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Cardiometabolic risk spikes around the time of menopause, found an observational study of more than 1,000 women ages 45 to 60.
The increase in a metabolic syndrome factor severity score was greater for all pre- and peri-menopausal women than for those who had already made the transition, researchers reported in the Journal of the American Heart Association.
"Previous research showed that after menopause, women were at much greater risk for metabolic syndrome than before menopause began. This latest study indicates that the increased risk observed earlier may be related more to the changes happening as women go through menopause and less to the changes that take place after menopause," co-author Mark DeBoer, MD, of the University of Virginia in Charlottesville, said in a release.
"At this point, these data suggest that it may be important to make improvements to lifestyle factors in the years leading up to menopause to offset the increase in cardiovascular risk," he added in an interview with MedPage Today. "This would include increased exercise and dietary improvements, such as reducing intake of sugar and saturated fat."
See the full MedPage Today story here.
Mixed Feelings on Sharing (Data) Nicely
In an ongoing debate over if, how freely, and when patient-level clinical trial data should be shared with other researchers, four groups laid out their proposals in the New England Journal of Medicine this week.
While these articles indicated some level of support for some form of sharing, they also expressed grave concerns and suggested limits and safeguards.
For one, the group of leading cardiovascular researchers in ACCESS CV (Academic Research Organization Consortium for Continuing Evaluation of Scientific Studies -- Cardiovascular) said they supported "the concept of data sharing." But their proposed "strategy to thoughtfully operationalize" the International Committee of Medical Journal Editors recommendations would weaken some of its stronger provisions by extending the deadline for sharing to 2 years and having a formal process of submission and review managed by ACCESS CV members for cardiovascular trials.
Milton Packer, MD, of Baylor University in Dallas, had some choice words for these groups' proposals that suggest investigator "ownership" of the data.
"The fact that it was collected as a result of observations in human beings other than the investigators ethically makes it a shared resource without proprietary considerations," he told CardioBrief for MedPage Today. "No one is trying to deprive the original investigators of their ability to present the major findings of a study first. But we should think of the data presentation as a responsibility and a privilege; it is not a possession, which needs to be guarded and to which access needs to be minimized."
See the full article here.
Heart Transplant and the ACA
States that adopted the Affordable Care Act (ACA) Medicaid expansion saw a 17% increase in heart transplants after implementation, an analysis of the United Network for Organ Sharing registry showed.
Heart transplant listings among Medicaid patients increased 22% in expansion states versus 2% in non-expansion states, although the trend was not statistically significant at P=0.08.
"We believe that these data support our hypothesis that the ACA allows previously uninsured patients enhanced access to heart transplantation," the researchers wrote in JAMA Cardiology. But, "longer transplant lists will potentially exacerbate the donor shortage crisis, making expansion of donor pools and reexamination of organ allocation strategies even more urgent."
ECG-Based Risk Screening
A risk equation based on just age, sex, and ECG-determined heart rate, frontal T axis, and QT interval was good at predicting cardiovascular disease in asymptomatic people, researchers reported in JAMA Cardiology.
Validated on National Health and Nutrition Examination Survey data, the score had a C statistic of 0.79 and improved net reclassification for 24% against the Framingham risk score for fatal cardiovascular disease, with similar results for ischemic heart disease and for all-cause mortality.
"Although the ECG risk equation is low cost, further research is needed to ascertain whether this additional step in risk stratification may improve prevention efforts and reduce cardiovascular disease events," the researchers concluded.