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Beta Blockers May Not Prevent Heart Attacks and Strokes

http://abcnews.go.com/Health/video/beta-blockers-effective-previously-thought-17378539

By SYDNEY LUPKIN
Oct. 2, 2012

New research suggests that beta-blocker pills don’t prevent heart attacks, strokes or cardiac deaths in patients with heart disease, but doctors are torn over whether there’s enough in the study to make them want to stop prescribing the drugs. Beta blockers have been a standard heart medication for decades.

The study, published in the Journal of American Medical Association, looked at nearly 45,000 patients with prior heart attacks, coronary artery disease or risk factors for coronary artery disease, and found that those on beta blockers didn’t show significantly lower rates of heart attack, stroke or cardiac death than those not on the medication.

“This is a very compelling study that has the potential to shake up the conventional wisdom that exists regarding the role of beta blockers in the management of patients with cardiovascular disease,” said Dr. Randal Thomas, a cardiovascular specialist at the Mayo Clinic. “At a minimum, it will lead to new studies that address this issue once again.”

Beta blockers work by blocking adrenalin receptors in the brain that become activated when the body is stressed. Beta blockers are used to treat heart disease, high blood pressure, anxiety and other conditions.

Some doctors say they are glad beta blockers are being questioned because their use had been “written in stone” for so many years, but others say using a non-randomized data sample is not as reliable as a randomized drug trial.

While the authors attempted to account for differences between the patient groups that might have had an impact on their health, they did not have access to information on why some patients were prescribed these drugs and some were not, said Dr. Richard Besser, the chief heath and medical editor at ABC News.

Dr. Melvin Rubenfire, who directs cardiovascular medicine at the University of Michigan, said he’d been hoping for a study like this, but it won’t change his prescribing habits because he uses beta blockers only in specific cases. Rubenfire also weans patients off the pills 18 months after they have a heart attack if they experience adverse side effects, such as fatigue and erectile dysfunction.

Rubenfire said the existing data wasn’t enough to determine which patients would benefit from beta blockers, and what kinds of beta blockers are better than others. Beta blockers include at least six brand names, including Sectral, Tenormin and Zebeta.

Even study coauthor Christopher Cannon, a professor at Harvard Medical School, said he will continue to prescribe beta blockers to his patients, adding “I would not make too much of this” because the study is only observational.

“All it can do is raise up an idea for us researchers to consider for further study,” he said.

Cannon said this research shows that it’s unclear whether beta blockers add more benefit than the other therapies developed in the decades since beta blockers became a standard of practice for treating patients with heart disease. Since patients are often taking several drugs, it’s hard to pinpoint how much one agent helps compared with another.

Dr. Steven Nissen, who chairs the department of cardiovascular medicine at the Cleveland Clinic Foundation, said the medicine might not be ideal for all of the patients it’s prescribed to, but a new randomized, controlled trial will be necessary to change guidelines for prescribing beta blockers.

“Abandonment of this type of therapy for post-MI [post-heart attack] patients based upon an observational study is not warranted,” he said.

For the time being, the study raises questions, said Dr. Harlan Kumhulz, a professor of medicine, epidemiology and public health at Yale University.

“The question it raises is about how long after having a heart attack should patients remain on beta blockers?” Kumhulz said, noting that beta-blocker patients didn’t have better outcomes than the other patients did after the first year. “The study cannot definitively answer that question — but raises doubts about the need to continue to take them for the rest of a patient’s life.”

Dr. Lauren Hughes of the ABC News Medical Unit contributed to this report.

http://abcnews.go.com/Health/beta-blockers-prevent-heart-attack-stroke-study-jama/story?id=17378403#.UG32y5jA-Sp

8 REASONS WHY WOMEN SHOULD LIFT WEIGHTS Livestrong

The benefits of resistance training go far beyond sculpting a lean, toned body

Jun 25, 2012 | By Linda Melone

We know: You don’t want bulging biceps or thunderous thigh muscles like Lance Armstrong. No woman does. But that doesn’t mean you should skip the weight room.

Lifting weights has some surprising perks that you can’t get from cardio alone. Research shows that just two strength-training sessions a week can help you burn more fat, sculpt lean muscles, feel more energized, and so much more. Here are eight reasons you should start lifting today.

1. You’ll burn more calories

Although cardio burns more calories than strength training during your 30-minute sweat session, lifting weights burns more overall. It all goes back to building muscle. It takes more energy (calories) for your body to maintain muscle cells than it does fat cells. So by lifting weights to add more muscle mass, you’ll boost your metabolism and turn your body into a more efficient fat-burning machine.

2. You’ll maintain muscle and feel better in your clothes

Research shows that between the ages of 30 and 70, women lose an average of 22 percent of their total muscle. What’s even more upsetting is that over time, the muscle void is often filled with fat. One pound of fat takes up 18 percent more space than one pound of muscle, so even if the number on the scale goes down, your pants size might go up. The best way to stay tightly packed? Keep strength training!

For best results, Tom Holland, MS, CSCS, author of Beat the Gym, recommends two to three total-body strength workouts per week for 30 minutes each session. Include three to four days of cardiovascular exercise, either on the same days or alternate days.

3. You’ll build stronger bones

Lifting weights can be your best defense against osteoporosis—a disease affecting 10 million Americans, 80 percent of which are women, according to the National Osteoporosis Foundation. “When you lift weights you engage muscles that pull on the tendons which, in turn, pull on the bones,” says Holland. “This added stress makes bones stronger.”

4. Your heart will be healthier

It may seem counterintuitive that weight lifting helps lower blood pressure, since blood pressure actually goes up during and immediately after your strength session. But research shows it’s a powerful way to protect your ticker in the long run. “As muscles contract, blood is pushed back up to the heart,” says Irv Rubenstein, PhD, exercise physiologist and founder of S.T.E.P.S., a fitness facility in Nashville, TN. “The heart then recirculates this oxygenated blood back to the muscles, which keeps the cardiovascular system in better working order.” Plus, maintaining lean muscle mass enables you to do more work overall, further enhancing this effect, Rubenstein says.

5. You’ll remember where you left the keys (and everything else)

Muscles strengthen both your body and your brain. According to a new study published in the May 2012 issue of Mayo Clinic Proceedings, a combination of mentally stimulating activities like using a computer and exercise (which included walking and other cardio as well as strength training and sports activities) helped protect brain functioning in older adults. The combination of computer use with moderate exercise decreases the risk of memory loss more than either one activity on its own.

6. You’ll be happier and less stressed

Move over, runner’s high! Weight training also has the power to induce pleasure by releasing endorphins, the “feel-good” chemical in your brain. Research shows that resistance training can help beat the blues. One Australian study found that people who did three strength workouts a week (chest presses, lat pull-downs, and biceps curls) reported an 18 percent drop in depression after 10 weeks. In addition, exercise reduces levels of the stress hormone cortisol, relieving feelings of anxiety and agitation.

7. You’ll reduce your risk of diabetes (or improve quality of life if you already have diabetes)

Lifting weights helps improve the way your body processes sugar, which can help prevent diabetes. And if you already have diabetes, research shows that extended periods of strength training improve blood sugar control as well as taking a diabetes drug. In fact, the combination of strength training and aerobic exercise may be even more beneficial than drugs.

8. You’ll improve balance

Ever try to put on one sock while standing on the other leg? Without strength training, this simple act can feel more like a circus trick over time. The reason: fast-twitch muscles fibers we use for strength training deteriorate with age. (Aerobic exercises use mostly slow-twitch fibers.) “The fast-twitch fibers assist in speed and power movements and contract quickly and with sufficient force to catch yourself when you lose your balance,” Rubenstein says. “Resistance training maintains the ability of these fibers to activate.”

Last updated on: Jun 25, 2012

Read more: http://www.livestrong.com/article/557657-8-reasons-why-women-should-lift-weights/#ixzz21T4i7cRJ

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