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Heart Therapy Studies Highlight Advantages of Keeping it Simple

Practical steps in prevention and care of cardiac risks yield important benefits

ATLANTA, G.A. -- March 13, 2006 -- Practical and inexpensive techniques can be among the most effective ways to prevent and treat cardiovascular disease, reducing blood pressure and controlling disabling fainting spells, according to two studies presented today at the American College of Cardiology's 55^th Annual Scientific Session.

ACC.06 is the premier cardiovascular medical meeting, bringing together more than 30,000 cardiologists to further breakthroughs in cardiovascular medicine.

"Sometimes simple preventive interventions can have an enormous impact on long-term cardiovascular health," said George A. Beller, MD, FACC, University of Virginia Health Center. "These two studies remind us of that as researchers we should never neglect exploring the value of low cost and simple interventions that can be effective in treating heart and vascular disease."

A Low Sodium, High Potassium Salt Substitute Substantially Lowers Blood Pressure Levels Among High-Risk Individuals in Rural Northern China: The China Salt Substitute Study (CSSS)

A salt substitute specially formulated to be both flavorful and effective has significantly reduced blood pressure in residents of northern, rural China at high-risk of heart complications, where home-pickled foods are a dietary mainstay and hypertension is rampant. If widely adopted, this simple approach could markedly cut the risk of stroke and other cardiovascular diseases.

"It's only recently been realized that chronic diseases are the main cause of death in China," said Bruce C. Neal, MD, PhD, director of the cardiac and renal division of The George Institute for International Health, Sydney, Australia. "We were interested in trying to find a new, practical way of addressing this very serious health problem."

Dr. Neal and his colleagues randomly assigned 608 study participants to replace their usual supply of household salt with either a salt substitute or the study salt for 12 months. In rural China, most meals are prepared at home. Unlike many salt substitutes, which consist primarily of potassium chloride and leave a bitter after-taste, the salt substitute used in the study was formulated using 65% sodium chloride (table salt), 35% potassium chloride, and 10% magnesium sulfate.

At the beginning of the study, blood pressure averaged 159/93 mmHg. After 12 months, systolic blood pressure was 5.4 mmHg lower among those using salt substitute when compared to the control group, a highly significant difference.

"That's the really exciting thing: this is a dietary intervention that is producing a blood pressure reduction comparable to that achieved in many large-scale trials of blood pressure lowering drugs versus placebo," Dr. Neal said.

Dr. Neal will present the full CSSS results at a Late Breaking Clinical Trials session on Tuesday, March 14, at 10 a.m.

The Physical Counterpressure Manoeuvre Trial (PC-Trial): Study on the Effectiveness of Physical Counterpressure Manoeuvres in Preventing Vasovagal Syncope

For people who suffer from frequent episodes of fainting, simple muscle-tensing exercises can offer significant relief, reducing the number of episodes and prolonging the time between episodes, according to the first randomized, controlled study to assess the effectiveness of physical counterpressure techniques in daily life.

"Fainting episodes can have a very serious impact on patients' lives," said Nynke van Dijk, MD, a clinical epidemiologist at Academic Medical Center-University of Amsterdam, The Netherlands. "Patients avoid situations in which they might faint and in which fainting might be embarrassing. They are not allowed to drive or perform any other activities that might pose a risk should they lose consciousness. In these patients, frequent fainting can be considered a disease."

The PC-Trial enrolled 223 patients with a history of repeated fainting preceded by tell-tale symptoms. Dr. van Dijk and colleagues randomly assigned patients to conventional therapy, consisting of education and lifestyle modification, or physical counterpressure training in three techniques: leg-crossing, handgrip exercises, and arm-tensing exercises. Patients were instructed to use the preventive techniques in situations known to provoke fainting and immediately when experiencing warning symptoms. During a 14-month follow-up, use of physical counterpressure techniques reduced the risk of fainting by more than one-third.

"This treatment is very simple, inexpensive, and noninvasive, and has no long-term side-effects," Dr. van Dijk said.

Dr. van Dijk will present the PC-Trial at a Late Breaking Clinical Trials session on Sunday, March 12, at 2:25 p.m.


SOURCE: American College of Cardiology

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