Tackling Heart Disease Together or Alone: The Behavioural Science of Self-Management

Heart disease is the leading killer in the U.S. and throughout most of Europe. People’s behaviour can protect and reduce risk of heart disease, and interventions to help people “self-manage” exist. But what is the best way to “self-manage”? A recent study shows that group programmes and self-directed programmes have remarkably different effects [1].

heart-disease

Self-management interventions exist for many health problems. They are notoriously difficult to define. One thorough definition is that it relates to activities undertaken by the person who has a “chronic” or “long-term” condition such as asthma, multiple sclerosis or arthritis. These activities include problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning and self tailoring [2]. Interventions or programmes are designed around these activities to help support people to manage their own illness. The idea is that following attendance at a programme of some sort, the activities and skills learned will be continued to be used, thus improving health, maintaining fitness and/or quality of life and reducing the risk of future acute episodes of ill health. These interventions are popular for many reasons, including the relatively low cost to health service providers as interventions can be delivered by health-care professionals or by people with the relevant condition who have been trained, or a mixture of both. Self-management interventions also allow people with long-term conditions to be meet in a group with people with similar conditions. The experience of being in a group, knowing one is not alone and sharing stories is thought to play some part in the effectiveness of self-management interventions. But to what extent is this true?

New Genes Associated with Blood Pressure and Hypertension

High blood pressure or hypertension affects more than one in three people worldwide and is a major cause of strokes, heart attacks and heart failure [1]. The degree with which blood pressure traits can be inherited suggests a genetic component. However, limited consistent evidence of genes associated with blood pressure have been produced. A new study in the journal Nature Genetics reports for the first time a number of genes showing significant associations with blood pressure and hypertension across the genome [2].

Blood pressure

Meat Consumption and Mortality Risk

According to a study published recently in the Archives of Internal Medicine, a high intake of red or processed meat increases the risk of death [1]. In contrast, those consuming white meat had a decreased risk of both total mortality and cancer mortality. Two years ago, a similar study identified an association between red and processed meat and cancers of the colorectum and lung [2], but this is the first large-scale study to assess the relationship between red, white and processed meat consumption and the overall risk of death.

Researchers prospectively (meaning in real time) investigated red, white and processed meat consumption as risk factors for total mortality, cancer mortality and cardiovascular disease (CVD) mortality. The dietary habits of more than a half-million men and women aged 50 to 71 years were assessed in 1995 using a 124-item food frequency questionnaire. Cohort members were then followed-up over a 10 year period (i.e. from 1995 to 2005).

Pharmacogenetic Algorithm Accurately Predicts Warfarin Dosing

This article was written by Noelle K. LoConte, M.D.

Warfarin (brand name Coumadin) is one of the most commonly used anticoagulants (meaning a medication that thins the blood). It is used in a variety of medical situations, including atrial fibrillation, blood clots and when there is an increased risk of blood clotting due to genetic predisposition. When a patient is on warfarin, they need frequent blood draws to measure blood thinness and frequent dose adjustments until they have reached a stable level of blood thinning.

DNA

Lifetime Immunity From the Flu

Scientists report in the current issue of the journal Nature Structural and Molecular Biology the isolation of a group of high-affinity antibodies that are potent inhibitors of a wide range of influenza viruses, including the H5N1 avian flu, the 1918 Spanish flu and some seasonal strains [1]. The antibodies may someday be used to create a vaccine that provides lifetime immunity from the flu.

Seasonal flu hospitalizes an average of 226,000 people in the U.S. annually, killing 36,000 every year [2]. Influenza A viruses have been associated with an increasing number of deaths; from 1990 — 1999, the greatest mean number of flu deaths were associated with influenza A (H3N2) viruses [3]. Each season, between one quarter- and a half-million people die of influenza worldwide [4].