood pressure. The result? A 9.5 per cent fall in the number of people with undiagnosed high blood pressure. Good news.
In terms of new treatments and research, there are already several interesting studies and reports from early 2009.
First, a new study by cardiologists at the Cardiovascular Imaging Center at the Methodist DeBakey Heart and Vascular Center in Houston, shows that the innovative imaging technique Echocardiography 'had a significant impact on the diagnosis and treatment of people hospitalized with heart disease.' The study, published for the first time in the Journal of the American College of Cardiology, reports that 'After contrast echocardiography, the percentage of uninterpretable studies decreased from 11.7 percent to 0.3 percent, and technically difficult studies decreased from 86.7 percent to 9.8 percent.' Dr. William A. Zoghbi, professor of medicine and director of the Cardiovascular Imaging Center at the Methodist DeBakey Heart and Vascular Center in Houston, emphasised the importance of this study as the first such study to assess and measure 'the impact of contrast echocardiography on assessment of ventricular function'. More details on this particular study can be found here
Perhaps also of interest is the revolutionary new work in the field of stem cell research – particularly for patients with heart disease. By extracting a patient's own cells and growing them in a laboratory, scientists then hope to be able to turn the cells into human heart stem cells and inject them into the heart of the patient. Dr Jonathan Hill, a consultant cardiologist at London's King's College Hospital, is at the head of a team who are currently negotiating to test the pioneering new treatment on British patients, having already thoroughly tested the treatment in animals. Professor Sian Harding, of Imperial College London also believes the futuristic new technique 'has a very good chance of working'. Heart disease affects millions in the UK every year. Read more here
In addition, President Obama's signal that he would be willing to overturn many of the Bush administration's prohibitions on stem cell research is a positive sign for wider global research. Moreover, the 44th President's broader interest in the advancement of scientific research and discovery, may come to be of considerable importance to the wider scientific community in the years to come. A change of direction in Washington that was emphasised by Obama in his inaugural address at the East Front of the U.S. Capitol on January 20th when he pledged to 'restore science to its rightful place and wield technology's wonders to raise health care's quality'. As with almost everything that he touches, President Obama's commitment to the future of science and stem cell research will radiate not just across the United States – but the whole world. U.S. Presidents set the tone in many fields – the healthcare industry is no exception.
On the topic of available hypertension treatments, Novartis, Pfizer, Merck and others continue to lead the way. However, writing for the Financial Times Weekend, Glasgow-based GP Margaret McCartney repeated a fairly well held view amongst GPs that 'there is still considerable uncertainty about which drugs are most effective'. Specifically, her view contends that whilst beta blockers 'should not be recommended as a first choice', many of the available medications have proven their usefulness for the right patient. In other words, 'The best antihypertensive treatment is the one which the person is happy with and which causes the most tolerable side effects'. McCartney, like many other Doctors, applauded the DTB review that judged that 'evidence to use a particular drug depending on a patient’s age is not compelling'.
With a wave of economic stimulus being injected into economies all over the world, there is also evidence that healthcare will also come to feel the brunt of some notable changes. And whilst many analysts predict that Obama's desire to extend Medicare and Medicaid to an additional 8.5 million people will have a negative impact on the insurance market in the US, the industry also stands to gain where subsidised customers have more to spend.
For cardiology, important research is making steady strides. Be it the innovative stem cell research conducted by the team at King's College Hospital or new research across the pond proving at least a degree of effectiveness for Echocardiography, the field is brimming with new studies and groundbreaking research. Nevertheless, whilst the pharmaceutical industry never fails to break through glass ceilings in producing the latest cures and treatments, we'd also do well not to forget the importance of prevention. Indeed, as McCartney emphasises in her article, 'drugs are not the only treatment for high blood pressure'. There is, for example, substantial evidence to prove the benefits of cutting down on salt intake and eating more fruit and vegetables. And whilst that may just sound like old advice, it's never been more relevant. In fact, as proven by the aforementioned study on improved awareness, public health awareness, healthy eating and other forms of prevention are just as important in tackling this silent, but ultimately deadly killer.
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