Tag Archives: heart

Owning a dog cuts risk of heart attacks and other fatal diseases, study shows

Never mind the chewed slippers, the hair on the sofa, and the inexplicable barking at 3am. Having a dog in the home substantially reduces the risk of heart attacks and other fatal conditions, a major study has shown.

Researchers found that dog ownership had a dramatic effect on people who live alone, cutting the risk of death from cardiovascular disease by 36%. In households with more people under the same roof, dogs had less of a positive impact, but still lowered deaths from heart disease by 15%, the work reveals.

The findings emerge from a study of more than 3.4 million people in Sweden whose medical and pet ownership records were analysed to investigate the potential health benefits of dog ownership. Those who took part in the study were aged 40 to 80 years old and were followed for up to 12 years. Just over 13% had pet dogs.

Tove Fall, professor of epidemiology at Uppsala University, and owner of a five-month-old Kooikerhondje puppy, said the health benefits of dog ownership appeared to be starkest for people who otherwise lived alone. “We see effects in the single households that are much stronger than in multiple-person households,” she said. “If you have a dog you neutralise the effects of living alone.”

Last month, the leader of Britain’s GPs, Helen Stokes-Lampard, warned that loneliness was as bad for human health as a long-term illness. The estimated 1.1 million lonely Britons are 50% more likely to die prematurely than those with good social networks, making loneliness as harmful to the nation’s health as diabetes. While people who live alone are not necessarily lonely, many in the Swedish study seemed to benefit disproportionately from having a dog around.

Working with her colleague, Mwenya Mubanga, on records from Sweden’s national registries, Fall also looked at deaths from any cause and found that people who lived alone with their dogs were a third less likely to die over the study period than those without dogs. For those in larger households, the risk of death was 11% lower among dog owners, the researchers write in Scientific Reports.

The study cannot explain how dogs have a health-boosting impact, but the company alone may reduce stress and motivate people to live healthier lifestyles. In the study, Fall analysed the effects of different breeds and found that owners of dogs originally bred for hunting, such as terriers, retrievers, and scent hounds, had the lowest risk of cardiovascular disease.

People who buy hunting dogs may be more physically active in the first place, because the dogs require so much exercise. The relationship may work both ways though, with livelier dogs effectively demanding that their owners do not slip into an overly-sedentary lifestyle.

But Fall does not believe that getting more exercise explains all, or even most, of the health effects that come with dog ownership. “My impression is that this has to do with social support,” she said.

Other explanations have been put forward, too. Having a dog around the house might influence what varieties of microbes take up residence on and in human bodies, and these may influence our health for the better, Fall said. In previous research, she showed that having a pet dog reduced a child’s risk of asthma by 15%, lending support to the “hygiene hypothesis” which suggests that living in too clean an environment can increase susceptibility to allergies.

Fall hopes to have more answers soon. One key question is whether dogs protect humans against heart disease by reducing blood pressure or through some other effect. “It may be that dog owners like to be outdoors more, or are more organised, or more empathic,” she said.

Owning a dog cuts risk of heart attacks and other fatal diseases, study shows

Never mind the chewed slippers, the hair on the sofa, and the inexplicable barking at 3am. Having a dog in the home substantially reduces the risk of heart attacks and other fatal conditions, a major study has shown.

Researchers found that dog ownership had a dramatic effect on people who live alone, cutting the risk of death from cardiovascular disease by 36%. In households with more people under the same roof, dogs had less of a positive impact, but still lowered deaths from heart disease by 15%, the work reveals.

The findings emerge from a study of more than 3.4 million people in Sweden whose medical and pet ownership records were analysed to investigate the potential health benefits of dog ownership. Those who took part in the study were aged 40 to 80 years old and were followed for up to 12 years. Just over 13% had pet dogs.

Tove Fall, professor of epidemiology at Uppsala University, and owner of a five-month-old Kooikerhondje puppy, said the health benefits of dog ownership appeared to be starkest for people who otherwise lived alone. “We see effects in the single households that are much stronger than in multiple-person households,” she said. “If you have a dog you neutralise the effects of living alone.”

Last month, the leader of Britain’s GPs, Helen Stokes-Lampard, warned that loneliness was as bad for human health as a long-term illness. The estimated 1.1 million lonely Britons are 50% more likely to die prematurely than those with good social networks, making loneliness as harmful to the nation’s health as diabetes. While people who live alone are not necessarily lonely, many in the Swedish study seemed to benefit disproportionately from having a dog around.

Working with her colleague, Mwenya Mubanga, on records from Sweden’s national registries, Fall also looked at deaths from any cause and found that people who lived alone with their dogs were a third less likely to die over the study period than those without dogs. For those in larger households, the risk of death was 11% lower among dog owners, the researchers write in Scientific Reports.

The study cannot explain how dogs have a health-boosting impact, but the company alone may reduce stress and motivate people to live healthier lifestyles. In the study, Fall analysed the effects of different breeds and found that owners of dogs originally bred for hunting, such as terriers, retrievers, and scent hounds, had the lowest risk of cardiovascular disease.

People who buy hunting dogs may be more physically active in the first place, because the dogs require so much exercise. The relationship may work both ways though, with livelier dogs effectively demanding that their owners do not slip into an overly-sedentary lifestyle.

But Fall does not believe that getting more exercise explains all, or even most, of the health effects that come with dog ownership. “My impression is that this has to do with social support,” she said.

Other explanations have been put forward, too. Having a dog around the house might influence what varieties of microbes take up residence on and in human bodies, and these may influence our health for the better, Fall said. In previous research, she showed that having a pet dog reduced a child’s risk of asthma by 15%, lending support to the “hygiene hypothesis” which suggests that living in too clean an environment can increase susceptibility to allergies.

Fall hopes to have more answers soon. One key question is whether dogs protect humans against heart disease by reducing blood pressure or through some other effect. “It may be that dog owners like to be outdoors more, or are more organised, or more empathic,” she said.

Most important meal of the day? Skipping breakfast may be linked to poor heart health

From the full English to a continental croissant, the importance of a hearty breakfast has long been debated – now scientists say skipping the morning meal could be linked to poorer cardiovascular health.

The findings reveal that, compared those who who wolfed down an energy-dense breakfast, those who missed the meal had a greater extent of the early stages of atherosclerosis – a buildup of fatty material inside the arteries.

But, the researchers add, the link is likely to be down to indirect effects.

“People who skip breakfast, not only do they eat late and in an odd fashion, but [they also] have a poor lifestyle,” said Valentin Fuster, co-author of the research and director of Mount Sinai Heart in New York and the Madrid-based cardiovascular research institute, the CNIC.

The research is part of a larger study that will follow the participants over a decade or more to see how disease in the arteries progresses.

Published in the Journal of the American College of Cardiology, the research looked at the health and diets of 4,052 middle-aged bank workers, both men and women, with no previous history of cardiovascular disease.

At the start of the study, which is partly funded by the Spanish bank Santander, participants completed a detailed questionnaire into what they had eaten and when over the previous 15 days.

Body mass index, cholesterol levels and other measures were collected, together with data including the participants’ smoking status, educational attainment and level of physical activity. Imaging techniques were used to track the extent of the early, sub-clinical stages of atherosclerosis in six arteries, including those around the heart, thighs and neck.

The results reveal that, compared to those tucking into more than 20% of their daily calories at breakfast, those who consumed next to nothing for breakfast had a greater extent of atherosclerosis.

While almost 57% of those eating a high-energy breakfast had sub-clinical atherosclerosis, the figure was almost 75% among those who skipped the meal. The trend held once factors including age, sex, smoking status, high blood pressure, diabetes and waist circumference were taken into account.

That, say the authors, suggests the pattern of eating, and the amount consumed, is of importance, with Fuster convinced that skipping breakfast disrupts the body’s internal clock, meaning that individuals end up eating more calories and at unusual times.

“Skipping breakfast in the morning by itself is not the problem; the problem is what you eat afterwards,” he said, adding that the study also found that those who skipped breakfast were – among other traits – more likely to be obese, have high blood pressure, frequently consume alcohol, smoke, and eat high levels of red meat.

But the study has limitations, not least that just 3% of participants said they missed breakfast, with the majority of breakfast-eaters consuming a low-calorie meal. Moreover, measurements were only taken at one point in time, and it isn’t clear whether, for example, obese individuals were missing breakfast to lose weight.

Naveed Sattar, professor of metabolic medicine at the University of Glasgow who was not involved with the study, said that the research did not show that disruption of the body clock was behind the link. “It might be that there is something about having regular meals throughout the day that somehow regulates your appetite [and] means you don’t over-consume calories – that there is something about eating breakfast per se – [but] I don’t think you can answer from this study,” he said.

But, he added, skipping breakfast could be a useful marker to help identify those who need encouragements and support with their lifestyle. “This is just a way to recognise people who have high risk,” he said.

Most important meal of the day? Skipping breakfast may be linked to poor heart health

From the full English to a continental croissant, the importance of a hearty breakfast has long been debated – now scientists say skipping the morning meal could be linked to poorer cardiovascular health.

The findings reveal that, compared those who who wolfed down an energy-dense breakfast, those who missed the meal had a greater extent of the early stages of atherosclerosis – a buildup of fatty material inside the arteries.

But, the researchers add, the link is likely to be down to indirect effects.

“People who skip breakfast, not only do they eat late and in an odd fashion, but [they also] have a poor lifestyle,” said Valentin Fuster, co-author of the research and director of Mount Sinai Heart in New York and the Madrid-based cardiovascular research institute, the CNIC.

The research is part of a larger study that will follow the participants over a decade or more to see how disease in the arteries progresses.

Published in the Journal of the American College of Cardiology, the research looked at the health and diets of 4,052 middle-aged bank workers, both men and women, with no previous history of cardiovascular disease.

At the start of the study, which is partly funded by the Spanish bank Santander, participants completed a detailed questionnaire into what they had eaten and when over the previous 15 days.

Body mass index, cholesterol levels and other measures were collected, together with data including the participants’ smoking status, educational attainment and level of physical activity. Imaging techniques were used to track the extent of the early, sub-clinical stages of atherosclerosis in six arteries, including those around the heart, thighs and neck.

The results reveal that, compared to those tucking into more than 20% of their daily calories at breakfast, those who consumed next to nothing for breakfast had a greater extent of atherosclerosis.

While almost 57% of those eating a high-energy breakfast had sub-clinical atherosclerosis, the figure was almost 75% among those who skipped the meal. The trend held once factors including age, sex, smoking status, high blood pressure, diabetes and waist circumference were taken into account.

That, say the authors, suggests the pattern of eating, and the amount consumed, is of importance, with Fuster convinced that skipping breakfast disrupts the body’s internal clock, meaning that individuals end up eating more calories and at unusual times.

“Skipping breakfast in the morning by itself is not the problem; the problem is what you eat afterwards,” he said, adding that the study also found that those who skipped breakfast were – among other traits – more likely to be obese, have high blood pressure, frequently consume alcohol, smoke, and eat high levels of red meat.

But the study has limitations, not least that just 3% of participants said they missed breakfast, with the majority of breakfast-eaters consuming a low-calorie meal. Moreover, measurements were only taken at one point in time, and it isn’t clear whether, for example, obese individuals were missing breakfast to lose weight.

Naveed Sattar, professor of metabolic medicine at the University of Glasgow who was not involved with the study, said that the research did not show that disruption of the body clock was behind the link. “It might be that there is something about having regular meals throughout the day that somehow regulates your appetite [and] means you don’t over-consume calories – that there is something about eating breakfast per se – [but] I don’t think you can answer from this study,” he said.

But, he added, skipping breakfast could be a useful marker to help identify those who need encouragements and support with their lifestyle. “This is just a way to recognise people who have high risk,” he said.

Most important meal of the day? Skipping breakfast may be linked to poor heart health

From the full English to a continental croissant, the importance of a hearty breakfast has long been debated – now scientists say skipping the morning meal could be linked to poorer cardiovascular health.

The findings reveal that, compared those who who wolfed down an energy-dense breakfast, those who missed the meal had a greater extent of the early stages of atherosclerosis – a buildup of fatty material inside the arteries.

But, the researchers add, the link is likely to be down to indirect effects.

“People who skip breakfast, not only do they eat late and in an odd fashion, but [they also] have a poor lifestyle,” said Valentin Fuster, co-author of the research and director of Mount Sinai Heart in New York and the Madrid-based cardiovascular research institute, the CNIC.

The research is part of a larger study that will follow the participants over a decade or more to see how disease in the arteries progresses.

Published in the Journal of the American College of Cardiology, the research looked at the health and diets of 4,052 middle-aged bank workers, both men and women, with no previous history of cardiovascular disease.

At the start of the study, which is partly funded by the Spanish bank Santander, participants completed a detailed questionnaire into what they had eaten and when over the previous 15 days.

Body mass index, cholesterol levels and other measures were collected, together with data including the participants’ smoking status, educational attainment and level of physical activity. Imaging techniques were used to track the extent of the early, sub-clinical stages of atherosclerosis in six arteries, including those around the heart, thighs and neck.

The results reveal that, compared to those tucking into more than 20% of their daily calories at breakfast, those who consumed next to nothing for breakfast had a greater extent of atherosclerosis.

While almost 57% of those eating a high-energy breakfast had sub-clinical atherosclerosis, the figure was almost 75% among those who skipped the meal. The trend held once factors including age, sex, smoking status, high blood pressure, diabetes and waist circumference were taken into account.

That, say the authors, suggests the pattern of eating, and the amount consumed, is of importance, with Fuster convinced that skipping breakfast disrupts the body’s internal clock, meaning that individuals end up eating more calories and at unusual times.

“Skipping breakfast in the morning by itself is not the problem; the problem is what you eat afterwards,” he said, adding that the study also found that those who skipped breakfast were – among other traits – more likely to be obese, have high blood pressure, frequently consume alcohol, smoke, and eat high levels of red meat.

But the study has limitations, not least that just 3% of participants said they missed breakfast, with the majority of breakfast-eaters consuming a low-calorie meal. Moreover, measurements were only taken at one point in time, and it isn’t clear whether, for example, obese individuals were missing breakfast to lose weight.

Naveed Sattar, professor of metabolic medicine at the University of Glasgow who was not involved with the study, said that the research did not show that disruption of the body clock was behind the link. “It might be that there is something about having regular meals throughout the day that somehow regulates your appetite [and] means you don’t over-consume calories – that there is something about eating breakfast per se – [but] I don’t think you can answer from this study,” he said.

But, he added, skipping breakfast could be a useful marker to help identify those who need encouragements and support with their lifestyle. “This is just a way to recognise people who have high risk,” he said.

E-cigarettes containing nicotine linked to raised heart attack risk

E-cigarettes containing nicotine could increase the risk of heart attacks and strokes, researchers have found.

A study discovered that vaping devices containing the stimulant could cause a stiffening of the arteries, as well as an increased heart rate and blood pressure.

Swedish scientists recruited 15 healthy volunteers to take part in the experiment, none of whom had used e-cigarettes before.

The tests found in the 30 minutes after smoking the e-cigarettes containing nicotine, there was a significant increase in blood pressure, heart rate and arterial stiffness.

There was no such effect in the volunteers who smoked the e-cigarettes without nicotine.

Dr Magnus Lundback of the Karolinska Institute, a medical university in Stockholm, said: “The number of e-cigarette users has increased dramatically in the last few years. E-cigarettes are regarded by the general public as almost harmless.

“The industry markets their product as a way to reduce harm and to help people to stop smoking tobacco cigarettes. However, the safety of e-cigarettes is debated, and a growing body of evidence is suggesting several adverse health effects.

“The results are preliminary, but in this study we found there was a significant increase in heart rate and blood pressure in the volunteers who were exposed to e-cigarettes containing nicotine. Arterial stiffness increased around three-fold in those who were exposed to nicotine-containing e-cigarettes compared with the nicotine-free group.”

While the effects seen in the tests were temporary, Lundback said that chronic exposure to e-cigarettes with nicotine could have permanent effects.

E-cigarettes containing nicotine linked to raised heart attack risk

E-cigarettes containing nicotine could increase the risk of heart attacks and strokes, researchers have found.

A study discovered that vaping devices containing the stimulant could cause a stiffening of the arteries, as well as an increased heart rate and blood pressure.

Swedish scientists recruited 15 healthy volunteers to take part in the experiment, none of whom had used e-cigarettes before.

The tests found in the 30 minutes after smoking the e-cigarettes containing nicotine, there was a significant increase in blood pressure, heart rate and arterial stiffness.

There was no such effect in the volunteers who smoked the e-cigarettes without nicotine.

Dr Magnus Lundback of the Karolinska Institute, a medical university in Stockholm, said: “The number of e-cigarette users has increased dramatically in the last few years. E-cigarettes are regarded by the general public as almost harmless.

“The industry markets their product as a way to reduce harm and to help people to stop smoking tobacco cigarettes. However, the safety of e-cigarettes is debated, and a growing body of evidence is suggesting several adverse health effects.

“The results are preliminary, but in this study we found there was a significant increase in heart rate and blood pressure in the volunteers who were exposed to e-cigarettes containing nicotine. Arterial stiffness increased around three-fold in those who were exposed to nicotine-containing e-cigarettes compared with the nicotine-free group.”

While the effects seen in the tests were temporary, Lundback said that chronic exposure to e-cigarettes with nicotine could have permanent effects.

New heart treatment is biggest breakthrough since statins, scientists say

Anti-inflammatory injections could lower the risk of heart attacks and may slow the progression of cancer, a study has found, in what researchers say is the biggest breakthrough since the discovery of statins.

Heart attack survivors given injections of a targeted anti-inflammatory drug called canakinumab had fewer attacks in the future, scientists found. Cancer deaths were also halved in those treated with the drug, which is normally used only for rare inflammatory conditions.

Statins are the mainstay drugs for heart attack prevention and work primarily by lowering cholesterol levels. But a quarter of people who have one heart attack will suffer another within five years despite taking statins regularly. It is believed this is because of unchecked inflammation within the heart’s arteries.

The research team, led from Brigham and Women’s hospital in Boston, tested whether targeting the inflammation with a potent anti-inflammatory agent would provide an extra benefit over statin treatment.

The researchers enrolled more than 10,000 patients who had had a heart attack and had a positive blood test for inflammation into the trial, known as the Cantos study. All patients received high doses of statins as well as either canakinumab or a placebo, both administered by injection every three months. The trial lasted for four years.

For patients who received the canakinumab injections the team reported a 15% reduction in the risk of a cardiovascular event, including fatal and non-fatal heart attacks and strokes. Also, the need for expensive interventional procedures, such as bypass surgery and inserting stents, was cut by more than 30%. There was no overall difference in death rates between patients on canakinumab and those given placebo injections, and the drug did not change cholesterol levels.

Dr Paul Ridker, who led the research team, said the study “usher in a new era of therapeutics”.

“For the first time, we’ve been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk,” he said.

“This has far-reaching implications. It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to significantly improve outcomes for certain very high-risk populations.”

The hospital said the reductions in risk were “above and beyond” those seen in patients who only took statins.

Ridker said the study showed that the use of anti-inflammatories was the next big breakthrough following the linkage of lifestyle issues and then statins.

“In my lifetime, I’ve gotten to see three broad eras of preventative cardiology,” he said. “In the first, we recognised the importance of diet, exercise and smoking cessation. In the second, we saw the tremendous value of lipid-lowering drugs such as statins. Now, we’re cracking the door open on the third era. This is very exciting.”

But there were some downsides to the treatment. The researchers reported an increase in the chances of dying from a severe infection of about one for every 1,000 people treated, although this was offset by an unexpected halving of cancer deaths across all cancer types. In particular, the odds of succumbing to lung cancer were cut by over 75%, for reasons the team do not yet understand. The researchers are planning further trials to investigate canakinumab’s potentially protective effect against cancer.

Dr Paul Ridker, who led the study, which was published in the New England Journal of Medicine, said it had far-reaching implications.

“It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to improve outcomes for certain very high-risk populations,” he said.

Prof Martin Bennett, a cardiologist from Cambridge who was not involved in the study, said the trial results were an important advance in understanding why heart attacks happen. But, he said, he had concerns about the side effects, the high cost of the drug and the fact that death rates were not better in those given the drug.

“Treatment of UK patients is unlikely to change very much as a result of this trial, but the results do support investigation of other drugs that inhibit inflammation for cardiovascular disease, and the use of this drug in cancer,” he said.

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, was optimistic about the trial opening the door to new types of treatment for heart attacks.

“Nearly 200,000 people are hospitalised due to heart attacks every year in the UK,” Pearson said. “Cholesterol-lowering drugs like statins are given to these people to reduce their risk of another heart attack and this undoubtedly saves lives. But we know that lowering cholesterol alone is not always enough.

“These exciting and long-awaited trial results finally confirm that ongoing inflammation contributes to risk of heart disease, and [lowering it] could help save lives.”

New heart treatment is biggest breakthrough since statins, scientists say

Anti-inflammatory injections could lower the risk of heart attacks and may slow the progression of cancer, a study has found, in what researchers say is the biggest breakthrough since the discovery of statins.

Heart attack survivors given injections of a targeted anti-inflammatory drug called canakinumab had fewer attacks in the future, scientists found. Cancer deaths were also halved in those treated with the drug, which is normally used only for rare inflammatory conditions.

Statins are the mainstay drugs for heart attack prevention and work primarily by lowering cholesterol levels. But a quarter of people who have one heart attack will suffer another within five years despite taking statins regularly. It is believed this is because of unchecked inflammation within the heart’s arteries.

The research team, led from Brigham and Women’s Hhospital in Boston, tested whether targeting the inflammation with a potent anti-inflammatory agent would provide an extra benefit over statin treatment.

The researchers enrolled more than 10,000 patients who had had a heart attack and had a positive blood test for inflammation into the trial, known as the Cantos study. All patients received high doses of statins as well as either canakinumab or a placebo, both administered by injection every three months. The trial lasted for four years.

For patients who received the canakinumab injections the team reported a 15% reduction in the risk of a cardiovascular event, including fatal and non-fatal heart attacks and strokes. Also, the need for expensive interventional procedures, such as bypass surgery and inserting stents, was cut by more than 30%. There was no overall difference in death rates between patients on canakinumab and those given placebo injections, and the drug did not change cholesterol levels.

Dr Paul Ridker, who led the research team, said the study “usher in a new era of therapeutics”.

“For the first time, we’ve been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk,” he said.

“This has far-reaching implications. It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to significantly improve outcomes for certain very high-risk populations.”

The hospital said the reductions in risk were “above and beyond” those seen in patients who only took statins.

Ridker said the study showed that the use of anti-inflammatories was the next big breakthrough following the linkage of lifestyle issues and then statins.

“In my lifetime, I’ve gotten to see three broad eras of preventative cardiology,” he said. “In the first, we recognised the importance of diet, exercise and smoking cessation. In the second, we saw the tremendous value of lipid-lowering drugs such as statins. Now, we’re cracking the door open on the third era. This is very exciting.”

But there were some downsides to the treatment. The researchers reported an increase in the chances of dying from a severe infection of about one for every 1,000 people treated, although this was offset by an unexpected halving of cancer deaths across all cancer types. In particular, the odds of succumbing to lung cancer were cut by over 75%, for reasons the team do not yet understand. The researchers are planning further trials to investigate canakinumab’s potentially protective effect against cancer.

Dr Paul Ridker, who led the study, which was published in the New England Journal of Medicine, said it had far-reaching implications.

“It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to improve outcomes for certain very high-risk populations,” he said.

Prof Martin Bennett, a cardiologist from Cambridge who was not involved in the study, said the trial results were an important advance in understanding why heart attacks happen. But, he said, he had concerns about the side effects, the high cost of the drug and the fact that death rates were not better in those given the drug.

“Treatment of UK patients is unlikely to change very much as a result of this trial, but the results do support investigation of other drugs that inhibit inflammation for cardiovascular disease, and the use of this drug in cancer,” he said.

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, was optimistic about the trial opening the door to new types of treatment for heart attacks.

“Nearly 200,000 people are hospitalised due to heart attacks every year in the UK,” Pearson said. “Cholesterol-lowering drugs like statins are given to these people to reduce their risk of another heart attack and this undoubtedly saves lives. But we know that lowering cholesterol alone is not always enough.

“These exciting and long-awaited trial results finally confirm that ongoing inflammation contributes to risk of heart disease, and [lowering it] could help save lives.”

Anti-inflammatory drugs may lower heart attack risk, study finds

Anti-inflammatory injections could lower the risk of heart attacks and may slow the progression of cancer, a study has found, in what researchers say is the biggest breakthrough since the discovery of statins.

Heart attack survivors given injections of a targeted anti-inflammatory drug called canakinumab had fewer attacks in the future, scientists found. Cancer deaths were also halved in those treated with the drug, which is normally used only for rare inflammatory conditions.

Statins are the mainstay drugs for heart attack prevention and work primarily by lowering cholesterol levels. But a quarter of people who have one heart attack will suffer another within five years despite taking statins regularly. It is believed this is because of unchecked inflammation within the heart’s arteries.

The research team, led from Brigham and Women’s Hhospital in Boston, tested whether targeting the inflammation with a potent anti-inflammatory agent would provide an extra benefit over statin treatment.

The researchers enrolled more than 10,000 patients who had had a heart attack and had a positive blood test for inflammation into the trial, known as the Cantos study. All patients received high doses of statins as well as either canakinumab or a placebo, both administered by injection every three months. The trial lasted for four years.

For patients who received the canakinumab injections the team reported a 15% reduction in the risk of a cardiovascular event, including fatal and non-fatal heart attacks and strokes. Also, the need for expensive interventional procedures, such as bypass surgery and inserting stents, was cut by more than 30%. There was no overall difference in death rates between patients on canakinumab and those given placebo injections, and the drug did not change cholesterol levels.

Dr Paul Ridker, who led the research team, said the study “usher in a new era of therapeutics”.

“For the first time, we’ve been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk,” he said.

“This has far-reaching implications. It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to significantly improve outcomes for certain very high-risk populations.”

The hospital said the reductions in risk were “above and beyond” those seen in patients who only took statins.

Ridker said the study showed that the use of anti-inflammatories was the next big breakthrough following the linkage of lifestyle issues and then statins.

“In my lifetime, I’ve gotten to see three broad eras of preventative cardiology,” he said. “In the first, we recognised the importance of diet, exercise and smoking cessation. In the second, we saw the tremendous value of lipid-lowering drugs such as statins. Now, we’re cracking the door open on the third era. This is very exciting.”

But there were some downsides to the treatment. The researchers reported an increase in the chances of dying from a severe infection of about one for every 1,000 people treated, although this was offset by an unexpected halving of cancer deaths across all cancer types. In particular, the odds of succumbing to lung cancer were cut by over 75%, for reasons the team do not yet understand. The researchers are planning further trials to investigate canakinumab’s potentially protective effect against cancer.

Dr Paul Ridker, who led the study, which was published in the New England Journal of Medicine, said it had far-reaching implications.

“It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to improve outcomes for certain very high-risk populations,” he said.

Prof Martin Bennett, a cardiologist from Cambridge who was not involved in the study, said the trial results were an important advance in understanding why heart attacks happen. But, he said, he had concerns about the side effects, the high cost of the drug and the fact that death rates were not better in those given the drug.

“Treatment of UK patients is unlikely to change very much as a result of this trial, but the results do support investigation of other drugs that inhibit inflammation for cardiovascular disease, and the use of this drug in cancer,” he said.

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, was optimistic about the trial opening the door to new types of treatment for heart attacks.

“Nearly 200,000 people are hospitalised due to heart attacks every year in the UK,” Pearson said. “Cholesterol-lowering drugs like statins are given to these people to reduce their risk of another heart attack and this undoubtedly saves lives. But we know that lowering cholesterol alone is not always enough.

“These exciting and long-awaited trial results finally confirm that ongoing inflammation contributes to risk of heart disease, and [lowering it] could help save lives.”