Monthly Archives: April 2016

Endocrine Society experts call for expanded screening for primary aldosteronism

Posted on by MaryO

Washington, DC–The Endocrine Society today issued a Clinical Practice Guideline calling on physicians to ramp up screening for primary aldosteronism, a common cause of high blood pressure.

People with primary aldosteronism face a higher risk of developing cardiovascular disease and dying from it than other people with high blood pressure. As many as one in ten people with high blood pressure may have primary aldosteronism. Uncontrolled high blood pressure can put these individuals at risk for stroke, heart attack, heart failure or kidney failure.

The guideline, entitled “The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline,” was published online and will appear in the May 2016 print issue of The Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society. The guideline updates recommendations from the Society’s 2008 guideline on primary aldosteronism.

“In the past eight years, we have come to recognize that primary aldosteronism, despite being quite common, frequently goes undiagnosed and untreated,” said John W. Funder, MD, PhD, of the Hudson Institute of Medical Research in Clayton, Australia, and chair of the task force that authored the guideline. “This is a major public health issue. Many people with primary aldosteronism are never screened due to the associated costs. Better screening processes are needed to ensure no person suffering from primary aldosteronism and the resulting risks of uncontrolled high blood pressure goes untreated.”

Primary aldosteronism occurs when the adrenal glands — the small glands located on the top of each kidney – produce too much of the hormone aldosterone. This causes aldosterone, which helps balance levels of sodium and potassium, to build up in the body. The resulting excess sodium can lead to a rise in blood pressure.

The Endocrine Society recommends primary aldosterone screening for people who meet one of the following criteria:

  • Those who have sustained blood pressure above 150/100 in three separate measurements taken on different days;
  • People who have hypertension resistant to three conventional antihypertensive drugs;
  • People whose hypertension is controlled with four or more medications;
  • People with hypertension and low levels of potassium in the blood;
  • Those who have hypertension and a mass on the adrenal gland called an adrenal incidentaloma;
  • People with both hypertension and sleep apnea;
  • People with hypertension and a family history of early-onset hypertension or stroke before age 40; and
  • All hypertensive first-degree relatives of patients with primary aldosteronism.

Other recommendations from the guideline include:

  • The plasma aldosterone-to-renin ratio (ARR) test should be used to screen for primary aldosteronism.
  • All patients diagnosed with primary aldosteronism should undergo a CT scan of the adrenal glands to screen for a rare cancer called adrenocortical carcinoma.
  • When patients choose to treat the condition by having one adrenal gland surgically removed, an experienced radiologist should take blood samples from each adrenal vein and have them analyzed. This procedure, called adrenal vein sampling, is the gold standard for determining whether one or both adrenal glands is producing excess aldosterone.
  • For people with primary aldosteronism caused by overactivity in one adrenal gland, the recommended course of treatment is minimally invasive surgery to remove that adrenal gland.
  • For patients who are unable or unwilling to have surgery, medical treatment including a mineralocorticoid receptor (MR) agonist is the preferred treatment option.

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The Hormone Health Network offers resources on primary aldosteronism athttp://www.hormone.org/questions-and-answers/2012/primary-aldosteronism.

Other members of the Endocrine Society task force that developed this guideline include: Robert M. Carey, of the University of Virginia Health System in Charlottesville, VA; Franco Mantero of the University of Padova in Padua, Italy; M. Hassan Murad of the Mayo Clinic in Rochester, MN; Martin Reincke of the Klinikum of the Ludwig-Maximilians-University of Munich in München, Bavaria, Germany; Hirotaka Shibata of Oita University in Oita, Japan; Michael Stowasser of the University of Queensland in Brisbane, Australia; and William F. Young, Jr. of the Mayo Clinic in Rochester, MN.

The Society established the Clinical Practice Guideline Program to provide endocrinologists and other clinicians with evidence-based recommendations in the diagnosis and treatment of endocrine-related conditions. Each guideline is created by a task force of topic-related experts in the field. Task forces rely on evidence-based reviews of the literature in the development of guideline recommendations. The Endocrine Society does not solicit or accept corporate support for its guidelines. All Clinical Practice Guidelines are supported entirely by Society funds.

The Clinical Practice Guideline was co-sponsored by the American Heart Association, the American Association of Endocrine Surgeons, the European Society of Endocrinology, the European Society of Hypertension, the International Association of Endocrine Surgeons, the International Society of Hypertension, the Japan Endocrine Society and The Japanese Society of Hypertension.

The guideline was published online at http://press.endocrine.org/doi/10.1210/jc.2015-4061, ahead of print.

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society, which is celebrating its centennial in 2016, has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

From http://www.eurekalert.org/pub_releases/2016-04/tes-ese042616.php

How women can spot heart attack warning signs

Posted on by MaryO

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According to the CDC, heart disease is the leading cause of death in the U.S. But shockingly, the World Health Organization says that 80 percent of heart disease is preventable. That’s right, 80 percent. The most common risk factors for heart disease are smoking, high cholesterol, high blood pressure, inactivity, obesity and diabetes. You can prevent heart disease by doing things like exercising, eating right and quitting smoking, but that’s for another article.

First, let’s talk a little science so you know why heart attacks happen. A heart attack happens when the blood flow that brings oxygen to the heart is severely reduced or stopped. This occurs because over time, the arteries that supply the heart with blood can slowly become thicker and harder from a buildup of fat, cholesterol and other substances. This process is known as atherosclerosis. If the plaque breaks open and a blood clot forms, it can block the blood flow in the vessel, causing a heart attack. Heart attacks are perhaps the most feared complication of heart disease, so it’s important to learn how to spot the signs. We’ve all seen the classic signs of a heart attack in movies. It can be dramatic and sudden, and can include:

  • Chest pain in the center of your chest that can feel like squeezing, pressure or fullness and can radiate down the left arm or to other areas. The pain can come and go and lasts longer than a few minutes. It has often been described as “having an elephant sit on your chest” or “having your chest in a vise.”
  • Shortness of breath
  • Palpitations or heart racing
  • Sweating

The American Heart Association and a body of recent research suggest that this typical picture of a heart attack is more typical for men who experience symptoms. A report by BlueCross BlueShield revealed that while heart attacks are more common in men, women “who experience heart attacks have worse outcomes — they are more likely than men to die within one year of a heart attack, to have another heart attack within six years, and to be disabled because of heart failure within six years.” Women receive less aggressive treatment after a heart attack than men and often delay care longer than men. This is why it is especially important that women learn to identify signs of a heart attack. For women, the picture can be more insidious than the dramatic Hollywood heart attack. While chest pain is still a common symptom for women, many have atypical symptoms that can seem more like the flu than a heart attack. Some don’t even have chest pain. For women, signs of a heart attack can include more than the typical symptoms above, such as:

  • Unusual fatigue
  • Indigestion
  • Trouble sleeping
  • Pain in neck, jaw or back
  • Nausea
  • Vomiting
  • Stomach pain

There’s a story circulating in national news about a local woman who believed she was suffering symptoms of a viral illness. She wanted to sleep it off, but at the insistence of her husband, she went to the emergency room and discovered she was in the throes of a heart attack. These stories are common, so it’s important to listen to your body. If you don’t feel right, go in to the hospital and get checked out. If you do believe that you are suffering the symptoms of a heart attack call 911 immediately and, according to a suggestion by Harvard Medical School, chew a tablet of aspirin.

By 2020, the American Heart Association wants to improve the cardiovascular health of Americans by 20 percent and reduce death from cardiovascular disease by 20 percent. The key to this goal is education. Let’s all work together to spread awareness of the preventable nature of heart disease and the subtle signs of a heart attack.

From http://www.tennessean.com/story/life/entertainment/12th/2016/04/28/how-women-can-spot-heart-attack-warning-signs/83539580/