Intense research into the causes, diagnosis, treatment, and prevention of heart disease is underway right now throughout the world and medical studies on the heart are published daily. The sheer volume of information can be overwhelming. Below is an overview of some of the recent medical developments in heart disease research and links to some developing news stories about the heart.
Heart disease risk factors
A lot of research goes into finding reliable determinants of heart disease and heart attack risk. However, just finding an association between one factor and heart disease or heart attack does not prove that it is a cause of the problem. In fact, until large controlled studies demonstrate a conclusive association between the risk factor and the disease, most doctors and heart organizations will not recommend using it for screening. The burden of proof is very high, especially with something as important as heart disease, so it takes many years to prove the value of any one risk factor as a good diagnostic test. What follows are some of the factors that have received some attention in the past ten years or so, but still are not conclusively proven to be reliable markers of heart disease or heart attack risk.
Lipoprotein(a) cholesterol
Lp(a) is a naturally occurring genetic variation of LDL (low density lipoprotein) cholesterol. A higher level of Lp(a) is an important risk factor for developing premature atherosclerosis and may also increase the likelihood of forming clots inside the vessels. It not yet clear how to reliable lower Lp(a) levels and if it is effective at preventing heart disease.
Homocysteine
Homocysteine is an amino acid found in the blood. High levels of homocysteine seem to be related to a higher risk of coronary artery disease and vascular problems. It is unclear how homocysteine causes these problems but some evidence suggests that homocysteine may damage the inner lining of arteries (the endothelium) and promote blood clots. Screening for blood homocysteine levels is not widely available but it might be useful for patients with a history of cardiovascular disease.
B vitamins
Folic acid and vitamins B6 and B12 help to break down homocysteine (see above) in the body. Several studies have found that higher levels of B vitamins in the blood may be related to lower concentrations of homocysteine. Other studies suggest that levels of folic acid in the blood are linked with a higher risk of fatal coronary heart disease and stroke. No controlled studies have yet shown that folic acid supplements either reduce or increase the risk of cardiovascular disease.
C-reactive protein (CRP)
C-reactive protein is a molecule found in the blood as a marker of inflammation. While inflammation is a helpful response to injury and infection, chronic inflammation may contribute to atherosclerosis and heart disease. Studies in both men and women have suggested that elevated levels of CRP in the blood increase the risk of heart attack and other vascular problems. Lifestyle changes and medication may be effective at lowering CRP levels.
Serum ferritin (iron)
Iron is a mineral used in the body to make red blood cells; low levels of iron cause anemia. However, high levels of iron may also be problematic. Levels of a protein called ferritin that is used to carry iron in the blood tend to be higher in people with cardiovascular disease. What is not clear is whether the higher levels of iron cause the cardiovascular disease or whether they are simply a symptom of it.
Fibrinogen
When your blood clots an entire cascade of blood molecules are involved. The very last step in the process is the activation of fibrinogen into fibrin. Fibrinogen is present in the blood all the time but it does not become sticky until it is activated by this final step. Some studies have demonstrated that higher levels of the inactive, non-sticky fibrinogen are related to higher risk of heart attack, possibly because having more of it raises the risk of its accidentally becoming activated into the stickier fibrin form and causing a clot. As of now, there are no reliable ways to lower fibrinogen levels.
Natriuretic peptides
The natriuretic peptides known as brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) are proteins made by the heart and blood vessels that act as natural diuretics. They help relax blood vessels and eliminate fluids to reduce the blood pressure and the stress placed on the heart. High levels of these proteins in the blood indicate that the heart is stressed and are associated with an increased risk of heart attack.
Links to recent heart disease developments
The latest coronary heart disease news for heart disease researchers and other healthcare professionals.
http://www.incirculation.net/acs/0_0.aspx
American Heart Association Journals features free research articles from recent issues of the family of medial research journals published by the American Heart Association.
http://www.ahajournals.org/
PubMed is a U.S. National Institutes of Health search engine that covers all research published in medical and bio-scientific journals.
http://www.ncbi.nlm.nih.gov/PubMed/
PubMed Central is the National Institutes of Health free digital archive of biomedical and life sciences journal literature.
http://www.pubmedcentral.nih.gov/
The U.S. Food and Drug Administration Center for Biologics Evaluation and Research is the government agency charged with reviewing and approving applications for new drugs and medical devices and their website ahs information about recent developments in these areas.
http://www.fda.gov/Cber/index.html
New York Times articles on heart disease.
http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/heartdisease/
Harvard Medical School has recent heart health news for patients and research developments for clinicians.
http://hms.harvard.edu/public/disease/heartdisease/heartdisease.html
Search for latest information about heart disease on Healia.
/healia/search.do?query=heart+disease&submit=
Information about clinical trials
If you are interested in finding out more about clinical trials for heart disease, the National Institutes of Health has a clinical trials website at http://clinicaltrials.gov/.
To find a clinical trial being conducted in your area, visit the Healia clinical trials search page: /healia/en/index.jsp?&mSp=ct