THURSDAY, Sept. 20, 2018 (American Heart Association) — Black patients hospitalized for heart attacks continue to receive different medical treatment than white patients, according to a new study that explored whether previously reported racial differences in care have faded.
Researchers found that black heart attack patients were less likely than white patients to undergo aggressive medical procedures or be given certain types of medications normally prescribed under common treatment guidelines.
Although racial differences in medical care “are well documented,” according to the study published Thursday in the Journal of the American Heart Association, researchers were investigating whether those disparities had gotten better or worse over time.
In the 15-year snapshot examined by researchers, not much changed.
“Over the years, because of the standardization of evidence-based therapies, we thought the differences would have narrowed, but trends stayed consistent between black and white patients,” said the study’s lead author, Dr. Sameer Arora, a cardiology fellow at the University of North Carolina.
The study examined data on 17,755 patients hospitalized between 2000 to 2014 in four regions in Maryland, North Carolina, Mississippi and Minnesota. It found that black patients were 24 percent less likely than white patients to receive an antiplatelet drug that wasn’t aspirin. They were 9 percent less likely to get medication to reduce their level of lipids, fats in the blood.
Black patients also had a 29 percent lower chance of getting an angiogram, an imaging technique used to see inside the heart’s blood vessels, and were 45 percent less likely to undergo more aggressive therapy such as bypass surgery or angioplasty.
The study only looked at heart attacks in which an artery was partially blocked, partially reducing blood flow. It excluded heart attacks in which a coronary artery is completely obstructed.
Some of the study’s findings provided hints about why racial differences in care have continued over the years. For example, the study found black patients are more likely than their white counterparts to smoke and have chronic illnesses such as diabetes and kidney disease in addition to their heart problems.
“If physicians see you as a high-risk patient, you might not benefit from all of these traditional therapies because they might be considered too aggressive for you,” Arora said.
The study also found that black patients were younger, more often women, and less likely to have medical insurance than white patients.
The findings point to a need to have more voices join the conversation about disparities in patient care and the strategies necessary to achieve health equity, said Dr. Ivor Benjamin, president of the American Heart Association.
“These kinds of studies are extremely important if only that they get the attention of and can be viewed by policymakers, health care systems and providers,” he said. The study also shows the need for early awareness and intervention in the black population to help chip away at some of the multiple risk factors they are more prone to have at younger ages.
“Diabetes, hypertension — those kinds of factors may conspire to drive clinical presentation much earlier in blacks compared to whites,” said Benjamin, director of the Cardiovascular Center at the Medical College of Wisconsin. “What this says is that we need to continue to intensify our efforts at primary prevention while incorporating shared decision-making between providers and patients, especially at points of care using high-complexity interventions.”
For example, new AHA guidelines issued last November redefined high blood pressure as 130/80, versus the previous 140/90. That change of 10 millimeters of mercury was enough to classify nearly half of all Americans as having high blood pressure, which is particularly prevalent among black Americans.
Arora agreed that emphasizing efforts to help black patients reduce their number of co-existing chronic illnesses could make the biggest difference.
“We should aim at reducing the cardiovascular risk factors in these patients,” he said. “I think that’s where one of the main problems lie and that’s where the interventions have to be made to eventually reduce disparities in these patients.”
THURSDAY, Sept. 20, 2018 (HealthDay News) — The Mediterranean diet may do more than help you reach and maintain a healthy weight: New research suggests that women who follow it also lower their stroke risk.
But men did not reap the same benefit from the diet, which concentrates on fish, fruits, nuts, vegetables and beans, and avoids meat and dairy products.
“Simple changes in dietary habits may bring a substantial benefit regarding reducing stroke, which remains one of the leading causes of death and disability worldwide,” said lead researcher Dr. Phyo Myint. He is clinical chair of medicine at the University of Aberdeen School of Medicine in Scotland.
Although the Mediterranean diet is considered healthy, this study could not prove that the diet itself caused stroke risk to drop.
In addition, why men’s risk for stroke isn’t also lowered isn’t yet clear, Myint said.
But, “it is widely acknowledged that men and women are very different with regard to normal physiology,” he added.
Women have unique stroke risk factors that include using oral contraceptives or hormone replacement therapy. And during pregnancy, having preeclampsia and gestational diabetes are considered risk factors for stroke, Myint pointed out.
“It may be that certain components in the Mediterranean diet may influence risk of stroke in women more than in men,” he said.
For the study, the investigators collected data on more than 23,000 men and women, aged 40 to 77, who took part in a large cancer study. The participants were followed for 17 years.
The researchers found that, overall, those who followed a Mediterranean diet cut their risk for stroke 17 percent. When looking at men and women separately, however, women saw a reduction in risk of 22 percent, while men saw a 6 percent drop in risk. The risk reduction among men, however, might be so small that it is a “chance” finding, the scientists added.
Moreover, among those with a high risk for stroke, the risk was lowered 13 percent for those who followed a Mediterranean diet, the findings showed. This association, however, was mainly due to a 20 percent reduction in risk among women, the researchers found.
The findings were published online Sept. 20 in the journal Stroke.
According to Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, “The Mediterranean eating style, which has great variations among several different cultures, is characterized by foods high in anti-inflammatory compounds, including fiber, vitamins, minerals and healthy plant compounds.”
Previous research has suggested that the Mediterranean diet reduces the risk of heart disease, type 2 diabetes, certain cancers, obesity and declines in thinking skills, she said.
Foods such as olive oil, zucchini, lemons, hummus, tabouleh, pasta, eggplant, lentils, tomatoes, artichokes, salads and spices are staples in many parts of the Mediterranean, Heller explained.
“In contrast, the typical Western diet is high in foods that increase inflammation, such as burgers, hot dogs, steak, butter, sodium, sugary beverages, fried foods, fast and junk foods, all of which have been associated with increased risks of chronic diseases,” she said.
Heller suggests skipping the ham and cheese on white bread with mayo for lunch, and instead trying hummus on whole wheat pita with cucumbers and tomatoes. For dinner, try going meatless a few nights a week with a pasta primavera, roasted vegetables, Greek salad, quinoa and lentil-stuffed lettuce wraps, she added.
The American Heart Association has more about the Mediterranean diet.
THURSDAY, Sept. 20, 2018 (HealthDay News) — By fourth grade, girls in the United States read and write better than boys, a new study reveals.
Australian researchers found this gender achievement gap appears in standardized tests and worsens over time.
“The common thinking is that boys and girls in grade school start with the same cognitive ability, but this research suggests otherwise,” said the study’s lead author, David Reilly. He’s a doctoral student at Griffith University in South East Queensland.
“Our research found that girls generally exhibit better reading and writing ability than boys as early as the fourth grade,” he added.
For the study, the researchers examined a nationally representative sample of standardized test scores compiled over 27 years. The 3.4 million U.S. students tested included fourth, eighth and 12th graders.
The tests showed that by the fourth grade, girls scored much higher than boys in reading and writing. This disparity increased over the next eight years. By 12th grade, however, the gender gap in writing was more significant than it was for reading.
“It appears that the gender gap for writing tasks has been greatly underestimated, and that despite our best efforts with changes in teaching methods does not appear to be reducing over time,” Reilly said in a news release from the American Psychological Association.
Statistically, boys are at higher risk for learning disabilities than girls. In addition, boys may be less likely than girls to prioritize reading because of peer pressure to obey “masculine norms,” the study authors suggested.
Behavioral problems may also play a role. The researchers said there are gender differences in issues such as physical aggression, defiance and attention disorders. Such conditions have been linked with reading and writing problems. “These can be disruptive in the classroom, but might also point to a neurological contribution,” Reilly said.
The researchers added that previous studies have also shown that girls use both hemispheres of the brain while reading and writing. Boys, on the other hand, are more likely to rely on only one side of their brain.
“Bilateral language function presumably affords some benefits, which could explain the female advantage observed on such tasks,” Reilly said.
The authors caution that reading and writing are the foundation for academic success later on. “While we’ve concentrated on basic literacy, the demands on students for writing grow stronger as they progress through education. In particular, it’s crucial for high school and college entry,” Reilly said. “Each year, more women than men apply for college entry, and more women than men complete their college degrees. It has a cascading effect on students, either up or down.”
However, the study isn’t endorsing single-sex education, he said. “Rather, it suggests that we need to better tailor our education to meet the needs of boys and really encourage in them early a love not just of reading but also writing,” Reilly said.
The study was published Sept. 20 in American Psychologist.
The American Academy of Pediatrics has more about encouraging kids to read.
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — Brain injury research typically focuses on football players and military veterans, but a new study suggests head injuries are far more widespread than estimated.
About 1 in every 6 U.S. adults — roughly 23 million people aged 40 or older — have been knocked out by a head injury, researchers report.
“Those numbers are huge,” said lead researcher Dr. Andrea Schneider, a neurologist with Johns Hopkins University in Baltimore. “Head injury in the United States is much more common than we thought.”
Further, these head injuries are associated with neurological and psychological problems such as depression, sleep disorders, stroke and alcoholism, the researchers found.
For this study, Schneider and her colleagues relied on data gathered by the National Health and Nutrition Examination Survey, which is conducted by the U.S. Centers for Disease Control and Prevention.
The data showed that nearly 16 percent of U.S. adults aged 40 and older answered yes to the question, “Have you ever had loss of consciousness because of a head injury?”
Men were nearly twice as likely to have answered yes, about 20 percent compared with 12 percent among women.
This could be because men are more involved in careers and pastimes with an increased risk of head injury, such as military service or contact sports, Schneider said.
People who reported a head injury that knocked them out were 54 percent more likely to have a sleep disorder, 68 percent more likely to have had a stroke, twice as likely to be a heavy drinker, and more than twice as likely to have symptoms of depression.
However, researchers can’t say from this data which way the relationship runs between head injury and these health problems, Schneider said.
It could be that depression or sleeplessness or heavy drinking make you more likely to suffer a head injury. It also could be that a head injury increases your risk to subsequently suffer from these problems.
“More prospective studies are needed to look into the directionality of these relationships,” Schneider said.
Kristen Dams-O’Connor, co-director of the Brain Injury Research Center of Mount Sinai in New York City, suspects the relationship runs both ways. Head injuries are prompted by these neurological and psychological problems, but the injuries also can either cause new problems or make existing problems worse.
“We may be talking about people who are associated with previous risk factors, and you’ve now got a traumatic brain injury overlaid upon whatever they were suffering before,” said Dams-O’Connor, who wasn’t involved with the study.
She believes the number of people who’ve suffered a brain injury is even higher than found here.
“I think the numbers are impressive. The numbers are staggering. They certainly support the notion that we need to learn a heck of a lot more about how to prevent this injury,” Dams-O’Connor said. “But at the end of the day, I think this is definitely an undercount.”
The single question used in this survey does not capture all of the potential scenarios in which a traumatic brain injury could occur, Dams-O’Connor explained.
For example, the survey question would not reflect people who were dazed or confused by a blow to the head that did not cause them to lose consciousness, she said.
“That would meet the criteria for a mild traumatic brain injury, and none of those people are even included in this estimate,” Dams-O’Connor noted.
It’s unknown whether these 23 million or more people are at increased risk for neurological problems like dementia or Parkinson’s disease down the road, Dams-O’Connor added.
It’s widely suspected that one traumatic brain injury (TBI) doesn’t result in the kind of long-term damage caused by repeated brain injuries, she said.
“A substantial number of people sustain a TBI that heals and they return to their normal,” Dams-O’Connor said. “These are the lucky ones who go back to their baseline and they don’t have long-term symptoms that don’t go away. Overall, most people who survive a brain injury are not going to develop these terrible outcomes.”
The findings appear in a letter published Sept. 19 in the New England Journal of Medicine.
There’s more from the U.S. National Institutes of Health about traumatic brain injury.
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — Women who have their ovaries removed before menopause may find themselves at higher risk for chronic kidney disease, a new study suggests.
Researchers believe the reason behind it is the drop in estrogen levels that follows the procedure.
“This is the first study that has shown an important link between estrogen deprivation in younger women and kidney damage,” said study senior author Dr. Walter Rocca, a neurologist and epidemiologist at the Mayo Clinic in Rochester, Minn.
Though the study did not prove cause and effect, women considering having their ovaries removed should be aware of this potentially serious risk, particularly if they aren’t at high risk for ovarian and breast cancer, the researchers added.
Chronic kidney disease occurs when the kidneys are damaged and can’t filter the blood as well as they should. If the kidneys fail, patients must undergo dialysis and a kidney transplant. Chronic kidney disease is the ninth leading cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention.
Previous studies have shown that the female hormone estrogen has a protective effect on the kidneys. In this latest study, researchers investigated how the removal of both ovaries affected the kidney function of women who had not yet experienced menopause.
For the study, the researchers analyzed data on more than 1,600 premenopausal women in Minnesota who had their ovaries removed before the age of 50. These women were compared to a second group of women who were about the same age but did not have their ovaries removed.
After following the women for a median of 14 years, the researchers found the women who had ovary removal had a 6.6 percent greater risk for chronic kidney disease than those who didn’t. For women younger than 46 at the time of ovary removal, there was a 7.5 percent greater risk for kidney damage later.
The findings were published Sept. 19 in the Clinical Journal of the American Society of Nephrology.
“For women who do not have an increased genetic risk for breast and ovarian cancer, we recommend against the removal of the ovaries as a preventive option due to the increased risk of diseases, including chronic kidney disease,” Rocca said in a Mayo news release.
The Emory University School of Medicine provides more information on ovary removal.
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — Every nine minutes, a patient in a U.S. hospital dies because a diagnosis was wrong or delayed — resulting in 80,000 deaths a year.
That sobering estimate comes from the Society to Improve Diagnosis in Medicine (SIDM).
To help remedy this situation, more than 40 health care and patient advocacy groups have joined forces to improve the quality of diagnoses, especially those that can result in patient harm. The effort is called ACT for Better Diagnosis.
“Providing an accurate medical diagnosis is complex and involves uncertainty, but it’s obviously essential to effective and timely treatment,” Paul Epner, chief executive officer and co-founder of SIDM, said in a statement.
“Nearly everyone will receive an inaccurate diagnosis at some point in their life, and for some, the consequences will be grave. Major improvement is needed to systematically identify how to improve diagnostic quality and reduce harm to patients,” he said.
In addition to the deaths of hospital patients, diagnostic errors affect 12 million outpatients and is the most common cause of medical errors that patients report, according to SIDM.
The society says obstacles to accurate and timely diagnoses include:
- Incomplete communication when patients are transferred between facilities, doctors or departments.
- Lack of standardized measures for hospitals, health systems or doctors to understand how well they are doing in the diagnostic process, to guide improvement or report errors.
- Patients and doctors both report feeling rushed by limited appointment times, which is a risk in getting a complete medical history essential to making a working diagnosis.
- The diagnostic process is complicated, and limited information is available to patients about the questions to ask or whom to notify when changes in their condition occur or what symptoms are serious.
“The diagnostic process can be complex, as well as emotional and fearful, for women heart patients,” registered nurse Evan McCabe, WomenHeart champion and chair of the board of directors, said in the media statement.
“Having the right information to help mitigate the fear of the unknown is crucial. It’s important that health care providers listen to patients and have the research and other tools they need to provide answers,” she said.
Dr. Ana Maria Lopez, president of the American College of Physicians added, “The diagnosis process — thinking through a patient’s clinical presentation — is a defining task for our profession, and for internal medicine specialists and subspecialists in particular. Critically assessing diagnostic decision-making reveals knowledge gaps, communication pitfalls, and risk for errors.”
Some of the groups that have joined the ACT for Better Diagnosis include the American Academy of Family Physicians, the American Cancer Society Cancer Action Network and the American Heart Association. Also participating are these federal agencies: the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services and the Veterans Health Administration.
For examples of difficult diagnoses, visit the Association of American Medical Colleges.
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — 1 in 7 Americans has diabetes, and many don’t even know they have the blood sugar disease, a new report shows.
According to the U.S. Centers for Disease Control and Prevention, 14 percent of U.S adults have diabetes — 10 percent know it and more than 4 percent are undiagnosed.
“Diabetes remains a chronic health problem in this country, affecting some 30 million people,” said lead researcher Mark Eberhardt, an epidemiologist at CDC’s National Center for Health Statistics (NCHS).
A number of factors may be responsible for the increases in diabetes, he said. This includes an aging population, since diabetes strikes the elderly more often.
In addition, the obesity epidemic is also driving the growing number of people with diabetes, Eberhardt said.
People need to be tested for diabetes even if they think they don’t have it, he said. The data showed that a third of those in the study didn’t think they had diabetes, but tests showed they did, Eberhardt said.
According to the report, nearly 16 percent of men have diabetes, and about 12 percent of women. Moreover, the odds of developing diabetes, both diagnosed and undiagnosed, increases with age.
In terms of populations, diabetes is more common among Hispanics (20 percent) and blacks (18 percent) than whites (12 percent).
The overweight and obese are also more likely to develop diabetes, the researchers found. Only 6 percent of underweight or normal-weight adults had the disease, while 12 percent of overweight adults and 21 percent of obese adults did.
Although treatment for diabetes is available, Eberhardt said, the public health goal should be taking steps to prevent the disease. “Sometimes prevention is the best treatment,” he said.
For the study, the researchers used data from the U.S. National Health and Nutrition Examination Survey.
Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, expressed exasperation with the lack of progress in curbing the diabetes epidemic.
“We need to stop talking the talk and start walking the walk,” he said. Preventing diabetes starts with individuals making healthy lifestyle choices. These include a healthy diet and plenty of exercise.
Zonszein agreed that preventing diabetes should be the goal, but because diabetes is largely a matter of lifestyle it will take major changes in the American culture to accomplish that goal.
To get people to make healthy choices is going to take a drastic change in society, he said. Some of these changes might include taxing sugary drinks and getting people to eat less processed foods and fast foods.
Dr. William Cefalu, chief scientific and medical officer at the American Diabetes Association, said doctors haven’t been able to make that happen in the real world.
“We know how to prevent diabetes,” Cefalu said. “But how to do this in the real world is really the holy grail of the challenge.”
Once someone is diagnosed with diabetes, the goal has to be treatment that prevents complications such as heart disease, amputations and kidney failure.
“The problem is the patients diagnosed are not treated, and those treated are poorly treated with the great majority not achieving goals of sugar control, blood pressure control and cholesterol control,” Zonszein said.
Unfortunately, the best treatment only kicks in when the complications of diabetes become critical, he said.
These treatments consist of treating complications, including kidney failure, heart disease, heart failure and stroke, Zonszein said. “These are expensive and very well covered by our health care system, but primary and secondary prevention are not.”
The findings were published Sept. 19 as an NCHS data brief.
For more information on type 2 diabetes, visit the American Diabetes Association.
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — Widely practiced in Asia for thousands of years, acupuncture is one of the key components of traditional Chinese medicine. Yet it’s still viewed with some skepticism in the Western world.
And for the squeamish, just the idea of needles can be a turnoff. But, depending on what ails you, it might bear trying.
Acupuncture uses very thin needles inserted lightly into the skin to stimulate specific points to correct imbalances in qi (pronounced chee), the flow of energy throughout the body. And these needles don’t cause a similar level of pain to the needle used for, say, your annual flu shot.
Even after hundreds of studies, acupuncture’s effects are just beginning to be understood. Much research has been done on acupuncture for pain relief. It has benefits for people with frequent headaches and offers some relief for some people with back, neck or arthritis pain. There’s even some evidence that it helps with nausea, insomnia, weight loss and quitting smoking as part of a multi-prong approach.
Results vary widely from person to person, even for the same condition, and your expectations and beliefs may factor into whether this drug-free approach helps. So, have an open mind if you’re interested in trying it.
Acupuncture is usually safe in the hands of an experienced, well-trained acupuncturist using sterile needles. But improperly performed, it can cause serious side effects. So always check credentials.
Most states require practitioners to have a license, certification or registration, like a diploma from the National Certification Commission for Acupuncture and Oriental Medicine.
Because of the growing interest in this alternative approach, some conventionally trained health care providers also practice acupuncture. The websites of accrediting organizations are a great way to find qualified practitioners.
The National Certification Commission for Acupuncture and Oriental Medicine has detailed information on acupuncture, including a practitioner directory.
TUESDAY, Sept. 18, 2018 (HealthDay News) — In what is being billed as the largest genetic study ever conducted, British scientists report they have spotted more than 500 genes that play a role in blood pressure.
The research, which involved more than 1 million people, expands the understanding of the genetic factors that determine blood pressure and could lead to new treatments for the condition, according to researchers from Queen Mary University of London and Imperial College London.
“This is the most major advance in blood pressure genetics to date,” said study author Mark Caulfield, director of the National Institute for Health Research Barts Biomedical Research Centre.
“We now know that there are over 1,000 genetic signals which influence our blood pressure. This provides us with many new insights into how our bodies regulate blood pressure, and has revealed several new opportunities for future drug development,” he said.
“With this information, we could calculate a person’s genetic risk score for high blood pressure in later life,” Caulfield explained in a Queen Mary University news release. He is a professor and researcher at the university.
Doctors could then suggest lifestyle interventions, including weight loss, lower alcohol consumption and exercise, for those at genetic risk for high blood pressure, he added.
High blood pressure, which is a risk factor for stroke and heart disease, claimed almost 8 million lives around the world in 2015 alone, the researchers noted.
For the study, they examined the DNA of more than 1 million people and cross-referenced their genetic information with their blood pressure.
After comparing the people at highest risk for high blood pressure with those at lowest risk, the team calculated that all the genetic variants linked with the condition were associated with blood pressure that’s roughly 13 mm Hg higher.
Among the newly identified blood pressure genes were variants already tied to other conditions, including the APOE gene linked to heart disease and Alzheimer’s disease. The researchers noted some genes also played a role within the adrenal glands, and in body fat.
Study co-leader Paul Elliott, from Imperial College London, said, “Identifying these kinds of genetic signals will increasingly help us to split patients into groups based on their risk of disease.”
The findings also pointed to some possible new treatment approaches for high blood pressure. One of the newly found gene regions linked to high blood pressure is already targeted by the type 2 diabetes drug canagliflozin (Invokana, Sulisent). This drug and medicines used to treat other diseases could be safely and inexpensively repurposed for the management of high blood pressure, the researchers said.
The findings were published Sept. 17 in the journal Nature Genetics.
The U.S. Centers for Disease Control and Prevention has more on blood pressure genetics.
TUESDAY, Sept. 18, 2018 (American Heart Association) — Levels of anxiety and depression seen in people who have a common heart rhythm disorder called atrial fibrillation may be affected by how the heart condition is treated, a new study suggests.
Past studies have shown that anxiety, distress and depression are common among people with AFib. The new Australian study, published Tuesday in the Journal of the American Heart Association, looked at personality traits and levels of anxiety and depression in 78 patients who had sought treatment for the disorder. Twenty chose to have an ablation, a procedure that destroys the heart tissue causing the abnormal heartbeat; the other 58 were on medications to control their heart rate and prevent blood clots.
When the study began, 35 percent of the participants reported experiencing severe anxiety and distress and 20 percent reported having had suicidal thoughts. One year later, the researchers found that the patients who had an ablation were less likely to report feelings of anxiety and depression than the patients taking medications. In addition, the number of patients in the ablation group with suicidal thoughts dropped from six to one.
The study’s senior author, Jonathan Kalman, an electrophysiologist at the Royal Melbourne Hospital in Australia, said the study “demonstrates that effective treatment of atrial fibrillation markedly reduces psychological distress.”
In addition, Kalman said the findings “implicate atrial fibrillation as the cause” of the anxiety and depression. “This psychological impact is not well appreciated by many heart specialists and is important to take into consideration when considering” how patients are treated, he added.
The study also found higher levels of anxiety and distress among patients found to have a Type D personality, which is characterized by anger and pessimism. Previous studies have linked this personality type to poor health outcomes and lower quality of life in patients treated for AFib.
Of the 78 patients in the study, 35 were identified as having this type of personality on the distressed personality scale. The researchers suggest that identifying patients with this personality type could help health care providers focus attention on those most at risk for experiencing anxiety, distress or suicidal thoughts.
At least 2.7 million Americans are living with AFib, an abnormal heartbeat that affects blood flow and can lead to stroke, heart failure and other heart complications.
Dr. Dimpi Patel is an internist and researcher at Wilmington Health at New Hanover Regional Medical Center in North Carolina who studies the mind-heart link. “Patients need to be aware that physical ailments can and do have psychological manifestations, and both must be acknowledged and managed to ensure a good quality of life and perhaps even prevent worse outcomes,” she said.
Patel, who was not involved in the study, said the study’s small size limited what could be construed from the findings. She said that she would like to see studies that look at the impact of different types of psychological therapies on patients with AFib as well as studies that focus on how women with the condition are affected by psychological distress.
Many physical health problems can affect someone’s mental health. “It is important to note that psychological distress, depression, anxiety and, at times, suicidal ideation are not exclusive to atrial fibrillation, but to many chronic diseases such as diabetes, chronic obstructive pulmonary disease and congestive heart failure,” Patel said.
“Physicians have an obligation to broaden their approach in managing any chronic illness to include emphasis on the psychological well-being of their patient,” she added. “To me, it is simply practicing good and compassionate medicine.”