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The illness usually has to run its full course, but Kris-Etherton urged people with bloody stools or a fever of 102 or above to go to the doctor. People who have uncontrollable vomiting or diarrhea also should head straight to the emergency room to get quick IV hydration.

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Group 10: What's it like to get a new heart during a pandemic? This Texas pastor can tell you By American Heart Association News

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Group 10: What's it like to get a new heart during a pandemic? This Texas pastor can tell you By American Heart Association News

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Rev. Eddie Woods went from feeling healthy to needing a heart transplant - all during the COVID-19 pandemic. (Photo courtesy of City Point Church)

On the Friday before Mother's Day, the Rev. Eddie Woods did his best to hide his discomfort.

Short of breath and lightheaded, he didn't want his wife, Julie, to notice. He hoped she'd be distracted by getting ready to host dinner for her parents, a gathering that would mark the first time they'd had guests over since the coronavirus pandemic hit.

But Julie knows Eddie too well. High school sweethearts whose bond tightened further by starting and growing a church in the Dallas suburb of Allen, she could tell his complexion was too pale and his body looked puffy.

They'd had a scare two years earlier, when a severe flu weakened Eddie's heart. But he'd recovered and had recently been fit and energetic. Was this another flu? Or even the coronavirus?

"You look horrible," Julie told him just before her parents were to arrive. "I'm taking you to the hospital now."

But because of coronavirus protocols, Julie wasn't allowed to accompany Eddie or even stay in the waiting room. Whatever was wrong, he would fight it alone.

Rev. Eddie Woods with his wife, Julie. (Photo by Whitney Rogers Photography)

Several hours later, Eddie texted to say he'd been put on the COVID floor, just in case. The two hatched a virtual rendezvous. Julie returned to the hospital and Eddie flashed his bedside light on and off. Standing outside, she could at least see which room he was in.

Eddie tested negative for COVID-19. But his condition deteriorated. Doctors said he was going into heart failure.

After Eddie caught the flu in 2018, he resumed his active life and exercising regularly, but then he nearly passed out while tying his shoe. It turned out the viral infection had weakened his heart, causing it to enlarge, and left fluid around his heart and lungs.

Then, he'd spent a week in the hospital and months wearing a defibrillator. Earlier this year, he got permission to ease off his new regimen of medications.

But now, a day after arriving in the ER, he was transferred to a facility in Dallas that specialized in heart patients.

Although she followed the ambulance to the hospital, Julie wasn't allowed to go inside. Two days later, doctors set up a video call in the intensive care unit.

They were not prepared for the message. Eddie needed a new heart.

"Give me some time to get better," he pleaded. "I'll adjust my medication and get back on top of it."

But a transplant was the only solution, they said.

Eddie reached out through mutual friends to two heart transplant recipients to get a better understanding of what he was facing.

"After hearing how great they felt, I thought, 'OK, there's a life on the other side,'" he said.

Julie, meanwhile, had another issue: Sharing the news about Eddie with their congregation at City Point Church. They opened the non-denominational Christian church in 2013, and it had grown to more than 1,000 congregants.

"I wanted to keep it private, but knowing that we don't live a private life, I really had no choice," she said. "I didn't know how to accept people helping me with things. I'm always the one to help others."

Staff members posted updates on the church's website and social media accounts, and set up a twice-daily prayer gathering via video chat. Cards and letters started pouring in. Members also reached out to comfort the couple's 12-year-old son and two daughters, ages 21 and 23.

Eddie, however, wasn't on the transplant list quite yet. The delay wasn't medical, it was financial.

The hospital and the couple's health-sharing plan (an alternative to insurance) were at odds over payment. Nothing could be done until an agreement could be made or upfront costs of $465,000 were paid.

During this wait, the hospital allowed Julie to enter once. Knowing she likely wouldn't be allowed back, she stayed for a week.

Then, things started to come together. A financial deal was reached. Visitation restrictions were lifted. Julie went home, knowing she'd be able to return.

Only a few days later, doctors called her from Eddie's room with good news.

Rev. Eddie Woods just before going into surgery to receive his new heart. (Photo courtesy of the Woods family)

Eddie received a new heart the next day. The following week, he walked 2 miles a day through the halls of the hospital.

"My heart felt normal for the first time in a long time," he said.

He returned home June 15, passing through streets lined with dozens of sign-waving well-wishers.

Still in cardiac rehabilitation, he's learned to ask for help, a difficult shift for someone accustomed to being the one who gives it.

"I've faced some things in my life, but this one was definitely the biggest cliff I've ever stood on," he said. "I feel like it's deepened my empathy and compassion. I leaned on my faith a lot. I think determination makes a big difference when you're dealing with something like this. God's given us the ability to be stewards over things. For me, that's my family, my church and my body."
Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates. If you have questions or comments about this story, please email editor@heart.org.

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What's it like to get a new heart during a pandemic? This Texas pastor can tell you

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On the Friday before Mother's Day, the Rev. Eddie Woods did his best to hide his discomfort. Short of breath and lightheaded, he didn't want his wife, Julie, to notice. He hoped she'd be distracted by getting ready to host dinner for her parents, a gathering that would mark the first time they'd had guests over since the coronavirus pandemic hit.

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Hospital communication plans and resources during COVID

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Hospital communication plans and resources during COVID

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This is about internal communication plans

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As the coronavirus continues to unfold, hospitals and health systems across the field are working hard to develop, execute and adjust their communications plans. There's a lot we still don't know about the novel virus and the situation is constantly changing, so the challenges are great. Yet, smart approaches to communicating during this health care crisis are happening all around us.

The AHA in partnership with SHSMD have identified tools and resources to help you and your teams communicate effectively, as well as examples of successful communications efforts by hospitals big and small.

We hope this will serve as a great source of support and inspiration for your communications teams.

Communications Checklist

This communications checklist is designed to help you adjust your communications strategies and channels to help keep your internal and external audiences informed and engaged.

Communicating Recovery Strategies

While hospitals and health systems continue to respond to the pandemic, the need for safe medical care not related to COVID-19 becomes more important than ever. The field is taking incredible steps to ensure emergency, nonemergent and preventive care is still available and safe to access.

Hospital communications teams need to take proactive steps to address community concerns and communicate how their policies and procedures have changed to ensure the safety of their staff, patients and other stakeholders. The Recovery Communications Toolkit is designed to help you amplify the message that your hospital is safe, continues to implement proactive safety measures, and is prepared to handle all emergency and nonemergency patient care during these challenging times.

Hospital Communications Examples

AHA Communications Tools & Resources

Additional Resources

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As the coronavirus continues to unfold, hospitals and health systems across the field are working hard to develop, execute and adjust their communications plans. There's a lot we still don't know about the novel virus and the situation is constantly changing, so the challenges are great.

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When it comes to Labor Day menu choices, safety is tasty

Use a food thermometer to make sure foods are cooked to the appropriate internal temperature.

Store perishable foods at or below 40 F within two hours. If the surrounding temperature is above 90 F, then refrigerate within one hour.

Keep raw meat, poultry, seafood and eggs separate from ready-to-eat foods.

Because of COVID-19 small outdoor activities are more common, which makes food safety and preparation that much more important

48 million (1/8) people in the United States get food poisoning each year

Symptoms include stomach cramps, nausea, vomiting, diarrhea, and possible death

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(valentinrussanov/E+, Getty Images)

Labor Day weekend is synonymous with picnics and barbecues, and because of the COVID-19 pandemic, small outdoor gatherings are more popular than ever. However, food that sits out too long or is improperly prepared can lead to trouble.

The good news is, that can be avoided by following a few simple steps.

Penny Kris-Etherton, a distinguished professor of nutrition at Pennsylvania State University recommends keeping hands, utensils, and cooking and food prep surfaces as clean as possible.

"Wash your hands with soap for 20 seconds, and make sure to clean beneath your fingernails and in between your fingers," she said.

Following the cooking guidelines on Foodsafety.gov also can help keep you safe. Beef, pork, veal and lamb should be cooked to an internal temperature of 160 F, while turkey and chicken should be at 165 F. "If you're eating extra lean ground beef, it should never be medium rare or raw," said Kris-Etherton, citing the risk of E. coli.

The Academy of Nutrition and Dietetics suggests other simple steps to reduce the risk of food poisoning:

- Keep raw meat, poultry, seafood and eggs separate from ready-to-eat foods.

- Use a food thermometer to make sure foods are cooked to the appropriate internal temperature.

- Store perishable foods at or below 40 F within two hours. If the surrounding temperature is above 90 F, then refrigerate within one hour.

The risks are real, said Kris-Etherton, a past chair of the American Heart Association's Council on Lifestyle and Cardiometabolic Health. "A lot of people get food poisoning every year, and it's something that's preventable."

According to the Centers for Disease Control and Prevention, 48 million people in the United States - about 1 in 6 - get food poisoning each year. While most recover, 128,000 end up in the hospital and 3,000 die.

Symptoms can range from mild to severe - from stomach cramps, nausea, vomiting and diarrhea to death. In fact, there are more than 250 foodborne diseases, mostly infections caused by bacteria, viruses and parasites. Those pathogens include salmonella, norovirus, listeria and E. coli.

Food poisoning peaks in the summer months when warmer temperatures cause foodborne germs to flourish, according to the CDC.

The illness usually has to run its full course, but Kris-Etherton urged people with bloody stools or a fever of 102 or above to go to the doctor. People who have uncontrollable vomiting or diarrhea also should head straight to the emergency room to get quick IV hydration.

While anybody can get food poisoning, Kris-Etherton said people with compromised immune systems are most at risk. That includes people with autoimmune diseases and those being treated with chemotherapy and other immunosuppressant drugs. Young children, pregnant women and older people also are more vulnerable.

There is no evidence to suggest the coronavirus is spread by handling or eating food. But the CDC urges people to limit close contact with others outside their homes, wash their hands, wear masks and avoid sharing utensils during events and gatherings.
If you have questions or comments about this story, please email editor@heart.org.

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When it comes to Labor Day menu choices, safety is tasty

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Labor Day weekend is synonymous with picnics and barbecues, and because of the COVID-19 pandemic, small outdoor gatherings are more popular than ever. However, food that sits out too long or is improperly prepared can lead to trouble. The good news is, that can be avoided by following a few simple steps.

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Group 10: What's it like to get a new heart during a pandemic? This Texas pastor can tell youBy American Heart Association News

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Group 10: What's it like to get a new heart during a pandemic? This Texas pastor can tell youBy American Heart Association News

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Marijuana may hurt heart, more research needed, report finds.

Marijuana use could hurt the heart and blood vessels, according to a report that found no cardiovascular benefits to cannabis use and called for more research of the drug that is growing in popularity.

Observational studies have linked the chemicals in marijuana to an increased risk of heart attacks, heart failure and a heart rhythm disorder called atrial fibrillation, according to the report.

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(Cavan Images, Getty Images)

Marijuana use could hurt the heart and blood vessels, according to a report that found no cardiovascular benefits to cannabis use and called for more research of the drug that is growing in popularity.

Cannabis studies have been limited because it is listed as a Schedule 1 controlled substance, defined by the U.S. Controlled Substances Act as having no accepted medical use and a high potential for abuse. A new scientific statement from the American Heart Association, published Wednesday in its journal Circulation, suggests the federal Drug Enforcement Agency remove cannabis from the Schedule I category so it can be widely studied by scientists.

Its use has risen over the past decade, especially among people 18-25. In all, 47 U.S. states, the District of Columbia, and 4 of 5 U.S. territories allow some form of cannabis use. Although many states have legalized medical and/or recreational use, cannabis growing, sales and use are illegal at the federal level, further complicating scientific research.

"We urgently need carefully designed, prospective short- and long-term studies regarding cannabis use and cardiovascular safety as it becomes increasingly available and more widely used," Robert L. Page II, chair of the writing group for the statement, said in a news release. "The public needs fact-based, valid scientific information about cannabis's effect on the heart and blood vessels. Research funding at federal and state levels must be increased to match the expansion of cannabis use - to clarify the potential therapeutic properties and to help us better understand the cardiovascular and public health implications of frequent cannabis use."

Observational studies have linked the chemicals in marijuana to an increased risk of heart attacks, heart failure and a heart rhythm disorder called atrial fibrillation, according to the report.

A recent study cited in the statement suggests 6% of heart attack patients under age 50 use cannabis. Other research found users ages 18-44 had a significantly higher risk of having a stroke compared to nonusers.

"Unfortunately, most of the available data are short-term, observational and retrospective studies, which identify trends but do not prove cause and effect," said Page, who also is professor in the department of clinical pharmacy and the department of physical medicine/rehabilitation at the University of Colorado in Aurora.

"Health care professionals need a greater understanding of the health implications of cannabis, which has the potential to interfere with prescribed medications and/or trigger cardiovascular conditions or events, such as heart attacks and strokes," he said.

Although cannabis may be helpful for conditions such as muscle stiffness associated with multiple sclerosis, the new statement said cannabis does not appear to have any well-documented benefits for the prevention or treatment of cardiovascular diseases.

Some studies suggest cannabis - which contains the "high"-inducing THC (tetrahydrocannabinolic acid) and CBD (cannabidiol) - may be safe and effective for older populations. Though they are the least likely to use cannabis, older adults have used it to reduce neuropathic pain, common among people with Type 2 diabetes.

Researchers also have reported benefits for people with age-related diseases, including Parkinson's and Alzheimer's, but there is a dearth of research on the long-term effects of cannabis use among this population. One concern is the potential of interactions with other medications, including blood thinners, antidepressants, antipsychotics, antiarrhythmics for heart rhythm abnormalities, and statin drugs, which reduce cholesterol levels.

Some research has found that within an hour of smoking cannabis, THC may induce heart rhythm abnormalities. THC also appears to stimulate the sympathetic nervous system, which is responsible for the "fight or flight" response, resulting in a higher heart rate, a greater demand for oxygen by the heart, higher blood pressure while lying down and dysfunction within the walls of the arteries.

In contrast, studies on CBD, which does not produce intoxication, have found associations with reduced heart rate, lower blood pressure, increased ability of the arteries to open and potentially reduced inflammation. Inflammation is linked to atherosclerosis, the slow narrowing of the arteries.

The way cannabis is consumed may influence how it affects the heart and blood vessels.

"Many consumers and health care professionals don't realize that cannabis smoke contains components similar to tobacco smoke," Page said. Smoking and inhaling cannabis, regardless of THC content, has been shown to increase the concentrations of carbon monoxide fivefold, and a threefold increase in tar, similar to the effects of inhaling a tobacco cigarette.

Marijuana use, and its potential health risks, should be discussed in detail with a health care professional, the report said.

"If people choose to use cannabis for its medicinal or recreational effects, the oral and topical forms, for which doses can be measured, may reduce some of the potential harms. It is also vitally important that people only use legal cannabis products because there are no controls on the quality or the contents of cannabis products sold on the street," Page said.

In addition to the poisonous compounds in cannabis smoke, vaping cannabis may result in serious health outcomes, especially when mixed with vitamin E acetate oils, which are linked to EVALI (e-cigarette or vaping product use-associated lung injury), the potentially fatal illness that emerged among e-cigarette users last year.

The AHA recommends people not smoke or vape any substance, including cannabis products, because of the potential harm to the heart, lungs and blood vessels.

Cannabis that is legal for medical purposes should align with patient safety and efficacy, according to the statement, which calls on the federal government to create and require standardized labeling about THC and CBD amounts on all legalized products.

The statement advocates folding cannabis into comprehensive tobacco control and prevention efforts, including age restrictions for purchasing; excise taxes; comprehensive smoke-free air laws; coverage of cessation treatment programs by insurers, Medicare and Medicaid; and medical screening, such as when a patient is admitted to the hospital and routinely screened to avoid medication interactions. These efforts should be adequately funded, and at least some portion of the revenue from cannabis taxation should be directed toward programs and services that improve public health.
If you have questions or comments about this story, please email editor@heart.org.

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Marijuana may hurt heart, more research needed, report finds

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Marijuana use could hurt the heart and blood vessels, according to a report that found no cardiovascular benefits to cannabis use and called for more research of the drug that is growing in popularity. Cannabis studies have been limited because it is listed as a Schedule 1 controlled substance, defined by the U.S.

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A study published this year shows that 43% of people using e cigarettes suffer from gum disease.  "E-cigarettes stress the bacterial communities that live in your mouth, and they encase themselves in slime. So they're no longer good bacteria and the inflammatory response is through the roof." Gum disease is thought to contribute to a higher rate of strokes.

Group 2

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break out room 6

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(NoSystem images/E+, Getty Images)

When schools close to protect families from the coronavirus, the main worry for many parents might be the lost learning. But for students who end up staying indoors and staring at phones and monitors most of the day, there could be health costs, too.

"You have to give the parents some grace and say we're all sort of in survival mode right now," said Hildi Nicksic, a clinical assistant professor in the department of health and kinesiology at Texas A&M University in College Station. Still, the increase in screen time and inactivity makes for "a really scary reality."

If you're a kid who has lost access to school, you've also lost recess and all the other opportunities for moving around during a school day. You've lost physical education classes and sports teams. "And really, you might not even be going outside because maybe you live in an area where your parent doesn't feel comfortable with you exiting the house," Nicksic said.

Families can find ways to cope, said Dr. Geetha Raghuveer, a pediatric cardiologist at Children's Mercy in Kansas City, Missouri. But it starts with knowing how vital it is for a child to stay physically active.

According to a 2020 report in Circulation written by an American Heart Association panel Raghuveer led, about 60% of U.S. youth have a less-than-healthy level of cardiorespiratory fitness.

The effects of low fitness are multifaceted, she said. "It's physical, it's cardiac, it's mental, it's academic, it's long term, it's short term."

Federal guidelines recommend children and teens ages 6 to 17 get at least an hour of moderate to vigorous activity a day, including more intense activities at least three times a week.

Nicksic, who spent more than 10 years as a teacher in public schools before earning her doctorate, said the benefits of activity go beyond basic health.

Regular physical activity has been shown to boost academic results. "A lot of the improvement is seen specifically in math, but there is a general understanding that that benefit will happen across subjects," she said.

And it might make things easier on teachers and parents by helping kids focus, studies have shown.

"If you take a 60-minute lesson, and you pare that down to 55 minutes and have five minutes of physical activity, the remaining 55 minutes is likely going to be a more productive learning time," Nicksic said.

Breaks aren't the only way to get kids to move. Teachers - or parents - can adapt lessons to include action. Younger students learning to use a ruler can actively measure things around the room instead of sitting in front of a piece of paper. A teacher working with students over video could ask them to fetch a topic-relevant item from somewhere in their home. "That gets the student away from just looking at the screen, even if it's just to stand up, move around and come back and sit down."

The Wide Open School project offers additional ideas, in English and Spanish, at wideopenschool.org. Nicksic compiled her own list at classroomsinmotion.com. The American Heart Association has suggestions through efforts such as Kick Cabin Fever to the Curb and the NFL Play 60 Challenge.

Ultimately, Nicksic and Raghuveer said, fitness works best as a family activity.

"It helps a lot if the family can engage in physical fitness activities as a family as opposed to just telling the kid to go out and do something," Raghuveer said.

That approach has worked for Jenny Groshong, a fourth-grade teacher in Eugene, Oregon.

Her daughters - Libby, 13, and Peyton, 12 - have had plenty of screen time this year, she said. But when it got to be too much, she didn't always just tell them to put the screen down.

"I'm a runner, so I would make one of them come with me. Some days, the other one would just jump up and say, 'I'm coming too,' and they ride their bikes while I go run."

Their family also hikes. An old tandem bike even gets hauled out sometimes. "Every once in a while, they'll get on that, which is hysterical," she said, laughing. "You want to teach your kids how to get along? Put them on a tandem."

She's aware that her family is privileged to get to do all they do. "When families are in crisis, or they're struggling financially, or they're having a hard time getting food on the table, they don't have the luxury of hopping in their Suburban and driving an hour to go on a hike," she said.

Groshong, who teaches at a school with many students from low-income families, found small ways to work movement into her curriculum. This spring, as the region's abundant plant life was in full bloom, she sent students (who had school-issued equipment) to capture images of flowers in "all the colors of the rainbow" and arrange them in a color-wheel collage. Not every kid had to walk very far, she said. "But at least they got outside."

Raghuveer and Nicksic would approve. Both emphasized it's OK to start small.

"Baby steps are fine," Nicksic said. "You don't need to go from no physical activity to making sure your kid goes for an hour-long walk or something. Anything helps."
If you have questions or comments about this story, please email editor@heart.org.

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How to keep kids active while learning from home - and why that's vital

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When schools close to protect families from the coronavirus, the main worry for many parents might be the lost learning. But for students who end up staying indoors and staring at phones and monitors most of the day, there could be health costs, too.

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Unpredictability of advanced heart failure complicate end of life care. Breakout room 3

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Unpredictability of advanced heart failure complicate end of life care. Breakout room 3

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"Many patients with HF don't realize they have a terminal disease
"approximately 6.2 million people have heart failure, one-tenth of that is classified as advanced heart failure"
"certain populations such as rural areas don't have access to palliative care which can help prolong life"

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(alvarez/E+, Getty Images)

Some people with advanced heart failure live for a long time, while others don't. That uncertain timeline poses challenges for doctors, their patients and families dealing with end-of-life care.

"We've had quality indicators for cancer for many years, which have been used to make sure that end-of-life patients get high-quality care," said Dr. Rebecca Hutchinson, a hospice and palliative medicine specialist at Maine Medical Center in Portland. "With heart failure, we don't have those indicators."

That discrepancy motivated Hutchinson and five colleagues to conduct in-depth interviews with 23 cardiologists and primary care physicians across Maine about treating people with advanced heart failure.

The study, published Monday in the Journal of the American Heart Association, found "prognostic uncertainty" of advanced heart failure complicates how doctors care for patients for several reasons.

"Heart failure is marked by frequent exacerbations where patients can get pretty sick and then recover back to baseline or pretty close back to baseline," said Hutchinson, who led the study. "At some point, one of those exacerbations usually marks the beginning of end of life, but it's not always easy to tell. Are you in one that's close to end of life or are you in one where there's going to be a recovery?"

That, she said, forces doctors to balance the desire to prolong life against the possibility that more treatment will do no good and cause unnecessary suffering. The uncertainty often makes it harder for patients to recognize the reality of their disease, and harder for doctors to discuss the situation with them, the study found.

"Doctors told us that patients with heart failure frequently don't realize that this is a terminal disease," she said. "That makes it harder to have the end-of-life conversations early to make sure we're giving them care that's consistent with their values."

According to American Heart Association statistics, an estimated 6.2 million U.S. adults have heart failure, where the heart cannot pump enough blood to meet the body's needs. About one-tenth of those are classified as advanced heart failure, where usual treatment is not effective but the remaining life span is hard to predict.

The study also examined differences in urban and rural areas, where patients may have less access to medical specialists and quality in-home care.

"That's good and bad," Hutchinson said. "Patients in rural areas tend to have less aggressive (unnecessary) interventions at the end of life, but it's bad in that they may not have access to life-prolonging therapies."

Hutchinson said the findings emphasize the need for better methods to calculate a patient's prognosis and determine a patient's values so that end-of-life care matches what the patient wants. Regardless, she said, palliative care - medical help to relieve the symptoms and stress of a serious illness - should be part of the plan.

"Palliative care really shouldn't be tied to a prognosis," Hutchinson said. "A lot of people associate palliative care with end-of-life care and hospice, but it's really not."

That point alone makes the study worthwhile, said Dr. Diane Meier, director of the Center to Advance Palliative Care and a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City.

While people choosing hospice must agree to relinquish insurance coverage for life-prolonging treatment, she said, "palliative care has no such restrictions. You can get it whether or not your disease can be cured, whether you're going to live with it for 20 years or whether it's progressive. Eligibility for palliative care is based on need - symptom distress, family exhaustion, uncertainty about what to expect - and not on prognosis."

Meier, who was not involved with the new study, said changing the mindset is particularly important for heart patients, who may have years to live but face issues such as depression, anxiety and social withdrawal. She said all of that can be helped by palliative care, which research shows can improve quality of life and symptom control in people with heart failure.

"The important take-home message is we offer both life-prolonging treatment and palliative treatments meant to improve quality of life and day-to-day functioning - at the same time," she said. "We need to replace our either/or mindset with a both/and model."
If you have questions or comments about this story, please email editor@heart.org.

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Unpredictability of advanced heart failure complicates end-of-life care, doctors say

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Some people with advanced heart failure live for a long time, while others don't. That uncertain timeline poses challenges for doctors, their patients and families dealing with end-of-life care. "We've had quality indicators for cancer for many years, which have been used to make sure that end-of-life patients get high-quality care," said Dr. Rebecca Hutchinson, a hospice and palliative medicine specialist at Maine Medical Center in Portland.

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BREAK OUT ROOM 7-Controlling diabetes takes on greater urgency during COVID-19 pandemic

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BREAK OUT ROOM 7-Controlling diabetes takes on greater urgency during COVID-19 pandemic

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-  diabetics are six times more likely to be hospitalized and 12 times more likely to die than those without pre-existing, underlying conditions
- people with uncontrolled blood sugar seem to be staying away from emergency rooms
- since the pandemic began emergency room visits for blood glucose problems have fallen 10% since March
- Telemedicine use has increased during the pandemic
-Take medications consistently as prescribed and keep enough on hand, manage stress

References:
American Heart Association. (2020, July 24). Controlling diabetes takes on greater urgency during COVID-19 pandemic. www.heart.org. https://www.heart.org/en/news/2020/07/24/controlling-diabetes-takes-on-greater-urgency-during-covid-19-pandemic

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High Blood Pressure Telemonitoring Might Help Cut Heart Attack, Stroke Rate in Half - Break out room 9

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High Blood Pressure Telemonitoring Might Help Cut Heart Attack, Stroke Rate in Half - Break out room 9

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450 participants with uncontrolled blood pressure after 6 months of telehealth monitoring 5.3% of the remote care group had heart attacks, strokes, stent placements or heart failure hospitalizations compared to 10.4% for the routine care group

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(mixetto/E+, Getty Images)

People taking part in a pharmacist-led telemonitoring program to control high blood pressure had about half as many cardiovascular events as those monitored through routine office visits, according to a new study.

The research, published Monday in the American Heart Association journal Hypertension, used data from 450 people with uncontrolled high blood pressure across 16 clinics in Minnesota. Participants were randomly split into two groups. After six months of using at-home monitors and being guided over the phone by pharmacists, participants had lower blood pressure for two years compared to the group who received routine care through their primary care doctor.

After five years, 5.3% of the remote care group had heart attacks, strokes, stent placements or heart failure hospitalizations compared to 10.4% for the routine care group.

Patients reported they liked having support from a trusted professional, rapid feedback and adjustments to their treatment, and having someone to be accountable to, said lead study author Dr. Karen L. Margolis in a news release.

"By avoiding serious cardiovascular events over five years, our results indicate significant cost savings," said Margolis, executive director of research at HealthPartners Institute in Minneapolis. Over five years, the study said the savings could be up to $1,900 per patient.

But researchers caution the five-year findings for a reduction in cardiovascular events fell "just short of statistical significance," which means they could have been due to chance. Still, Margolis said, she and her colleagues were "surprised that the figures on serious cardiovascular events pointed so strongly to a benefit of the telemonitoring intervention."

Nearly half of U.S. adults have high blood pressure, defined as equal to or greater than 130 for the top number or 80 for the bottom number. However, most adults with high blood pressure don't have their numbers under control.

Margolis said based on the study findings, "widespread adoption of the telemonitoring model might help U.S. adults with uncontrolled high blood pressure avoid serious cardiovascular events and reduce health care costs."

The study authors recommend future studies to figure out how to increase the number of patients engaged in home blood pressure monitoring over many years, and to measure cardiovascular risk factors and cardiovascular events over that extended period.
If you have questions or comments about this story, please email editor@heart.org.

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High blood pressure telemonitoring might help cut heart attack, stroke rate in half

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People taking part in a pharmacist-led telemonitoring program to control high blood pressure had about half as many cardiovascular events as those monitored through routine office visits, according to a new study. The research, published Monday in the American Heart Association journal Hypertension, used data from 450 people with uncontrolled high blood pressure across 16 clinics in Minnesota.

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Break out room 4 - "After years of decline, death rate from lung clots on the rise"

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Break out room 4 - "After years of decline, death rate from lung clots on the rise"

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-There were roughly 370,000 PE and 857,000 DVT events in the United States in 2016.
-The researchers found premature and preventable deaths from pulmonary embolism increased 23% from 2008 to 2018 among people ages 25 to 64.
-The cause of the rise has been very hard to determine.
-While white men showed the highest increase in PE mortality rates, the death rate for Black men and women was consistently higher than that of white people over the past two decades.
-Severe obesity to be a stronger risk factor for pulmonary embolism than DVT, suggesting "the continued rise in obesity may be playing a role.

Reference:  American Heart Association. (2020, August 17). After years of decline, death rate from lung clots on the rise. https://www.heart.org/en/news/2020/08/17/after-years-of-decline-death-rate-from-lung-clots-on-the-rise

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(doyota/iStock, Getty Images)

After nearly a decade of steady decline, the death rate for people with blood clots in the lungs reversed course and began rising over the past decade, new research finds.

The study, published Monday in the Journal of the American Heart Association, found death rates for pulmonary embolism (PE) dropped an average of 4.4% per year from 1999 to 2008, then began climbing an average of 0.6% per year. The biggest increases were for people under age 65.

"Death rates for PE are rising and seem to be doing so across age, race and geographic regions," said lead author Dr. Karlyn Martin. She is assistant professor of medicine in the division of hematology/oncology at Northwestern University's Feinberg School of Medicine in Chicago.

Pulmonary embolism is part of the broader disease called venous thromboembolism (VTE), or blood clots that start in the veins. VTE also includes deep vein thrombosis (DVT), a clot in a vein deep in the body, usually the leg. If such a clot breaks free, it can travel to the lungs and cause a pulmonary embolism.

There were roughly 370,000 PE and 857,000 DVT events in the United States in 2016, the last year for which data are available, according to American Heart Association statistics. PE and DVT kill up to 100,000 Americans each year, says the Centers for Disease Control and Prevention.

"We know that (PE and DVT) are more common as people get older," Martin said. "So, we expected there to be higher rates in older people. But we found a significant number of younger people dying from PE as well. We don't know what's causing it, but it's a worrisome trend that needs dedicated study to find out why."

The researchers found premature and preventable deaths from pulmonary embolism increased 23% from 2008 to 2018 among people ages 25 to 64, a trend that mirrors a rise in deaths from all causes among this age group.

While white men showed the highest increase in PE mortality rates, the death rate for Black men and women was consistently higher than that of white people over the past two decades, the study found. As with the change in mortality rates, the study did not address why racial disparities existed.

"These data, for the first time, describe an alarming trend that is impacting Black Americans in particular," said Dr. Mary Cushman, medical director of the Thrombosis and Hemostasis Program at the University of Vermont Medical Center. She was not involved in the study.

"It is very hard to determine the cause, apart from speculation," said Cushman. She chaired the writing group for a recent scientific statement from the AHA and International Society on Thrombosis and Haemostasis that pinpointed future research priorities in VTE.

Cushman led prior research that found severe obesity to be a stronger risk factor for pulmonary embolism than DVT, suggesting "the continued rise in obesity may be playing a role. Other lifestyle factors like sedentary behavior, which is also on the rise, might be at play," she said. "But the rising rate in younger adults is a mystery to me and requires further study."

She called the study "a wake-up call that we are going in the wrong direction."

That means current efforts to prevent or treat pulmonary embolism don't seem to be working to keep death rates down, Martin said. "We need to know what's underlying the drivers to prevent this and stop it from rising further."
If you have questions or comments about this story, please email editor@heart.org.

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After years of decline, death rate from lung clots on the rise

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After nearly a decade of steady decline, the death rate for people with blood clots in the lungs reversed course and began rising over the past decade, new research finds. The study, published Monday in the Journal of the American Heart Association, found death rates for pulmonary embolism (PE) dropped an average of 4.4% per year from 1999 to 2008, then began climbing an average of 0.6% per year.

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"Researchers explore how Covid-19 affects heart health in black women"

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"Researchers explore how Covid-19 affects heart health in black women"

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African Americans with covid-19 are 3x as likely to be hospitalized than white people with covid-19. Additionally, African Americans with covid-19 die at a rate of 3-4x that of white people with covid-19. Both of these statistics are related to the high rate and risk of cardiovascular disease for African Americans. Due to disparities in education, income, housing, etc., African Americans have an increased risk of hypertension, diabetes, and obesity. Cardiovascular disease in women is often goes unrecognized and untreated. Researchers are hoping to collect data on specific demographic groups to better understand complications that may affect African American women versus white women in order to better-prevent and treat disease.

Reference: American Heart Association News. (2020, August 25). Researchers explore how COVID-19 affects heart health in Black women. Www.Heart.Org. https://www.heart.org/en/news/2020/08/25/researchers-explore-how-covid-19-affects-heart-health-in-black-women