Sunday, June 15, 2008

Heart attack admissions fall by up to 40% since smoking ban

I thought the headline above was too good to be true. It is. See, for instance, the bit I have highlighted. Reading the small print is important in health matters too. The honest headline would be: "Smoking ban makes no difference"

The number of heart attack patients being admitted to emergency wards has fallen sharply in more than half of England's hospital trusts since smoking was banned in public places. The figures, obtained under the Freedom of Information Act, are an early indication of the impact of the smoking ban on heart disease rates in England. Some hospitals have seen the number of cases fall by 41 per cent since last July. The British Heart Foundation said that it showed the ban was the "most significant public health initiative this century".

Studies in Scotland and Ireland, which introduced a public-smoking ban in 2006, showed hospital admissions for heart attacks falling by 17 and 14 per cent respectively. Comparable evidence has come from France and Italy. These drops in the rate of heart attacks have been attributed to a large number of people stopping smoking, and far fewer people being exposed to airborne toxins through passive smoking.

The Government has not yet published figures documenting the effects of the ban in England. But NHS records show that there were 1,384 fewer heart attacks in the nine months after the legislation was introduced than in the same period a year earlier. The figures, obtained by the Daily Mail, show admissions for heart attacks from 114 trusts: 66 saw a drop in admissions compared with the same period the year before. The most striking figures came from Shrewsbury and Telford Hospital NHS Trust, where there was a 41 per cent fall, or 418 fewer cases. In the remaining 48 trusts, the number of admissions remained the same or increased slightly.

The Department of Health welcomed the figures as "good news" but added that it was too early to attribute falls in heart attack rates to the new legislation. Rates of heart disease were falling before smoking in public was banned in European countries, and various factors, including mild weather, can contribute to a fall. Nevertheless, the health benefits of stopping smoking are well established. A year after a person quits smoking, the risk of a heart attack falls to half that of a smoker.

Nicholas Boon, of the British Cardiovascular Society, said: "When you place these figures with the research in Scotland, Ireland, France and Rome, it is consistent with the observation that the ban has been followed by improvements in heart attack rates."


Breast cancer: brittle bone drug can stop disease taking hold

It might kill you too but who cares about that?

A drug prescribed to combat brittle bones has been shown to prevent invasive breast cancer. Scientists stumbled on the discovery while investigating whether the drug, raloxifene, could also protect against heart disease. Although there was no impact on heart disease, the trial showed that the drug reduced by 55 per cent the risk of invasive breast cancers, which spread through tissue barriers into surrounding areas.

Sold under the brand name Evista, raloxifene is used both to prevent and treat osteoporosis in postmenopausal women. It works by activating "receptors" or molecular switches in bone tissue that normally respond to the female sex hormone oestrogen. By blocking the receptors, raloxifene may prevent some of the effects of oestrogen that spur cancer growth, scientists say. They believe that raloxifene acts in the same way as the highly successful breast cancer drug tamoxifen.

During the trial, only hormone-sensitive cancers that are fuelled by oestrogen were affected, but they make up the majority of breast cancers. More than 10,000 women with heart disease, or at risk of the condition, took part. Over a period of more than five years, those who took raloxifene were 55 per cent less likely to develop invasive oestrogen-positive breast cancer than those who took a dummy placebo drug. Raloxifene had no effect on noninvasive cancer or cancers not affected by oestrogen. The findings are reported in the Journal of the National Cancer Institute.

There was a downside to the treatment: women given raloxifene were more likely to suffer blood clots and fatal strokes than those taking the placebo.


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