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Cardiovascular risk factors lead to higher lifetime risk of aortic aneurysm, study finds

November 11, 2016 - 10:00am

Abdominal aortic aneurysm (AAA) is a vascular disease found in adults. It involves the enlargement of the aorta, the main blood vessel delivering blood throughout the body, at the abdomen.

The University of Minnesota School of Public Health analyzed data from a 24-year ARIC study to determine risk factors associated with AAA. It is the first study to report the AAA lifetime risk in a community-based cohort with long-term follow-up.

Weihong Tang, Ph.D., M.S., M.D., an associate professor in the School of Public Health, analyzed data to examine midlife cardiovascular risk factors and their association with a higher lifetime risk of abdominal aortic aneurysm.

The study quantified AAA incidence and lifetime risk by race, gender and longitudinal smoking status. The study found that 1 in 17 people in the general public are at risk for the disease, and current smokers are at a higher lifetime risk of the disease. Smoking cessation reduced lifetime risk of AAA.

Tang and her team also found that white race, male gender, greater height and elevated LDL, or total cholesterol, were associated with increased risk of AAA.

Tang added that the lifetime risk of the disease for female current smokers is not far behind that of males.

These findings could make an impact on clinical care and health policy.

“Physicians need to start paying similar attention to the risk factors for this disease in women. They should be monitoring female current smokers for the occurrence of AAA as they do in male ever smokers after they pass middle age,” said Tang.

The next step, according to Tang, is to identify additional risk factors that predispose AAA to rupture, and to search for novel biomarkers of the disease.

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UMN researchers find the link between heart and blood cells in early development

October 7, 2016 - 7:20am

New research from the University of Minnesota reveals endoglin as a critical factor in determining the fate of early undifferentiated cells during development. Endoglin, a receptor involved in cell signaling, has previously been known mostly for its function in blood vessels and angiogenesis. In a new paper published in the journal Nature Communications, researchers showed endoglin modulates key signaling pathways to encourage early cells to develop into blood cells at the expense of the heart.

“During the early stages of development, cells have to make decisions very quickly,” said Rita Perlingeiro, Ph.D., professor of Medicine in the University of Minnesota Medical School’s Cardiovascular Division. “Fine-tuning of these early cell fate decisions can be easily disrupted by levels of key proteins within these cells.  When one cell type is favored, this implies less of another. In this case, high levels of endoglin expression enhance the cell differentiation into blood cells, whereas cardiac cells are in deficit.”

June Baik, PhD, a member of the Perlingeiro’s lab, and the leading author of this study, wanted to pinpoint the mechanism underlining the dual function of endoglin in blood and cardiac cell fate. She manipulated the levels of endoglin in differentiating mouse pluripotent stem cells as well as primary heart cells from zebrafish and mice. Her findings confirmed the endoglin expression connection.

The next step was to further understand the molecular regulation associated with endoglin’s function in this differentiation process. By looking closely at the pathways of development and differentiation, the research team identified JDP2 as a novel and important downstream mediator sufficient to induce blood fate when the endoglin signaling is disturbed.

Read more: full paper available online

“The blood and heart systems are the first organs to develop in mammals, but the mechanisms regulating these earliest cell fate decisions are poorly understood,” said Perlingeiro. “By using multiple model systems, combined with specialized cell sorting technology and sequencing tools, our findings help uncover mechanisms previously unseen in the few cells engaged in these early development decisions.

Perlingeiro points to a great opportunity to collaborate on next steps, identifying this as an interesting area to pursue in relation to the role of endoglin in congenital heart defects.

“The importance of these studies by the Perlingeiro laboratory is the discovery of key regulatory factors governing blood and heart formation,” said Daniel Garry, M.D., Ph.D, director of the Lillehei Heart Institute at the University of Minnesota, and co-author in this study. “The clinical significance of these findings rests in the possibility of targeting these newly discovered networks to promote the development of blood or heart tissue in congenital diseases and following injuries in adults.”

Funding for this project was provided by grants from the National Institutes of Health: R01 HL085840, R01 AR055299, U01 HL100407R01, R01 AR064195, and T32AR07612, and a grant from Regenerative Medicine Minnesota.

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Research snapshot: “Molecular band-aid” shows promise to prevent heart attack damage

June 28, 2016 - 8:23am

It’s estimated that someone in the U.S. has a heart attack every 43 seconds.

Currently, there is no clinical treatment available to prevent or reverse injuries that cut off blood flow caused by heart attacks, but injecting a special compound called Poloxamer 188 (P188) during a heart attack has shown promising results in pig models, researchers from the University of Minnesota Medical School found.

A poloxamer is a type of triblock copolymer, which is a macromolecule that acts as an agent to lower the surface tension between two liquids, or a liquid and a solid.

“P188 could repair damage as it’s happening,” said Joseph Metzger, Ph.D., professor and head of the Department of Integrative Biology and Physiology.

P188 preserves cell structure and reduces  damage. P188 is sometimes referred to as a “molecular band-aid.”

“If we can better understand how P188 is working, and how to apply that to treatments for people, this could greatly improve outcomes in patients suffering from heart attacks,” said Demetri Yannopoulos, M.D., associate professor in the cardiovascular division of the Department of Medicine.

The study was published recently in the Journal of the American College of Cardiology.

Heart attacks can cut off respiration and stress tolerance, leading to cell death and greater tissue damage. In this study, pigs who received immediate injections to the heart were able to preserve functions needed to keep cells alive.

In fact, the study found P188 reduced heart attack size by more than 60 percent when injected directly into the heart, in comparison with an intravenous injection.

Yannopoulos and Metzger co-authored the study with Frank Bates, Sc.D., regents professor in the Department of Chemical Engineering and Materials Science.

Metzger, Yannopolous and Bates will continue to study P188’s impact in ST-segment elevation heart attacks, and in other related heart conditions.

Learn more about their research.

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Research snapshot: Chronic kidney disease linked to masked hypertension

February 18, 2016 - 9:50am

Chronic kidney disease (CKD) patients could be suffering from masked hypertension, a recent UMN study found.

This type of undiagnosed high blood pressure can be difficult to spot because patients’ numbers come back normal in the clinic. But outside of the doctor’s office, they could have high blood pressure.

“Masked hypertension is a serious problem,” said Paul Drawz, M.D., lead author of the study. “Hypertension puts you at an increased risk for renal and cardiovascular damage. But if it’s not evident in the clinic, patients won’t get the treatment or preventative care that normally comes along with a hypertension diagnosis.”

Drawz is an assistant professor in the division of renal diseases and hypertension in the Medical School.

The study looked at more than 1,000 men and women with CKD who were enrolled in the Chronic Renal Insufficiency Cohort Study. Each patient received 24-hour ambulatory blood pressure monitoring, which can track spikes in blood pressure over the course of the day. More than one-quarter of the study participants had masked hypertension.

The study found that ambulatory blood pressure better demonstrated the association between high blood pressure and hypertension related target organ damage than blood pressure monitoring in clinic alone. Ambulatory blood pressure therefore could be useful as a prognostic tool, and it should be further studied for its effectiveness in identifying patients at high risk for adverse outcomes.

“We also found that patients with CKD had higher nighttime blood pressure,” Drawz said, which is another risk factor for cardiovascular and renal diseases.

“We need further research to determine whether treating masked hypertension is even feasible,” Drawz said. That could mean more ambulatory blood pressure monitoring, which requires that individuals wear a monitor for 24-hours, and could be more difficult on a mass scale.

More research could help determine whether treatment of masked hypertension would reduce the risk for adverse outcomes because there haven’t been clinical trials with masked hypertension patients.

“This is an opportunity for physicians and health care leaders to take a step back and really consider how we diagnose and treat hypertension, and explore if there are ways we can improve our current standards,” Drawz said.

The study was published in the Clinical Journal of the American Society of Nephrology. The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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In the News: University of Minnesota research drives home aspirin’s benefits

January 12, 2016 - 12:33pm

Despite its known benefits, new research from the University of Minnesota’s Medical School shows many older patients don’t talk to their doctors about the cardiovascular benefits of low-dose aspirin.

The study, published in the Journal of the American Heart Association, looked at aspirin use of 26,000 Minnesotans ages 25 to 74. The study found aspirin use for primary prevention of heart attacks and stroke increased in men from 1 percent in 1980 to 21 percent in 2009, and in women from 1 percent to 12 percent.

In this case, primary prevention means taking aspirin if you have known risk factors of heart attack and stroke, before an adverse event occurs. The recommended age is 45 for men and 55 for women. According to the research, the rate among men 65 to 74 rose from 3 percent in 1980 to 57 percent in 2009, which may not be high enough.

Although people have been using aspirin to prevent heart attacks and stroke since the 1980s, thousands of Minnesotans with high blood pressure are still not using aspirin daily. This is hoped to increase with the “Ask About Aspirin” campaign, lead by researcher Alan Hirsch, M.D., a cardiologist in the Medical School and Lillehei Heart Institute and Russel Luepker, M.D., M.S., professor of epidemiology and cardiology in the School of Public Health.  

“There’s been less clarity and more confusion about what to do when you’re at risk but haven’t had the event [stroke or heart attack],” said Hirsch in an interview with MPR. “In other words, if aspirin is your seat belt, you’d like to wear it before the accident happens.”

The campaign, which launched last year, is an initiative designed by the Lillehei Heart Institute at the University of Minnesota Medical School and the School of Public Health. The statewide campaign is designed to quickly and safely lower heart disease risk by generating public awareness and second, providing the education and tools necessary for health professionals to facilitate the appropriate recommendation.


As mentioned in Hirsch’s study, the campaign could potentially prevent 10,000 heart attacks and 1,200 strokes among Minnesotans who currently are at risk. Although increased aspirin use could lead to side effects such gastrointestinal bleeding and hemorrhagic strokes, the low cost and benefits of aspirin outweigh these risks.

“The fear of providing an innocent aspirin pill and causing a bleeding ulcer trumps the optimism of providing something that might prevent heart attack or stroke,” said Hirsch in an interview with the Star Tribune. “It will take a concerted effort to convince doctors and also patients who loathe taking pills when they aren’t sick.”

It’s always important to consult your doctor before taking over the counter medications, so have a conversation about whether it is right for you. Fighting heart attack and stroke could be as simple as taking one aspirin a day.


Community programs increase aspirin use among individuals at high-risk for heart disease

Some drugs may be off-label, but not off focus


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Intensive blood pressure lowering in patients with type 2 diabetes may have beneficial effect in preventing atrial fibrillation

December 11, 2015 - 10:37am

The most common heart rhythm abnormality, atrial fibrillation, is categorized by a rapid or irregular heartbeat leading to poor blood flow. In patients with type 2 diabetes (T2DM), there have been no proven strategies to prevent this condition, until recently.

In a new study from the University of Minnesota Cardiovascular Division, Department of Medicine, researchers found that as compared with standard blood pressure lowering, intensive blood pressure lowering in patients with T2DM was associated with a reduced incidence of atrial fibrillation and abnormal P-Wave indices (PWI).

Health Talk spoke with Associate Professor Lin Yee Chen, M.D., M.S., whose research is focused on atrial fibrillation.

Health Talk (HT): What is PWI?

Lin Yee Chen (LYC): PWI indices are not only a surrogate or an intermediate phenotype for atrial fibrillation; PWI, in and of themselves, are associated with adverse outcomes including ischemic stroke.

HT: In terms of “intensive blood pressure lowering” what categorizes intensive?

LYC: The way doctors treat blood pressure is based on the report from the panel members of the eighth Joint National Committee. These guidelines recommend blood pressure goals of 140/90 mm Hg for those younger than 60 years of age and 150/90 mm Hg for those older than 60 years of age. However, our results showed that when systolic blood pressure was lowered to less than 120 mm Hg, there were potential benefits in terms of lowering the risk of atrial fibrillation.

HT: What does that mean in regards to patient care?

LYC: The recently published SPRINT trial—a multicenter, randomized, open-label trial of nondiabetic individuals—found that as compared with standard treatment (target systolic pressure <140 mmHg), intensive treatment (target systolic pressure <120 mmHg) reduced the rate of the primary endpoint, a composite of myocardial infarction, acute coronary syndrome, stroke, heart failure, or cardiovascular death. Our findings extend the results of SPRINT by showing a potential cardiovascular benefit from intensive blood pressure lowering in patients with T2DM.


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Research snapshot: Effects of beta-blocker withdrawal in acute decompensated heart failure

August 13, 2015 - 8:00am

Responsible for approximately 1 million hospitalizations each year, acute decompensated heart failure (ADHF), poses a challenge for health care professionals. To combat high mortality rates, patients with heart failure are often treated with beta-blockers, medications that can prevent further weakening of the heart.

A recent study in the Journal of the American College of Cardiology-Heart Failure from the University of Minnesota Medical School found the discontinuation of beta-blockers in ADHF patients was associated with a significant increase in mortality and rehospitalization.

ADHF occurs when patients with heart failure require admission to the hospital after retaining too much fluid. When the heart fails, the fluid inside of the body does not sufficiently circulate throughout organs, causing the congestion.

Beta-blockers are used in patients with heart failure to protect the heart by preventing excessive stimulation says Kurt Prins, M.D., Ph.D., lead author of the study. Due to the concerns of beta-blockers on blood flow, some physicians choose to discontinue the medication when patients are hospitalized.

“We were inspired to investigate this question because patients with ADHF continue to have poor outcomes despite intensive research,” said Prins. “We wanted to investigate the role of beta-blockers in this population because their use is often debated. We hoped to provide a more definitive answer to help guide physician treatment choices going forward.”

The study was a collaborative project between physicians and statisticians, examining three outcomes of stopping the beta-blockers: in-hospital mortality, short-term mortality and combined short-term mortality and rehospitalization. Although it is unknown how beta-blocker withdrawal directly causes harm to the heart, all three endpoints were associated with worse outcomes when beta-blockers were stopped.

“The implications for our study are patients with ADHF should have their beta-blocker continued if possible because it may reduce the risk of adverse events,” said Prins. “Going forward, we hope more physicians will continue beta-blockers in ADHF patients.”

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Research snapshot: Potential therapeutic target for cardiomyopathy identified

July 21, 2015 - 2:33pm

New research out of the University of Minnesota Medical School shows a new potential therapeutic target for viruses causing cardiomyopathy, or disease of the heart muscle.

The paper was published in the July 2015 issue of Science Translational Medicine.

Research led by Joseph Metzger, Ph.D., looked at potential causes for cardiomyopathy, specifically related to enterovirus infection.

“We already knew enterovirus infection can cause severe cardiomyopathy,” said Metzger, chair of the Department of Integrative Biology and Physiology in the University of Minnesota Medical School. “The 2A protease is encoded by the virus and cleaves the cytoskeletal protein dystrophin. What we wanted to know was what part of the process was causing the cardiomyopathy; the loss of dystrophin or the cleaving process.”

Among the major findings in the paper:

  • The 2A protease-mediated C-terminal dystrophin cleavage fragment (CtermDys) is enough to cause marked dystrophic cardiomyopathy. When looking specifically at the heart muscle cells, cardiac stress tests showed CtermDys fragments directly caused myocardial fibrosis, higher death rates in animal models. Cardiomyopathy related to CtermDys was more severe than in hearts without dystrophin.
  • Chemical analysis indicates when CtermDys decays, dystrophin rebounds in the muscle fibers. Further testing, including looking into dystrophin replacement, shows the target balance is 50 percent membrane-bound intact dystrophin to prevent cardiomyopathy in mice.
  • Inhibiting CtermDys could stop the disease mechanisms. The research shows the CtermDys cleaved dystrophin fragment severs the critical link to cortical actin, and also inhibits the compensatory utrophin from binding at the membrane. This potential for disruption makes CtermDys a good target for potential treatments in the future.

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MN Resuscitation Consortium celebrates National CPR and AED Awareness Week

June 4, 2015 - 7:00am

Most assume that in the event of a major cardiac emergency, another bystander trained in CPR will be nearby to save the day. In reality, nearly 70 percent of Americans wouldn’t be prepared to give CPR. As National CPR and AED Awareness Week continues, Kim Harkins, from the Minnesota Resuscitation Consortium (MRC) at the University of Minnesota, brought Health Talk up-to-date on the latest CPR standards, and how to react when facing a cardiac arrest situation.

CPR in five steps
- Call 911.
- Place your hands in the center of the chest.
- Push at least 2 inches at 100 beats per minute.
- If an AED is nearby, grab it, turn it on, and follow the prompts.
- Proceed with compression CPR until help arrives.

CPR should be administered if a person suddenly collapses and does not respond. If you cannot see the chest moving with breaths at a regular rate, it is important to call 911 and then proceed with chest compressions. You should still take action if a person has abnormal and erratic breathing.

“Even with changes in CPR techniques; it is best to remember that doing something is better than doing nothing,” said Harkins. There are very similar threads to changes in techniques, so even providing CPR as you were trained years ago is better than waiting.  And the dispatch on the phone, when you call 911, can guide you through the correct steps.”

The MRC is inviting all Minnesotans to celebrate the week by hosting a CPR training session, attending a training session in person, or learning online. To help the planning process, the MRC has created CPR Training Planning Kits that assist with securing a training location, obtaining necessary equipment and promotion. An online option with training videos and instructions is available at

“The MRC works with the community and cardiac arrest survivors to improve outcomes from sudden cardiac arrest by impacting bystander, prehospital and hospital response,” said Harkins.

Minnesota HEARTsafe Communities, a program promoting the survival of sudden cardiac arrests, will celebrate reaching its goal of involving 100 communities this afternoon with the Governor’s office.

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Grant Announcement: University of Minnesota receives multimillion-dollar NIH grant to research new heart attack treatments

December 29, 2014 - 8:37am

A University of Minnesota multidisciplinary research team was awarded $2.6 million by the National Institutes of Health (NIH) to investigate new treatments for heart attacks. The research will focus on myocardial ischemia and reperfusion injury, which account for over 300,000 deaths each year in the U.S.

Myocardial ischemia occurs when blood flow to the heart muscle is stopped by blocked coronary arteries. The cessation causes the death of heart muscle cells, called necrotic cell death. Instances of a severely blocked coronary artery can result in a heart attack.

The re-opening of the blocked arteries to restore blood flow can cause additional damage to the cardiac muscle, known as reperfusion injury. This reperfusion is even more damaging to the cardiac tissues than the initial myocardial ischemia event.

The research team will focus on developing new strategies to prevent the second wave of heart damage. Investigating the advanced generation of synthetic molecular band-aids, the medical researchers plan to develop treatments to protect the cardiac tissue during the reperfusion process.

Leading experts on the research team specialize in a variety of disciplines including chemical engineering and material sciences, clinical cardiology, and biology and physiology.

Demetris Yannopolous, M.D., a physician in the University of Minnesota Medical School, will assist in leading the team with his expertise in reperfusion injury and cardiac resuscitation.

Additionally, Frank Bates, S.M., Sc.D., professor and past head of Chemical Engineering and Materials Science is a world leader in the development of the synthetic band-aids known as poloxamers.

Principal investigator, Joseph Metzger, Ph.D., is the head of the Department of Integrative Biology and Physiology also in the medical school. Metzger’s group previously discovered the application of the synthetic molecular band-aids for inherited heart diseases and plans to extend the base to acquired diseases.

“This grant offers a wonderful example of tapping into the richness of scholarship and expertise at UMN as directed toward a significant biomedical research problem,” said Metzger.

The team plans to understand how synthetic copolymers work in order to protect heart muscle. Through the success of the research, the molecular band-aid treatment could help millions of heart patients across the globe.

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U of M study finds sit-stand workstations help improve blood pressure, reduce cardiometabolic risk

December 22, 2014 - 2:01pm

You’re likely sitting down as you read this, but perhaps you should stand instead.

On average, adult Americans spend more than 7.5 hours per day sedentary (not counting sleep time), and employed adults in primarily office jobs spend up to 75 percent of their time at work sitting.

Recent studies also suggest that even modest decreases in sedentary time can help reduce your risk of obesity, cardiovascular diseases, diabetes and premature mortality.

Still sitting?

A recent study presented at the 2014 Obesity Week meeting in Boston from the School of Public Health at the University of Minnesota evaluated the effects of sit-stand workstations, with and without a worksite physical activity intervention, on risk factors for diabetes, heart disease, and stroke. Nearly 250 employees from Twin Cities office buildings, who spent most of their workday sitting, were randomly assigned to one of four groups for the six-month study.

The four groups were classified as General (usual behavior at work), Move (some intervention with a goal of at least 30 minutes of activity throughout the workday), Stand (standing at least 50 percent of the day using a sit-stand workstation), and Stand & Move (combined Stand and Move interventions).

The study found significant beneficial effects on blood sugar and triglycerides, and trends towards improvements in blood pressure for those in the intervention groups compared to control. More specifically, the Stand & Move group had the lowest six-month blood sugar, triglycerides, and blood pressure.

Now before you rush out and contact your company’s facilities staff to make the switch to a sit-stand workstation, Mark Pereira, Ph.D., associate professor of epidemiology and community health in the School of Public Health and co-author of the study, has some cautionary advice.

“If you are thinking of switching from a traditional sitting desk to a sit-stand workstation, you should start with an ergonomic evaluation of your workplace to determine the best sit-stand model for your office or cubical and also consider any physical limitations you may have,” said Pereira. “Never abruptly start standing at work, but rather, gradually increase your standing time so that after about four weeks you are standing at your desk for about half of your desk-time.”

Pereira added that the beauty of the sit-stand workstations is that they easily go up and down and take your computer monitor with them. Posture and footwear are also important.

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Men’s health: Ganesh Raveendran, M.D., and the fight against heart disease

June 30, 2014 - 1:31pm

Courtesy: Nicolas Raymond, Flickr Creative Commons

Heart disease is the top killer of Americans, both men and women, accounting for about one in four deaths each year. From diets high in fat and sugar to a growing sedentary lifestyle, combating heart disease is difficult. To curb this national epidemic, University of Minnesota researcher Ganesh Raveendran, M.D., is working to provide improved cardiac treatment.

Raveendran, director of the cardiac catheterization laboratory at the University of Minnesota Medical School, has conducted multiple studies on regenerative cardiac repair. Throughout his research, Raveendran has worked to find a way to help regrow damaged human hearts.

“If we identify the correct cell population, if we identify the correct dosage of cells, if we identify the correct rate of injection, I think that will make a huge difference in the patients who suffer from heart attack,” Raveendran said.

Medical advances could ease some of the ill effects heart disease inflicts, and since June is men’s health month, Health Talk is focusing on some practical ways men can lower their chances of experiencing heart issues.

Raveendran suggests:

1.     Start early. Signs of early heart disease are traced in people as early as their late teen years. It’s important to monitor your health before middle age and prevent complications that could arise later in life.

2.     You are what you eat. If you’re eating foods high in saturated fats, trans-fats, added salt or sugar  on a consistent basis, your arteries will clog at a much higher rate.

3.     Exercise regularly. Not only does working out help you lose weight and feel good, but it also gets your heart pumping. Getting active can be as simple as taking the stairs every day at work instead of the elevator. Get moving!

4.     Don’t smoke. When most people think about the side effects of smoking, they reference its effect on the lungs. However, smoking also inhibits circulation and increases the risk of heart attack.

5.     Assess your progress. It’s important to start checking your blood pressure and cholesterol levels from an early age. If you have a family history of heart disease, it’s even more important to monitor your health. Check in with your doctor regularly.

“Treatment for heart disease needs to be started early instead of waiting for middle age,” Raveendran said. “Prevention is the most important thing. If you have a family history of heart disease, it should be looked at more carefully and treated aggressively.”

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Health Talk Recommends: U.S. causes of death then & now

June 11, 2014 - 9:30am

Of the many spectacular inventions of the 1900s, it’s safe to say we never may have made it to where we are today without radar, plastics or the once-revolutionary vacuum tube triode (responsible, in case you’re wondering, for launching the age of electronics).

Medical advances made throughout the 20th century, too, are nothing to bat an eye at.

Electrocardiograms (EKGs), hearing aids and penicillin are all children of the last century. The University of Minnesota itself rolled out the first successful bone marrow and kidney transplants in the 1960s and the first successful open-heart surgery ten years before that.

Unfortunately, as medical advances crush health threats of the past, new problems are quick to arise.


How we Die: Comparing causes of death in 1900 v. 2010. In 1900′s, 53% died from infectious disease, today only 3%

— Avi Roy (@agingroy) June 8, 2014


Infectious diseases, for example, were once the number one U.S. killer. Vaccines, antibiotics and an awareness of how diseases spread, however, have knocked infectious diseases down the charts. But something must one day kill us. So, heart disease and cancer have risen to the challenge. Beyond them lie Alzheimer’s and other forms of dementia, frailty and the yet-to-be-discovered.

That said, the fall of infectious disease is absolutely worth celebrating. Americans have tacked on an additional 32 years of life expectancy since the dawn of the 20th century.

Check out the recent article “How Americans Died in 1900 vs. Today, in One Chart” from PolicyMic for more. We highly recommend the read!

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Community programs increase aspirin use among individuals at high-risk for heart disease

May 15, 2014 - 11:33am

Community-based programs combining a public health media campaign and health professional education have been shown to improve population-based aspirin use to reduce heart attack and stroke risk, according to new research from the Lillehei Heart Institute and School of Public Health at the University of Minnesota.

Results were published in the Center for Disease Control and Prevention’s journal Preventing Chronic Disease.

Aspirin has long been known to be effective in prevention of blood clots causing heart attack and stroke among high-risk patients. Its use may be particularly beneficial in preventing a first heart attack or stroke in certain individuals.

Current use of aspirin among potentially at-risk individuals without a history of heart disease remains low in Minnesota and across the nation. For the first time, this project sought to evaluate a community program to improve rates of aspirin use among this high-risk population.

The study was conducted by Niki C. Oldenburg, Dr.P.H., vascular research project manager, Alan T. Hirsch, M.D., director of the Vascular Medicine Program, Russell V. Luepker, M.D., professor in the Division of Epidemiology & Community Health, John R. Finnegan, Ph.D., dean of the School of Public Health, and others.

The study utilized the US Preventive Services Task Force recommendations, suggesting aspirin use for men between 45- and 79-years old to prevent a first heart attack and women between 55- and 79-years-old to prevent a first stroke.

Over 18 months, researchers collaborated with three health systems in Hibbing, Minnesota. They utilized several formats to increase awareness and education about aspirin use:

  • Clinic-based educational programs in all primary care clinics
  • Simple aspirin health messages were distributed in 3 media waves
  • Web-based public awareness and social media campaigns

Researchers also utilized cross-sectional population surveys to track aspirin use within the population.

“In most public health efforts to improve preventive behaviors, only small changes are achieved over many years,” said Oldenburg. “However, our research showed regular aspirin use increased rapidly among primary prevention candidates, from 36 percent to 54 percent after 4 months. Equally important, this increase was sustained at 52 percent after 16 months.”

The findings are particularly important as recent public interest in aspirin use is rising, generated by the Food and Drug Administration (FDA) denial of a primary prevention label for marketing aspirin to Bayer Healthcare.  National guidelines recommend aspirin use in populations in which the benefit exceeds risk, but it has previously been unclear how these guidelines might best be applied in real world practice.

“The recent FDA aspirin review simply clarifies that the decision to use aspirin to prevent a first heart attack or stroke is best made in partnership with a health professional,” said Hirsch. “Our study provides a pathway within which an entire community, supported by its health care systems, might safely use aspirin for preventative purposes.”

Funding for this project was provided by generous support from the Lillehei Heart Institute at the University of Minnesota.

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Active lifestyle: Good for the body and the brain

April 2, 2014 - 3:12pm

University of Minnesota researchers have good news for young adults who lead an active lifestyle: By staying active today, you may actually be preserving your memory and thinking skills in middle age.

The findings are most important for the young adults on the low and moderate end of fitness; the people with higher levels of fitness are already doing it right.

“Many studies show the benefits to the brain of good heart health,” said study author David R. Jacobs, Jr., Ph.D., at the University of Minnesota School of Public Health. “This is one more important study that should remind young adults of the brain health benefits of cardio fitness activities such as running, swimming, biking or cardio fitness classes.”

Jacobs emphasizes that for those on the lower end of fitness, cardio fitness activities themselves may even not be needed; just moving around in daily life and staying active can improve your future outlook.

So what does staying active have to do with memory retention?

While the thinking skills of humans are not well understood, it is known that the brain requires lots of oxygen to function properly. Subsequently, cardio fitness is a measure of how well the body transports oxygen to muscles, and how well muscles are able to absorb the oxygen during exercise.

For the study, 2,747 healthy people with an average age of 25 underwent treadmill tests the first year of the study and then again 20 years later. Cognitive tests taken 25 years after the start of the study measured verbal memory, psychomotor speed (the relationship between thinking skills and physical movement) and executive function.

During the treadmill test, participants walked or ran as the speed and incline increased until they could not continue. At the first test, participants lasted an average of 10 minutes on the treadmill. However, 20 years later that number decreased by an average of 2.9 minutes.

Participants of the study who lasted longer on the treadmill during the first test recalled more words correctly on the memory test 25 years later, even after adjusting for other factors such as smoking, diabetes and high cholesterol.

Furthermore, the people who had smaller decreases in their time completed on the treadmill test 20 years later were more likely to perform better on the executive function test than those who had bigger decreases. Specifically, they were better able to correctly state ink color (for example, for the word “yellow” written in green ink, the correct answer was “green”).

“These changes were significant, and while they may be modest, they were larger than the effect from one year of aging,” Jacobs said. “Other studies in older individuals have shown that these tests are among the strongest predictors of developing dementia in the future. One study showed that every additional word remembered on the memory test was associated with an 18-percent decrease in the risk of developing dementia after 10 years.”

“These findings are likely to help us earlier identify and consequently prevent or treat those at high risk of developing dementia,” Jacobs said. “The message is to engage in family, job, and community and in so doing move around, which will improve overall fitness.”

The study was published online in Neurology®, the medical journal of the American Academy of Neurology, and was supported by the National Heart, Lung, and Blood Institute and the National Institute on Aging.

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U of M helping LVAD patients live longer, fuller lives

March 4, 2014 - 12:20pm

For heart patients living with a left ventricular assist device (LVAD), until recently living in close proximity to the doctor who performed the surgery was a necessity. Now, more LVAD patients are able to live closer to their cardiologist giving them more flexibility.

Previously seen as a bridge to a heart transplant, now LVADs are lasting for years in comparison to twenty years ago when they would only last days and months.

Last week, nurse practitioners, physicians, cardiologists and LVAD patients convened at the University of Minnesota for the first-ever LVAD Shared Care symposium. The goal of the symposium was to help health care providers who care for LVAD patients in the community better understand the advanced technology and help to alleviate their fears and concerns when working with these patients.

Peter Eckman, M.D., a cardiologist and medical director of the Mechanical Circulatory Support Program at the University of Minnesota, led the symposium, which featured presentations from a number of University faculty members. Eckman also invited LVAD patients to share their experiences on how health care providers can best care for them.

With the increased lifespan of the LVAD, patients are living much longer, fuller lives. In some cases, patients have zip lined in foreign countries and played ice hockey. And while he doesn’t encourage patients to do so, Eckman says it speaks to a bigger point.

“We put these in to save people’s lives. That’s part of it,” he said. “But we want people to have their lives back.”

Greg Sperl was one of Eckman’s patients in attendance who shared his story with the group. Sperl said he was very glad he has the device and as he pointed out, “It beats pushing up on six feet of dirt. And that’s where I was headed.”

To learn more about the LVAD Shared Care symposium and what the U of M is doing to educate health care providers, read this Star Tribune article.

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Sedentary lifestyle, not shoveling itself, contributes to health hazards

February 17, 2014 - 8:16am

This probably isn’t news to you but shoveling that wet, heavy snow can be a real pain in the neck, err back. Unfortunately, some people have experienced that shoveling snow has led to aches, pains and in some severe instances heart attacks.

And while true in certain cases, the problem isn’t solely dependent upon the snow shoveling activity itself but rather the sedentary lifestyle that some of these people live.

Shoveling is a lot of work and you do use a lot of muscles in your legs, arms and back which places extra strain on your heart.

“Shoveling is great exercise so if you’re exercising regularly you will probably be fine to go shovel the driveway or sidewalk,” says William Roberts, M.D., professor with the University of Minnesota Medical School, Family Medicine and Community Health. “But, if you haven’t been active it’s not a great idea to go outside to shovel, especially wet, heavy snow.”

A key factor in reducing your risk of serious injury or heart attacks is to exercise regularly, even outdoors during the cold winter months.

For some of Roberts’ favorite outdoor winter exercises, be sure to check out this video.

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U of M Expert Perspectives: Assessing the potential of the world’s first bioprosthetic heart

December 30, 2013 - 6:00pm

Twelve days after receiving the world’s first bioprosthetic heart from French company Carmat, a 75 year old Frenchman is in “very satisfactory condition” according to a statement from the Georges Pompidou European Hospital in Paris.

In addition, the surgeons who implanted the device released a statement to the media which said, “the artificial heart is functioning normally, automatically catering to the body’s needs without any manual adjustment.”

Should the patient continue to make progress, the case – which captured international headlines prior to Christmas – may offer hope to thousands of heart failure patients nationwide who cannot receive a donor heart due to their age or lack of organ availability.

Artificial hearts have been in use since the 1980’s, however Carmat’s device is the first self-regulating device available to patients. Other artificial hearts beat at one rate, while the Carmat device can speed up or slow down based on physiological need calculated by an onboard microprocessor.

According to Peter Eckman, M.D., a cardiologist and heart failure expert with University of Minnesota Physicians Heart at Fairview, the device has a lot of potential, some of which centers around how the device is made. The Carmat artificial heart relies on synthetic materia but uses tissue from a cow for components that touch human tissue or blood.

“One of the key potential advantages here is lack of metal valves, which should improve biocompatibility and decrease risk of bleeding and clotting,” said Eckman.

Eckman believes the device could be a big step forward. “Heart failure is such a large problem and we are unlikely to solve the organ shortage anytime soon, and that includes incorporating stem cells or organ and tissue engineering. I think that mechanical solutions like this will play a much more prominent role over the next 10-15 years.”

Currently, three more patients in France are scheduled to receive the device as part of a clinical trial that will gauge how the device improves survival for patients suffering terminal heart failure. Eckman suspects it will be a year or two before clinical trials could potentially be available in the U.S., and nearly five years (at least) before the Carmat device will be commercially available nationwide.

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University of Minnesota surgeons unveil new hybrid OR

November 12, 2013 - 10:15pm

Earlier today, surgeons from University of Minnesota Heart at Fairview performed a complex endovascular aneurysm repair that demonstrated the technology and capabilities of a new hybrid operating room at the University of Minnesota Medical Center, Fairview, that integrates vascular surgery, cardiology, interventional radiology, cardiac surgery and anesthesia services.

The room, developed in partnership with Philips Healthcare, is a unique combination; part endoscopy suite and part operating room that offers unparalleled technology including:

  • An integration of technologies that allows for 70 percent less radiation exposure to patients and clinical providers during X-ray based procedures
  • A Philips Flexmove x-ray beam mounting system that allows for better beam positioning
  • A complete compliment of ultrasound and echo technology, as well as the ability to display a patient’s previous CT and MRI images, allowing for improved disease targeting and a reduction or elimination of some surgical incisions.

While much of the technology is designed to assist in minimally-invasive procedures, the room also offers technology designed to improve outcomes during the most serious and invasive operations, including a Maquet modular OR table that is almost infinitely adjustable, robotic surgery technology, heart-lung bypass circuitry and heart rhythm correcting technology.

“In designing this space, our focus has been locked onto one thing: improving care for our patients,” said University of Minnesota vascular surgeon Steven Santilli, M.D., Ph.D., who helped define the room’s needs, requirements and development. “This hybrid operating room is where clinical providers from across cardiovascular subspecialties can work together to provide the safest, most advanced, and most innovative care available in the nation.  We’ve even designed the room to incorporate future technology so that we can stay ahead of the curve and represent the forefront of cardiovascular medicine.”

Examples of procedures that can be performed in this room are:

  • Robotic assisted surgery
  • Thoracic and aortic procedures, repairs, implantations and debranching
  • Graft implantations and repairs
  • Advanced procedures for heart rhythm maladies
  • Endovascular repairs and fenestrations
  • Lower extremity revascularizations

Currently, the room is not equipped or staffed to manage emergency cases, however UMMC hopes to continue training additional staff on the specialized equipment with the goal of utilizing the room during emergency cases next year.

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Two U of M researchers honored with prestigious NIH awards

October 15, 2013 - 8:53am

The National Institutes of Health (NIH) recently recognized two University of Minnesota doctors for excellence in biomedical research. Demetris Yannopoulos, M.D., a Lillehei Heart Institute researcher and interventional cardiologist with University of Minnesota Physicians Heart at Fairview, received the Transformative Research award and Anna Tischler, Ph.D., a microbiologist within the University of Minnesota Medical School, was honored with the New Innovator award.

Yannopoulos received the award for innovative work in protection in the administration of CPR. His research proposal, “Reperfusion Injury Protection Strategies during Cardiopulmonary Resuscitation,” has shown encouraging results that could increase survival rate after cardiac arrest.

“This research shines a beacon of hope for the thousands of people that suffer from sudden cardiac arrest (SCA), Yannopoulos said. “More than 90 percent of Americans (295,000 people) that suffer SCA die in minutes.”

Yannopoulos, whose proposal was also written in conjunction with researchers from the Medical College of Wisconsin and the University of Michigan, will receive a grant of $5.4 million over five years.

Tischler’s award is intended to support researchers that received their terminal degree less than 10 years ago and have not yet received a Research Project Grant. Her work was recognized because of its potential to be particularly innovative. Tischler’s proposal is titled, “High-throughput Identification of Mycobacterium tuberculosis Persistence Mechanisms.

A grant of $1,500,000 over five years is expected for Tischler to conduct research.

Want to learn more? Check out the NIH press release here.

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