Breakthrough! Recent research from the LMA

September 5, 2014
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Anger boosts heart attack risk

New research from Beth Israel Deaconess Medical Center (BIDMC) shows a compelling reason to think about getting anger in check: a nearly fivefold increase in risk for heart attack in the two hours following outbursts of anger.

“There has been a lot of research on anger; we already know it can be unhealthy, but we wanted to quantify the risk, not just for heart attack, but for other potentially lethal cardiovascular events as well,” said lead author Elizabeth Mostofsky, of BIDMC in a press release. “The hope is this might help patients think about how they manage anger in their everyday lives and prompt physicians to discuss medications and psychosocial supports with their patients for whom anger is an issue, especially patients with known cardiovascular risk factors.”

The study results showed that the risk of heart attack heart problem symptoms was 4.7 times higher in the two hours following an angry outburst than at any other time. And the risk for stroke caused by a blocked artery in the brain was 3.6 times higher than at other times. One study indicated a six-fold increased risk for brain aneurysm in the hour following an outburst of anger compared with other times.

While it’s possible that medications and other interventions that may lower the frequency of angry outbursts or the risk associated with anger, Mostofsky says “more research including clinical trials are needed to identify which drugs or behavioral therapies will be most effective.”

Pill differences can confuse patients

The different colors and shapes of various generic versions of the same heart-medicine pills may lead patients to stop taking them, researchers from Brigham and Women’s Hospital found.

Generic versions of a prescription drug are clinically interchangeable but often look different depending on the manufacturer. The FDA does not require consistent pill appearance among interchangeable generic drugs, and the shape and color of patients’ pills may vary based on the particular supply at the patient’s pharmacy.

“After patients have a first heart attack, guidelines mandate treatment with an array of long-term medications, and stopping these medications may ultimately increase morbidity and mortality,” said Dr. Aaron Kesselheim, the BWH senior investigator of the study, in a press release.

The researchers collected records of over 10,000 patients discharged between 2006 and 2011 after hospitalizations for heart attacks who initiated treatment with generic heart drugs.

They then looked for breaks in medication refilling and determined whether the pill appearance had changed in the prior two prescriptions. They found that the odds that a patient would discontinue use or not refill their medication increased by 34 percent after a change in color and 66 percent after a change in pill shape.

The findings were published in July in the “Annals of Internal Medicine.”

Microscopic drugs treat bone cancer

A joint team from Dana-Farber Cancer Institute and Brigham and Women’s Hospital (BWH) has developed a drug-delivery system that can precisely target and attack cancer cells in the bone. It can also help rebuild and strengthen the bone to prevent bone cancer progression.

“Bone is a favorable microenvironment for the growth of cancer cells,” said BWH’s Dr. Archana Swami, co-lead study author, in a press release. “We engineered and tested a…system to selectively target the bone and release a drug in a controlled manner, leading to prevention of disease progression.”

The scientists developed “nanoparticles,” smaller than molecules, coated with alendronate, a substance that binds to calcium in human bones.

The nanoparticles homed in on bone tissue to deliver drugs contained within them. The drugs kill tumor cells, as well as stimulate healthy bone tissue growth.

The study was published in June in “Proceedings of the National Academy of Sciences.”

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