Saturday, March 10, 2012

Arthritis sufferers '40 per cent more likely to develop fatal heart problems'

The absolute numbers are however so low as to be trivial

Arthritis sufferers are far more likely to develop fatal heart problems and strokes, a major study reveals today. It shows that patients with rheumatoid arthritis have a 40 per cent higher risk of suffering from an irregular heartbeat which can lead to heart attacks and death.

They have also been found to be at 30 per cent greater risk from suffering strokes.

Danish researchers believe the inflammation of joints that occurs in arthritis may cause the heart to beat irregularly - a condition known as atrial fibrillation. This can lead to the formation of blood clots which in turn can trigger a stroke.

Around 400,000 people in England and Wales suffer from rheumatoid arthritis which causes debilitating pain and swelling in the joints.

Scientists from Copenhagen University studied more than 4 million people of whom 18,250 had rheumatoid arthritis over a period of five years. Those with rheumatoid arthritis were 40 per cent at higher risk of atrial fibrillation and 30 per cent higher risk of strokes than the general public.

Although this seems like a big increase, the overall risk still of having heart problems or strokes still remains low. In a group of 1,000 normal patients, six would likely suffer from atrial fibrillation in any given year while 5.7 would be likely to have a stroke.

But amongst a group of 1,000 rheumatoid arthritis sufferers, 8 would be expected to have atrial fibrillation while 7.6 would be likely to have a stroke.

However the researchers - whose findings are published on the website - point out that doctors need to be aware of these heightened risks amongst their patients.

Professor Michael Ehrenstein, of Arthritis Research UK said: ‘Inflammation plays a central role in rheumatoid arthritis and in the disease process of many other related conditions, so it’s not surprising that it may also play a role in the development of atrial fibrillation.’

Rheumatoid arthritis tends to strike between the ages of 40 and 70 and is more common amongst women than men. It happens when the body’s immune system attacks the cells lining the joints making them swollen, stiff and very painful. Experts believe that it may trigger inflammation of the blood vessels which in turn triggers heart problems.

In 2010 Swedish researchers who had looked at 400,000 people found the condition was also linked to heart attacks. They were found to be 60 per cent more at risk compared to other patients.


Passing electric current through the brain 'lifts half of patients from depression'

This is not exactly new. Electroconvulsive therapy goes back many decades. So this finding has some precedent. What appears to be different is that a much weaker current is applied

Passing electric currents through the brain has been found to lift half of patients out of depression, according to a new study.

Stimulating the brain with a weak electrical current was even beneficial for patients who hadn't responded to other treatments such as anti-depressants.

The randomised controlled trial of transcranial direct current stimulation (tDCS) by researchers from the University of New South Wales (UNSW) and the Black Dog Institute in Sydney Australia is the largest to have ever been carried out.

Patients remain awake and alert during the procedure, which involves a non-invasive form of brain stimulation by sending a depolarising electrical current into the front of the brain through electrodes on the scalp.

And the study, published in the British Journal of Psychiatry, showed the therapy was a successful treatment for many participants.

Trial leader Professor Colleen Loo, from UNSW's School of Psychiatry, said: 'We are excited about these results. 'This is the largest randomised controlled trial of transcranial direct current stimulation ever undertaken and, while the results need to be replicated, they confirm previous reports of significant antidepressant effects.

'The trial saw 64 depressed participants who had not benefited from at least two other depression treatments receive active or sham tDCS for 20 minutes every day for up to six weeks. 'Most of the people who went into this trial had tried at least two other antidepressant treatments and got nowhere. 'So the results are far more significant than they might initially appear — we weren't dealing with people who were easy to treat.'

Results after six weeks of treatment were better than those after just three weeks, suggesting the therapy works better over an extended period.

Participants who improved during the trial were offered follow up weekly 'booster' treatments - with about 85 percent showing no relapse into depression after three months.

Professor Loo continued: 'These results demonstrate that multiple tDCS sessions are safe and not associated with any adverse cognitive outcomes over time.' She added that tDCS is simple and cost effective to deliver and only requires a short visit to a clinic.

The study also turned up additional unexpected physical and mental benefits, including improved attention spans and information processing. One participant with a long-standing reading problem said his reading had improved after the trial and others commented that they were able to think more clearly.

Dr Loo continued: 'Another participant with chronic neck pain reported that the pain had disappeared during the trial. 'We think that is because tDCS actually changes the brain's perception of pain. We believe these cognitive benefits are another positive aspect of the treatment worthy of investigation.'

The researchers are now looking at an additional trial to include people with bipolar disorder, with early results from overseas suggesting tDCS is just as effective in this group.


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