Tag Archives: clinical data

EECP Therapy and Stroke Patients

There are an estimated 6.8 million Americans over 20 years old who have had a stroke, and 795,000 people experience a new or recurrent stroke every year.

Recently, there were several papers published to discuss the effects of using External Counterpulsation (ECP) therapy to treat ischemic stroke patients with cerebral large artery disease. The effects of ECP  as a treatment of acute stroke has been demonstrated to increase cerebral blood pressure and blood flow velocity in stroke patients previously. ECP has been used extensively to help functional recovery of ischemic stroke patients in China, even though it has not been cleared by FDA for treatment of this cohort of patients in the United States.

In brief, these papers have the following message:

  • The first paper analyzed 207 ischemic stroke patients, with 112 patients completed the 35 hour session of ECP, 43 did not, and 52 medical treated patients served as controls. Three months after a stroke, 70.5% of the patients who finished a whole course of EECP had a good clinical outcome, whereas only 46.5% achieved good outcome in the unfinished ECP group and 38.5% in the medical group. Patients with good clinical outcome were younger, had a lower baseline National Institute of Health Stroke Scale and longer ECP therapy. The paper concluded that the duration of ECP therapy is an important factor for a good clinical outcome.
  • The second paper published demonstrated that ECP treatment increased cerebral blood pressure significantly as well as blood flow velocity in both sides of the brain in 37 recent ischemic stroke patients with large artery occlusive disease but not in the 20 healthy controls. The study demonstrated that ECP can increase blood flow to both sides of the cerebral hemisphere presumably because the cerebral autoregulation was impaired soon after stroke.
  • The third paper published investigated the relationship between the magnitudes of external applied pressures during ECP, resulting in increased cerebral perfusion pressures and increased mean cerebral blood flow in 38 ischemic stroke patients and 20 elderly controls. The mean blood pressure increased significantly from baseline in both stroke and control groups in proportion to external applied pressure, whereas the mean cerebral blood flow increased to the same levels of around 5% above baseline in the stroke patients independent of the external applied pressure. Also, there were no changes in blood flow in the control group under different magnitudes of external applied pressure. The paper recommended 150 mm Hg as the optimal treatment pressure for ischemic stroke patients.

Dr. John CK Hui of Vasomedical remarked:  “It has been postulated for decades that increase in cerebral perfusion blood pressure and blood flow would improve the functional recovery rate of stroke patients. These recent papers provided evidence that ECP treatment within the first two weeks after stroke when the autoregulatory response is inactive is safe and effective in augmenting cerebral blood pressure and flow. Results of these studies were encouraging and they stimulate us to start developing protocols for studies to seek FDA labeling clearance for stroke patients.”

Come On and Get Happy!

The theme song to a popular 1988 movie named “Cocktail”, which starred Tom Cruise, was “Don’t Worry, Be Happy! This reggae classic was written by ten time Grammy winning song writer Bobby McFarin. It sounds like a great philosophy.  However, as we all know, sometimes it’s tough to remain constantly upbeat and positive. Whether stress at work has gotten you down, you are having personal or family health problems or the government shutdown has given you the blues, it’s tough to look on the bright side 24/7. However, a recent study of people with heart disease found that those who are more upbeat and enjoy life tend to live longer than those who don’t have such a positive outlook.

For the study, researchers created a mood scale ranging from 0 to 40 where higher scores indicate feeling more relaxed, self-confident and excited. Half of the 607 participants who participated in the study scored a 24 or above. During the 5 year follow-up period only 30 of the 300+ highly positive patients died of any cause, compared to 50 people with a lower positive attitude score who died during the same period. Also, the study noted people with high mood scores were more likely than other participants to say they exercised at least once a week, and exercisers were half as less likely to die as non-exercisers.

So what does the study tell us? It tells us that we need to exercise and that being more upbeat and positive will directly impact how we feel and hopefully help us live longer. At Vasomedical, where quality of life is so important in everything we do, we know it is not always easy to find the time to work out and it can be difficult to smile all the time when dealing with the stress and challenges of daily life. We just need to remember that every bit can help you live a longer, happier and more fulfilling life. Trying to see things from a more glass half-full perspective than half empty can improve your health and allow you to better enjoy the good times.

Won’t you please share with us your secrets for keeping a “glass half full” or positive attitude?

We Need To Be Proactive About Our Heart Health

The Center for Disease Control and Prevention (CDC) recently released a report declaring that nearly a quarter of deaths that occur each year as a result of heart disease and stroke are, in fact, preventable. The CDC noted that more than 200,000 people ages 75 and younger died from heart disease and stroke in 2010; and these lives could have been saved with more effective public health measures, treatments and simple lifestyle changes.

One reason for the high rates of preventable deaths is that young adults are normally less likely to receive health screenings and get early treatments for conditions such as high blood pressure and cholesterol, which are major risk factors that can lead to heart disease and stroke. This report should be a wake-up call for everyone to be more proactive in taking care of themselves, which can be as simple and easy as eating healthy and exercising on a regularly basis.

Regarding appropriate medical treatments, the report findings by the CDC create an opportunity for us at Vasomedical to generate awareness and educate the wider public about the benefits of EECP Therapy. With EECP Therapy, the leading non-pharmacological, non-invasive therapy, around 75-80 percent of patients realize the initial therapeutic benefits – including the elimination or reduction of symptoms such as chest pain, breathlessness and fatigue, among many other benefits – upon completion of their therapy. Clinical studies have shown that the benefits can last longer than three years. EECP Therapy carries few risk complications and is dramatically less expensive than leading invasive procedures.  For those suffering from heart disease, EECP Therapy can be a lifesaver and provides a significantly better quality of life.

It’s always good to be ahead of the curve, so take pride in your well-being and heart health. Together we can reduce the amount of preventable deaths in the U.S. and enjoy long, fulfilling and healthy lives.

Tales from the Road: The American Diabetes Association

We have just wrapped up our first exhibition at the American Diabetes Association (ADA) meeting in Chicago – which was a great experience and showed us that there is more opportunity to expand the reach of EECP® Therapy than ever before!

The show lasted from June 21st through 25th and was well attended with approximately 14,000 attendees from across the United States and around the world. The Vasomedical booth had a steady flow of interested attendees, and we spent a great deal of time educating attendees about EECP Therapy and the benefits it can have for patients.

The people we spoke with were fascinated to learn that EECP Therapy can provide relief to patients with angina symptoms such as chest or atypical pain, shortness of breath and fatigue, among others. This event was so relevant to our business because many patients with diabetes also have ischemic heart disease and can experience angina symptoms despite being on maximal medication. To our delight, numerous attendees commented that when they return home they are planning to speak to their cardiologists and hospitals about the positive effects EECP Therapy can have on their patients.

The attendees were interested to learn more about the clinical evidence recently published by the researchers at the University of Florida in Gainesville demonstrating the positive effects of EECP Therapy on glucose tolerance and insulin resistance.

At the exhibition, we also saw a great deal of interest in our BIOX ECG Holters and ambulatory blood pressure monitors as well as our EZ® pulse oximeters.

We thought the ADA was a successful conference, as we were able to raise awareness for EECP Therapy in this new patient population. We are continuing to learn more about diabetic patients and the potential impact EECP Therapy can have on this patient group’s quality of life.  We hope by next year’s ADA we have even more insight to share!

Next stop: Amsterdam, Netherlands!

In the News: Heart-Attack Risks Start Younger

Today, The Wall Street Journal published an article titled “Heart-Attack Risks Start Younger.” In the piece, Ron Winslow reports that heart attack risks can start at younger ages than usual, and doctors are now assessing heart health in children to anticipate risks for heart disease later in life.

When the hardening of the arteries occurs in children, it’s a sign of accelerated aging and likely raises the risk of dangerous outcomes relatively early in one’s adult life. However, a new study suggests that testing for triglycerides, conducted with a simple cholesterol test, can allow doctors to monitor children’s arterial health more closely. Triglycerides—often overlooked in cholesterol screenings—are an indicator of both fat and sugar in the blood stream.

Luckily, doctors also believe that health can be restored to a young person’s arteries with regular physical activity and a healthy diet. Doctors are hesitant to prescribe medications to remedy this problem in children, and while healthy lifestyle changes are effective, they are not always easy.

This article reinforces the importance of educating Americans about preventative measures for heart attacks—regardless of age—and best practices for treating heart disease after its onset.

You can read the full The Wall Street Journal article below.

Tell us: What are strategies that you and / or your family use to lead a healthy lifestyle and maintain your heart health? Let us know in your comments! 

Wall Street Journal

Heart-Attack Risks Start Younger

By RON WINSLOW

Updated April 29, 2013, 8:55 p.m. ET

Children on Track for a Heart Attack

A New Measure Finds Hardening of the Arteries Can Start Young; Cholesterol Tests for 9-Year-Olds

Do you know how old your kids’ arteries are?

It’s a potentially important question as scientists increasingly uncover links between healthy habits in childhood and risk for heart disease later in life. And there are growing concerns about the cardiovascular health of millions of children in the U.S. who are considered obese or overweight.

A new study suggests there is a simple way to assess a child’s arterial health with a calculation based on an often-overlooked component of cholesterol: triglycerides.

The calculation is the ratio of triglycerides to HDL, or good cholesterol. It can be easily determined from a standard cholesterol blood test. In the study, based on nearly 900 children and young adults, researchers at Cincinnati Children’s Hospital Medical Center found that the higher the ratio, the greater the likelihood a child would have stiff and damaged arteries.

“We are demonstrating vascular changes in supposedly healthy adolescents,” said Elaine Urbina, head of preventive cardiology at Cincinnati Children’s and lead author of the study. “Stiff vessels make your heart work harder. It isn’t good for you.” The study was published in the journal Pediatrics in April.

The problem is also called hardening of the arteries. In adults it typically arises from a combination of aging and the cumulative impact of blood pressure, cholesterol and other assaults on the walls of blood vessels over decades of life. It carries heightened risk for heart attacks, strokes and sudden death.

When it shows up in children, it’s a sign of “accelerated aging,” Dr. Urbina said, and likely raises the risk of dangerous outcomes relatively early in adult life. The good news is that doctors believe health can be restored to young people’s arteries with regular physical activity and a healthy diet. This includes cutting back on sugary beverages and foods high in carbohydrates such as potatoes, white rice and pasta.

In late 2011, concern that a generation of children is growing up with already established heart risks prompted federal health officials with the support of the American Academy of Pediatrics to recommend universal cholesterol screening for kids, preferably between ages 9 and 11.

Generally, the focus of attention in such tests is LDL, or bad cholesterol, which at high levels has long been associated with increased chances of heart attacks and strokes. A large body of evidence shows that heart risk can be reduced by lowering LDL with one of a class of drugs called statins.

But high triglycerides and low HDL—the other components that are measured in a standard cholesterol blood test—are a hallmark reflection of the poor diets and sedentary lifestyles that researchers say are behind the wide prevalence of obesity among both children and adults. These markers may get less attention because efforts to develop drugs that prevent serious events by manipulating either component have come up short.

Triglycerides amount to an indicator of both fat and sugar in the blood stream. Dr. Urbina describes them to patients as having a backbone of fat with three (tri) sugars (glycerides) attached.

Other research has linked a high triglyceride-to-HDL ratio to arterial stiffness in adults. Dr. Urbina and her colleagues wondered whether a similar correlation existed in children and young people.

Participants in the study, who ranged in age from 10 to 26, underwent fasting tests for cholesterol, blood pressure, blood sugar and other heart-risk markers. They also had three different noninvasive tests that measure elasticity in blood vessels.

One third of the participants were found to have stiff arteries based on one of the elasticity tests; 13% had abnormalities on two of the tests and 3% had arterial stiffness according to all three tests.

The researchers found a “progressive rise” in both heart-related risk factors and stiff arteries as the triglyceride-to-HDL ratio increased.

The study wasn’t large enough or intended to establish when a ratio is “healthy” or when especially aggressive treatment is called for. That will require additional research. But scientists found that the 378 participants whose ratio was in the highest of three groups had an average ratio of 2.7.

What this shows “is that being overweight and the cholesterol problems that often accompany it have an important impact on your blood vessels,” said Sarah de Ferranti, director of preventive cardiology at Boston Children’s Hospital, who wasn’t involved with the study. A direct correlation to damaged blood vessels in kids hadn’t previously been shown.

Dr. de Ferranti, a pediatrician, said that based on the study, “I would worry more about my patients in the realm” of 2.7 or higher.

The American Heart Association recommends adults maintain an HDL level of at least 40 milligrams per deciliter of blood (mg/dL) for men and 50 mg/dL for women, and preferably higher. Triglycerides for adults should be below 150 mg/dL, with lower being better. The ratio using these numbers is higher than that found in the study. That is partly because children generally have lower triglyceride levels than those of adults.

Dr. Urbina sometimes prescribes a prescription form of fish oil for patients with persistently high triglycerides; neither its benefit in children nor long-term impact among adults and children has been determined. Generally doctors are reluctant to give medications to children with the problem. Lifestyle change, including diet and exercise, is the mainstay remedy, although it poses big challenges.

A major strategy for doctors is getting kids to avoid or sharply reduce consumption of sugary beverages, including sodas and sports drinks, big contributors to triglyceride levels.

“It’s incredibly difficult to scale a kid down to the recommended 50 grams of sugar when a juice box has 24,” said Heather Vanderhaar, of suburban Cincinnati. Ms. Vanderhaar’s two boys, Benjamin, 12, and Maxwell, 10, have a genetic condition that results in elevated triglyceride levels. They are working with Dr. Urbina to keep those levels under control.

“At this point they’re maintaining,” Ms. Vanderhaar said. School sports and bike riding are among their physical activities. The boys aren’t allowed soda, cookies or junk food. “We allow them to have treats but in moderation,” she said. “The thinking is if you start early, you can reverse any damage done to your arteries.”

Molly and Kate Cassabon, 18-year-old identical twins from Waterville, Ohio, went for two years putting on substantial weight before their problem was diagnosed at age 10 as genetically high triglycerides that exceeded 800 mg/dL. Their grade school installed an automated external defibrillator out of fear that either of the girls could collapse at any moment from a heart attack.

Dr. Urbina prescribes a prescription form of fish oil pills to help reduce triglycerides. Lately, work at portion control and a weekly session with a personal trainer contributed in March to “the most improvement they’ve ever shown” during a checkup with Dr. Urbina, their mother, Sally Cassabon, said. Their triglycerides dipped below 200 mg/dL, still short of a goal of below 150 mg/dL, but enough to help them each lose at least 25 pounds.

http://online.wsj.com/article/SB10001424127887323798104578453123376765286.html

 

psychological-effects-of-the-massage-chair

EECP® Therapy Results in Positive Psychosocial Effects while Reducing Healthcare Costs

We came across a fascinating study showing refractory angina patients undergoing Enhanced External Counterpulsation (EECP®) therapy to experience lower levels of chest pain and higher levels of confidence and self-efficacy. This thesis research by R. Foxwell also finds the patients less afraid of dying – a surprising discovery.

“Not only did (EECP) push me to do it, but also by doing it, it showed me that I don’t need to worry so much about it for the future, so since I’ve come back I’m pushing myself that much more all the time, which is good,” said one of the patients after undergoing the therapy.

We know that EECP stimulates collateral formation—the growth of new blood vessels—that increases blood flow to the heart, having effects similar to exercise.  This thesis confirmed the belief that EECP Therapy reduces the effects of angina, which leads to a more optimistic view of the condition by the patient population, creating a positive cycle of physiological and psychological wellbeing.

psychological-effects-of-the-massage-chair

The study also finds EECP to have an overall reduction of healthcare expenses. Patients undergoing EECP therapy require less-frequent visits to general practitioners and less medication compared with the period before EECP Therapy.

Such findings motivates everyone here at Vasomedical to push harder to make sure all refractory angina patients learn and have access to EECP® Therapy!

*The study is a dissertation submitted in partial fulfillment of the requirements for the Degree of Doctor of Clinical Psychology in the University of Hull, United Kingdom by Rachel Foxwell, BSc in Psychology, entitled: Psychosocial Outcomes of Enhanced External Counterpulsation Treatment: Illness Perceptions and Psychological Wellbeing”.