Vernberg Lecture speaker has studies appearing in two major publications this month
October 3, 2012
Cardiologist Dr. Carl J. Lavie, the guest speaker for the 2012 Winona B. Vernberg Distinguished Lecture Series on Tuesday, Oct. 9, is an author on two major papers appearing this month – one in the Journal of the American College of Cardiology and another in the Mayo Clinic Proceedings.
The JACC report, “Body Composition and Survival in Stable Coronary Heart Disease,” addresses the “obesity paradox,” which Lavie will discuss at the Vernberg Lecture at the Russell House Theater beginning at noon.
Lavie is one of the first researchers to document the obesity paradox that is drawing increasing attention among scientists. Although obesity is a major risk factor for cardiovascular disease, obese patients may have a better rate of survival when they have a heart attack, congestive heart failure or even other diseases.
In the JACC report, Lavie, the lead author, and colleagues examined the impact of Lean Mass Index (LMI) and body fat (BF) on survival in patients with coronary heart disease (CHD). They reviewed 570 consecutive patients with stable coronary heart disease (CHD) who were referred to cardiac rehabilitation between Jan. 1, 2000, and July 31, 2005. The researchers found that mortality was highest among those determined to be Low BF/Low LMI group and lowest among those with High BF/High LMI.
“It is interesting to speculate that although High BF may be a factor for cardiovascular diseases and coronary heart disease, by some mechanism this may be protective in cohorts with known disease,” the researchers wrote.
They also reported “that higher BF and especially higher LMI may be associated with muscular strength, which is associated with better prognosis and survival in several populations, even independently of aerobic fitness.”
The study in the Mayo Clinic Proceedings examined “ideal cardiovascular health and mortality.” Dr. Enrique Artero, a postdoctoral researcher at the Arnold School of Public Health, led the study for which Lavie and Drs. Mei Sui and Steve Blair, both of the Arnold School, collaborated.
Their goal was to analyze the relationship of cardiovascular health to disease-specific death. Using data from the Aerobics Center Longitudinal Study from 1987 to 1999, the researchers examined the prevalence of ideal cardiovascular health among almost 12,000 individuals (24.3 percent women) and to examine its relationship with deaths from all causes, cardiovascular disease (CVD) and cancer.
During a follow-up at 11.6 years, 305 people died – 70 (23 percent) from CVD and 127 (41.6 percent) from cancer. In the entire study group, only 29 individuals (.2 percent) had seven positive behaviors and factors that increase the odds of preventing CVD and stroke. These include no smoking within the past year, ideal Body Mass Index (BMI), physical activity at goal levels, a diet promoting cardiovascular health, untreated total cholesterol at healthy levels, untreated blood pressure less than 120/80 and the absence of CVD (stroke, heart failure and coronary heart disease).
The research team found that the prevalence of ideal cardiovascular health was extremely low among middle-aged men and women.
Visit http://www.mayoclinicproceedings.org/article/S0025-6196(12)00765-3/fulltext to view a video of Lavie discussing the research findings.
The study is particularly relevant in terms of the American Heart Association’s 2020 goal to reduce CVD deaths. “The Simple 7” from the AHA calls for people to get active, control their cholesterol, eat healthy, manage blood pressure, lose weight, stop smoking and reduce blood sugar.
An editorial that appears in the same issue of the Mayo Clinic Proceedings by Dr. Francisco Lopez-Jimenez of the Mayo Clinic in Rochester, Minn., examined the study and its relationship with The Simple 7.
Lopez-Jimenez writes that the study by Artero and the research team “shows very troubling results, with an extremely low prevalence of ideal cardiovascular health in a sample of upper middle-class individuals attending a clinic that specializes in cardiovascular health … other studies have shown that the prevalence of ideal cardiovascular health is even worse among disadvantaged populations.”
The editorial writer cites a 2011 study in the journal Circulation which found that blacks had an 82 percent lower likelihood of achieving more than five of the seven health factors than whites.
The conclusion by Lopez-Jimenez is that “the challenges ahead of use are immense, and the responsibility to prevent a reversal of the favorable trends in cardiovascular disease should be shared among individuals, scientists, leaders in public policy and society as a whole.”
The ultimate victory against cardiovascular disease, he said, “will come when personal accountability, effective primary care practices, public policy, population-based interventions and universal health care work in concert.”
Also in the past month, Artero, along with Lavie, Blair and their colleagues, reviewed the evidence that muscular strength was strongly related with long-term prognosis and survival. The article appears online in the Journal of Cardiopulmonary Rehabilitation and Prevention.
Visit garnethealthanista.com for an interview with Lavie.