American Heart Association, Nov. 13-17

The American Heart Association Scientific Sessions 2020

The annual meeting of the American Heart Association was held virtually this year from Nov. 13 to 17 and attracted participants from around the world, including cardiovascular specialists, surgeons, and nurses as well as other health care professionals. The conference featured presentations focusing on the latest advances in cardiovascular medicine and surgery.

In a cross-sectional study, William Aitken, M.D., of the University of Miami Miller School of Medicine and UM/Jackson Memorial Hospital in Miami, and colleagues found that increased greenness and better air quality are associated with decreased cardiovascular disease mortality.

The authors evaluated whether environmental greenness or vegetative presence such as trees is related to cardiovascular disease mortality and weighed the effect greenness may have on the relationship between air quality and cardiovascular disease mortality. The authors used linear regression modeling to estimate the relationship between air pollution (measured in particulate matter 2.5), greenness (measured in normalized vegetation index), and cardiovascular disease mortality (at the county level), while controlling for sociodemographic variables (such as race, education, and income). The researchers found that increased greenness and air quality reduced cardiovascular disease mortality.

“We also found that environmental greenness mediates, or serves as an important intervening variable, in explaining the air quality-to-cardiovascular disease mortality relationship,” Aitken said. “Environmental interventions to increase greenness and reduce air pollution may reduce excess cardiovascular disease mortality.”

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In another study, Neil Kelly, Ph.D., of Weill Cornell Medicine in New York City, and colleagues found that healthy lifestyle behaviors, including a Mediterranean diet, physical activity, smoking abstinence, and sedentary avoidance, are each individually and cumulatively associated with a reduction in all-cause mortality regardless of medication burden.

Using data from a prospective, longitudinal cohort study, the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, the authors examined approximately 20,000 U.S. adults (average age, 65 years) to understand the link between lifestyle behaviors and mortality. The researchers evaluated patterns of the Mediterranean diet, physical activity, smoking, and time spent watching television (sedentary time) among three specific groups based on medication burden: no polypharmacy (take fewer than five medications), polypharmacy (take five to nine medications), and hyper-polypharmacy (take at least 10 medications). The researchers found that increased adherence to healthy lifestyle behaviors was associated with lower all-cause mortality, regardless of medication burden.

“Indeed, the benefits were observed even among individuals taking at least 10 medications,” Kelly said. “Our findings suggest that healthy lifestyle behaviors are important even after developing multiple chronic conditions and requiring the use of multiple medications. We are hopeful that our results will encourage the development of strategies to increase patient adherence to healthy lifestyle behaviors.”

One author disclosed a financial relationship with Amgen.

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In a randomized controlled study, Nisa M. Maruthur, M.D., of Johns Hopkins University in Baltimore, and colleagues found that time-restricted feeding (eating earlier in the day) does not decrease weight more than a usual feeding pattern (eating later in the day) in the setting of a constant calorie level.

In this controlled-feeding study, the authors prepared all study food in a metabolic kitchen for the entire 12-week intervention period. Participants in both arms received the same healthy diet. The authors determined each participant’s calorie level at the beginning of the study and held it constant during 12 weeks. The only difference between the intervention arms was the time of day that they consumed their calories. The researchers found that eating earlier in the day did not reduce weight more than eating later in the day if calories were held constant.

“It is important to remember that this is a single clinical trial,” Maruthur said. “However, we are contributing to a growing evidence base that the timing of your calorie intake does not seem to matter for body weight in the setting of caloric intake being held constant.”

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Garima Sharma, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues found that the prevalence of preeclampsia and other cardiovascular disease risk factors is lower in foreign-born Black women compared with U.S.-born Black women.

The authors performed an observational analysis of the Boston Birth Cohort between 2008 and 2016 and found that the prevalence of cardiovascular risk factors was higher in U.S.-born Black women compared with foreign-born Black women. The researchers also found that the prevalence of preeclampsia was higher in U.S.-born Black women compared with foreign-born Black women. The age-adjusted prevalence of preeclampsia was 12.4 and 9.1 percent among U.S.-born and foreign-born women, respectively.

“This prevalence increased based on the duration of residence in the United States. Foreign-born Black women who had greater than 10 years of residence in the United States had higher prevalence of preeclampsia than those who had less than 10 years. There was also an increase in the cardiovascular disease risk factors with duration of residence,” Sharma said. “The ‘healthy immigrant effect,’ which typically results in health advantages for foreign-born women, appears to wane with longer duration of U.S. residence (greater than or equal to 10 years). Further research is needed to better understand these associations.”

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AHA: Ablation Better Than Meds for Initial A-Fib Treatment

WEDNESDAY, Nov. 25, 2020 (HealthDay News) — Cryoballoon ablation is superior to drug therapy as an initial treatment for the prevention of atrial arrhythmia recurrence in patients with paroxysmal atrial fibrillation, according to a study published online Nov. 16 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2020, held virtually from Nov. 13 to 17.