Now that we've said goodbye to Daylight Savings Time for another 6 months, perhaps (according to researchers reporting in the New England Journal of Medicine last year), we'd be better off saying goodbye forever. That's because, they say, there is an association between switching to DST in the spring, and heart attacks.

Do we really need to add Daylight Savings Time to the long list of useful, enjoyable or fattening pleasures of life that we're supposed to give up? Read about it here.

This weekend at the Infectious Diseases Society of America in Philadelphia, researchers from the US Centers for Disease Control and Prevention (CDC) reported that statins (drugs prescribed for reducing cholesterol levels) may be associated with a reduced risk of dying from influenza.

The study was conducted by reviewing data from the CDC's Emerging Infections Program. Among 2800 patients from 10 states admitted to the hospital with confirmed cases of severe influenza in 2007-2008, those who were taking statins had a mortality rate that was half that of patients not taking statins.

This result is consistent with earlier reports suggesting that statins might be beneficial in influenza. The existence of those earlier reports is what stimulated the CDC to do their study in the first place.

Read more here about what we know (and don't know) about the ability of statins to prevent and treat the flu, and other infections.

In an era when "preventive health" is all the rage, and we are all being urged to assess our risk factors for heart disease, developing and marketing new tools for cardiac risk assessment has become a big business. In fact, the U.S. Preventive Services Task Force (USPSTF) notes that more than 100 "emerging" cardiac risk factors are being advanced, by someone or another, as being potentially important.

Accordingly, the USPSTF recently conducted several systematic reviews to evaluate the usefulness of nine of the most commonly promoted "emerging" cardiovascular risk factors. They concluded that there is insufficient evidence to support routinely using any of them. Included in these now-disparaged risk factors are ones you've likely heard of and seen advertised - including C-reactive protein measurement and cardiac calcium scores.

Read here about the nine cardiac risk factors which the USPSTF has found to be less than compelling.

For several years, cardiologists have known that coronary artery disease (CAD) in women can be quite different than it is in men. Women's symptoms may be different, the diagnostic tests that are used for CAD can give the "wrong" answer in women, and the underlying disease itself can be quite different.

It now appears that a new, possibly more significant difference has turned up. You can read all about it here.

Evidence from clinical trials now indicates that in patients with stable angina, medical treatment can be as effective as the more invasive treatments we hear so much about, treatments like bypass surgery, angioplasty and stents.

But what, exactly, is medical therapy for angina? It turns out that treating angina medically is an art that involves the judicious use of several treatment modalities, some of which are well-known to doctors and others less so. You can read all about the medical therapy of angina here.

On Sunday, three apparently healthy and well-trained male runners (ages 26 to 65) collapsed and died while competing in the Detroit Marathon. At this point the precise causes of death have not been released for any of them. Fortunately, a cluster of sudden deaths - even a single sudden death - during a long distance race is an extremely rare event.

There are several cardiac conditions that can produce sudden death in athletes. And unfortunately, because of the physiologic effects of prolonged exercise (for instance, core body temperatures typically reach 105 degrees Fahrenheit during a marathon), it is often difficult to resuscitate victims under these circumstances, even if trained medical personnel are nearby.

Read here about sudden death in athletes , and here about screening for the cardiac conditions that can lead to this tragic event.

Is the H1N1 flu more dangerous in people with heart disease? The answer is the same as it is for "regular" influenza - Yes.

If you have heart disease, you need to take precautions to reduce your chances of getting the H1N1 flu, and if you get sick, you need to know what to do. Read about H1N1 and heart disease here.

A study published in the October 6 online version of Circulation: Cardiovascular Quality and Outcomes says that even an intensive program of counseling and education failed to change a critical behavior in patients with significant coronary artery disease (CAD).

The issue at hand is the effort to reduce "prehospital delays" in patients with CAD who develop heart attacks or other forms of Acute Coronary Syndrome (ACS). The key to the successfully treating ACS is to open the blocked coronary artery immediately - so time is of the essence. Unfortunately, patients tend to wait at home for a long period of time, to see if their symptoms will go away on their own, before calling an ambulance.

On the theory that the delay in calling for help is due to a lack of knowledge on the part of patients with CAD, investigators conducted a randomized trial in over 3000 patients with CAD, to see whether intensive counseling would reduce the prehospital delay. Half of these patients received intensive education and counseling sessions aimed at helping them recognize the symptoms of ACS and understand the importance of getting early help; the other half got usual counseling from their physicians. After an average of 2 years, during which 16% of the enrolled patients had ACS, there was no significant difference in the prehospital delay when ACS occurred - it remained nearly 2 hours and 15 minutes for both groups.

The investigators concluded that the delay displayed by patients with ACS in seeking help is due more to emotional factors than to a lack of knowledge - that is, they spend a couple of hours denying that the symptoms they're experiencing represent anything serious, since the alternative explanation is so unpleasant. And as usual, mere education and counseling were ineffective at changing this particular variety of human nature.

What this study means for you - if you have CAD - is that you should not expect the healthcare system to pay for extensive counseling and education aimed at teaching you when to seek help (since that endeavor has been shown by a randomized study to be ineffective, and therefore paying for it will violate the principles of Evidence-Based Medicine). Rather, learn for yourself the symptoms of ACS, and the importance of getting early help if you have those symptoms, and take it upon yourself not to be an "average" patient with ACS (should the occasion arise), but instead, to get help quickly and become a survivor.

_Sources:

_{Dracup K, McKinley S, Riegel B, et al. A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome. Circ Cardiovasc Qual Outcomes 2009; DOI:10.1161/circoutcomes.109.852608.}

Thyroid disorders - either an underactive or overactive thyroid gland - are common, even in people with heart disease. And especially if you have heart disease, the symptoms produced by thyroid disorders, even if subtle, can be dangerous. Unfortunately doctors often attribute these symptoms to something other than thyroid disease, and sometimes it's up to the patient to lead them in the right direction. Read what you need to know about thyroid disorders and the heart, here.

It appears that the great "low-fat vs. low carb" diet controversy is at last coming to a resolution. So, which of these diets turns out to be better for heart health? As it turns out, neither. Instead, much of the information that has come to light over the last few years points toward a third diet as being best for a healthy heart: the Mediterranean diet. Read all about the Mediterranean diet here.