Replies to post #1961 on Biotech Values

[ello]

Dew

Test to measure risk of heart problems is CRP (C-reactive protein). It measures an inflammatory marker found in blood.

Not given to general population, only those considered at moderate or high risk for cardiovascular disease such as heart attack, stroke, deep vein thrombosis.

Measurements are 1.mg/L. 1.5 to 3 is ok, above 3, indicates high risk of problems.

Test not covered by medicare, $20 to $120 is the variation in different labs.

I so appreciate your wide ranging knowledge of companies, personalities, and medicine generally. Thanks for sharing same.

One of your little ducklings,

lois

[DewDiligence]

Most Heart Attacks Easily Predictable, Study Says

[We’ve been bombarded with so much research suggesting that heart disease is enigmatic that the conclusions of this study are astonishing in their simplicity.]

http://story.news.yahoo.com/news?tmpl=story&cid=594&e=1&u=/nm/20040829/hl_nm/health_hear...

>>
MUNICH August 29 (Reuters) - Virtually the entire risk of heart attack can be predicted and the impact of factors causing attacks is the same whether you live in a rich country or a poor one, a global study released Sunday showed.

Results of the study of more than 29,000 people in 52 countries, released at a meeting of the European Cardiology Society, showed that two factors alone -- an abnormal ratio of bad to good cholesterol and smoking -- were responsible for two-thirds of the global risk of heart attack.

Other risk factors were high blood pressure, diabetes, abdominal obesity, stress, a lack of daily consumption of fruits and vegetables, and lack of daily exercise.

Drinking small amounts of alcohol regularly was found to reduce risk slightly.

"This convincingly shows that 90 percent of the global risk of heart disease is predictable," researcher Salim Yusuf, a professor of medicine at McMaster University in Ontario, Canada, told a news conference.

"This is good news. It means we can do something about it."

The findings contradict current thinking which suggests that only around half of the risk of heart disease is accounted for by known factors.

They also imply that creating awareness of heart-attack risk factors may be easier than earlier thought.

"The impact of risk factors is the same in every ethnic group and every region of the world," Yusuf said, adding that this meant the message of preventing heart disease could be quite simple and fairly uniform across the world.

The study showed that smokers had a threefold risk of heart attack compared to non-smokers. Non-smokers who ate fruits and vegetables regularly, exercised three times a week and drank a little alcohol cut their risk by more than 80 percent.

Over 80 percent of heart disease occurs in low and middle-income countries but data on risk factors in these countries has so far been scanty.
<<

[DewDiligence]

Global High Blood Pressure Rates Set to Soar: Study

[This makes a good companion piece with #msg-2934280.]

http://story.news.yahoo.com/news?tmpl=story&cid=594&e=1&u=/nm/20050114/hl_nm/health_bloo...

>>
By Patricia Reaney

LONDON Jan 13 (Reuters) - A third of the world's adult population -- more than one billion people -- will suffer from high blood pressure by 2025, scientists predicted on Friday.

About a billion people around the globe were afflicted with high blood pressure or hypertension, the most important preventable risk factor for heart disease and stroke, in 2000. But in the next 20 years the number is expected to soar by about 60 percent and three-quarters of cases will be in developing countries.

"By 2025 we project that the number of adults with hypertension will be 1.56 billion," Dr Jiang He, of Tulane University School of Public Health and Tropical Medicine in New Orleans, told Reuters.

Cardiovascular disease is already one of the top killers in most countries and accounts for 30 percent of all deaths worldwide.

In the first study to estimate the total burden of hypertension in the world, the Tulane scientists compiled published research on regional and national figures from 1980 to 2002 to estimate the current worldwide and future prevalence.

In 2000, 333 million adults in developed countries and 639 million in poor nations had hypertension. The report estimates prevalence in developing states -- where it is set to rise by 80 percent -- will account for most of the predicted increase.

BRUNT OF BURDEN IN POOR COUNTRIES

"More than half of hypertension patients are living in developing countries now. By 2025 an even higher proportion will be in economically developing countries," He, an epidemiologist, explained.

"Cardiovascular disease will become the most serious public health challenge in developing countries."

Latin America and the Caribbean had particularly high prevalence of hypertension, according to the research published in The Lancet medical journal.

During recent decades, cases of high blood pressure have remained stable or decreased in wealthy nations, but have risen in poor nation because of lifestyle changes and the fact that people are living longer.

He and his team said developing countries consider infectious diseases as their most important health problem and do not focus prevention efforts on chronic illnesses.

Research has shown that reducing weight, salt and alcohol consumption, eating more fruits and vegetables and increasing exercise can reduce hypertension.

The researchers believe developing countries should follow the example of wealthy nations which have established national programs to prevent and treat high blood pressure.

"Our study gives a serious warning to health policy makers in developing countries and world organizations. They have to pay serious attention to hypertension and hypertension-related chronic diseases such as cardiovascular disease," said He.

"They have to pay attention now."
<<

[DewDiligence]

Studies Point to Drop In Heart Attacks, Cholesterol

[But this good news in the U.S. is in sharp contrast to what is happening worldwide, especially in the third world (#msg-2934280).]

http://online.wsj.com/article/SB112905297283965727.html

>>
Evidence Underlines Value Of Preventive Strategies; Overcoming Obesity, Diabetes

By RON WINSLOW
Staff Reporter of THE WALL STREET JOURNAL
October 12, 2005

In an encouraging sign for the nation's health, there's growing evidence that preventive medical strategies have led to declines in heart attacks and in cholesterol levels among Americans.

One important piece of evidence that preventive strategies are boosting health comes from a large, federally sponsored study. It shows that growing use of cholesterol-lowering drugs called statins and modest changes in diet are contributing to a gradual reduction in harmful cholesterol levels, especially in the older population.

Moreover, a report from Solucient LLC, a health-data company in Evanston, Ill., finds that annual hospital admissions for heart attacks have fallen more than 6% since 2000. Admissions for other conditions related to coronary-artery disease are leveling off or shrinking as well.

"Bit by bit, we are seeing improvement in heart health and heart outcomes relating to a whole host of factors that is neutralizing the increase you might expect to see in the baby-boom era," says Steven Nissen, a cardiologist and researcher at the prominent Ohio heart facility, the Cleveland Clinic.

The two studies -- done separately and with different methodologies -- are far from definitive and not designed to be linked. But many researchers say they offer a reasonable argument that gains are being made against the world's leading killer.

Some experts disagree. James Field, executive director at the Advisory Board Company, a Washington, D.C., health-care consulting company, says numerous medical studies convince him that poor compliance with prescription drugs and lifestyle changes even among high-risk heart patients means hospital admissions for cardiovascular disease will continue to grow over the next decade.

"Doctors know there is a difference between what happens in trials and what happens in clinical practice," he says.

Still, the evidence challenges long-held assumptions that the baby-boom generation, now entering prime heart-attack age, would provide a robust flow of patients into cardiac wards.

Deaths from cardiovascular disease have been declining for several decades, thanks significantly to a decline in smoking. [In the U.S., but not in the world at large.] Researchers have also documented lower average levels of LDL cholesterol in previous studies and a decline in some other risk factors as well. But until now, the impact of preventive strategies on heart attacks themselves hasn't been widely documented.

"We don't have a good surveillance system," says Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital, New York. "It is really hard for us to correlate the improvement in risk factors with what is actually going on with heart disease in the country."

The biggest hurdle to continued progress in the nation's heart health is the growing prevalence of obesity and diabetes. These two burgeoning problems could, if left unchecked, reverse the trend, and increase the number of heart attacks and need for major cardiovascular treatments in the years ahead. The worry, says Dr. Nissen, is that obesity and diabetes will "lead to the defeat of contemporary strategies designed to reduce society's overall risk of heart disease."

Of special concern is younger adults, who because of their age are at less immediate risk of heart problems, but who haven't been as attentive to heart health as their older counterparts.

A report being published today in the Journal of the American Medical Association says levels of LDL cholesterol, the bad one, fell 4.5% in the past decade, to 123 from 129. The study, based on the periodic government-sponsored National Health and Nutrition Examination Surveys, attributes the reduction to a sharp increase in prescriptions for statins and to a slight decrease in consumption of saturated fats. Statin drugs include Pfizer Inc.'s Lipitor, AstraZeneca PLC's Crestor, Bristol-Myers Squibb Corp.'s Pravachol and Merck & Co.'s Zocor.

Though the reduction was modest -- total cholesterol fell just three points, to 203 from 206 -- researchers said in men over 60 and women over 50, the actual reduction in LDL cholesterol was at least 10 points. Generally, a 1% reduction in LDL is associated with a 1% reduction in the risk of a heart attack or other serious cardiovascular event.

Current national guidelines call for patients with average risk to have LDL below 130; for those at high risk the target is below 100, and below 70 for the highest-risk patients. Total cholesterol is based on a combination of LDL, HDL, or good, cholesterol, and other potentially harmful blood fats called triglycerides. But LDL is the main event.

"Some of the risk factors are going down, and that's a very positive development," says James Cleeman, director of the National Cholesterol Education Program and a co-author of the JAMA study. The study's lead author is Margaret D. Carroll, a researcher at the U.S. Centers for Disease Control.

The study, which involved more than 13,000 adults surveyed between 1999 and 2002, found that use of statin drugs nearly tripled to 9.3% of adults age 20 and over, compared with a similar-size survey taken between 1988 and 1994. Among men 60 and over, statin use nearly quadrupled to 24.3% from 6.8%, while it jumped to 21.6%, from 8.7%, in women that age.

Saturated fat as a percentage of total calories dipped slightly in the recent period to 10.8% in men, from 11.3%, and 10.7% in women, from 11.1%. Those results weren't statistically significant but they could have contributed to improvement in LDL cholesterol readings.

At the same time, levels of blood fats called triglycerides rose slightly, possibly reflecting an increasing prevalence of people who are overweight or obese, which was also reflected in the findings.

"People shouldn't think that the message is, 'Leave it to the drugs,' " says Dr. Cleeman. "The way the general public should approach keeping themselves heart healthy is through lifestyle change."

A separate report from Quest Diagnostics, a Lyndhurst, N.J., medical-diagnostic testing company, said an analysis of 80 million laboratory tests found that LDL cholesterol fell about 10% between 2001 and 2004, to an average of 112 among people who were under a doctor's care.

Solucient's report of a decline in heart attacks is based on an analysis of data that include 55% of all hospital discharges, as well as additional data that enable the company to make the analysis current as of the end of 2004.

Kaveh Safavi, chief medical officer at Solucient, says in 2000, based on the aging of the population alone, the number of heart attacks would have been expected to grow 11% between 2000 and 2004, to about 1.1 million. Instead, the admission rate for acute heart attacks declined slightly, but steadily, during each of the years, to 927,600 last year, from 991,199, or a 6.4% drop.

Moreover, admissions for both chest pain, called angina, and unstable chest pain declined by about one-third over the same period. Dr. Safavi said increased use of statin drugs and increased public awareness of the signs and prevention of heart disease could have contributed to the findings.

The results don't prove statins or other interventions led to the decline, but they are consistent with a series of large randomized clinical studies sponsored by leading statin makers, including Merck, Bristol-Myers Squibb and Pfizer. Those studies have linked long-term use of statins to 25% to 30% reductions in risk of heart attacks and other serious events.

"It makes perfect sense," says Christopher Cannon, cardiologist at Brigham and Women's Hospital and Harvard Medical School, Boston. "But it's very encouraging to see it in real life."
<<

[DewDiligence]

Developing World Is New Frontline in Heart Disease

[This makes a good companion piece with #msg-2934280.]

http://news.yahoo.com/s/nm/20060905/hl_nm/heart_developing_dc_2

>>
By Ben Hirschler
5 Sep 2006

Heart disease, usually seen as a quintessentially Western problem, is rapidly becoming a major threat to the developing world, costing millions of lives and billions of dollars, top cardiologists said on Tuesday.

Worsening diets, lack of exercise and smoking mean heart attacks and strokes are taking a mounting toll on poorer countries, experts told the World Congress of Cardiology.

"They now cause four times as many deaths in mothers in most developing countries than do childbirth and HIV/AIDS combined," said Professor Stephen Leeder of the University of Sydney.

"Worldwide, HIV/AIDS causes three million deaths a year -- cardiovascular disease causes 17.5 million."

In some developing countries, the risk of dying from heart disease is actually many times higher than in rich countries. In Brazil, 28 percent of the population die from a heart attack or stroke before the age of 65 -- around three times the average in North America and most of Europe.

The emergence of new economic powerhouses in Asia and Latin America is creating societies in which over-eating and malnutrition go side by side, fuelling health problems at both ends of the wealth spectrum.

In China, the World Health Organization estimates that economic losses due to cardiovascular and other chronic diseases will total $558 billion between 2005 and 2015, while India will lose $236 billion and Russia $303 billion.

Dr Valentin Fuster, president of the World Heart Federation, said the United Nations must take a lead by including heart disease among its health-related Millennium Development Goals.

While the world needed to continue to focus on big infectious killers like AIDS and malaria, the overall approach to healthcare had to be rebalanced, he said.

Many of the measures needed to improve cardiovascular health were simple and low cost, experts argued. Education programs on smoking and diet could be highly effective, while a basic drug like aspirin -- which has been shown to saves lives -- cost only a few cents. Yet many of the world's poor cannot afford even such basic medication.

Dr Salim Yusuf of Canada's McMaster University said cardiovascular disease, which was virtually unknown 100 years ago, was an entirely man-made disease.

Recent research shows more than 90 percent of cases are avoidable and a handful of standard factors are responsible across the globe, such cholesterol, high blood pressure, smoking, poor diet, obesity and lack of exercise.

"We have the treatments for these risk factors, so we should treat them," Yusuf said.

Governments around the world could easily rank the cost-effectiveness of various prevention measures and implement as many as possible within their budget limits, he added.
<<

[DewDiligence]

10% of Chinese Adults Are Diabetic

[I first posted about The Global Demographic Tailwind and its impact on biotech investing almost six years ago (#msg-2934280). As evidenced by today’s article below, the chickens are coming home to roost faster than many of us probably expected.]

http://news.yahoo.com/s/ap/20100324/ap_on_he_me/as_med_china_diabetes_epidemic

›By MARGIE MASON
Wed Mar 24, 5:12 pm ET

After working overtime to catch up to life in the West, China now faces a whole new problem: the world's biggest diabetes epidemic.

One in 10 Chinese adults already have the disease and another 16 percent are on the verge of developing it, according to a new study. The finding nearly equals the U.S. rate of 11 percent and surpasses other Western nations, including Germany and Canada.

The survey results, published Thursday in the New England Journal of Medicine, found much higher rates of diabetes than previous studies, largely due to more rigorous testing measures. With 92 million diabetics, China is now home to the most cases worldwide, overtaking India.

"The change is happening very rapidly both in terms of their economy and in terms of their health effects," said David Whiting, an epidemiologist at the International Diabetes Federation, who was not involved in the study.

"The rate of increase is much faster than we've seen in Europe and in the U.S."

Chronic ailments, such as high blood pressure and heart disease, have been steadily climbing in rapidly developing countries like China, where many people are moving out of farms and into cities where they have more sedentary lifestyles.

Greater wealth has led to sweeping diet changes, including eating heavily salted foods, fatty meats and sugary snacks — boosting obesity rates, a major risk factor for Type 2 diabetes, which accounts for 90 percent to 95 percent of all diabetes cases among adults.

"As people eat more high-calorie and processed foods combined with less exercise, we see an increase of diabetes patients," said Huang Jun, a cardiovascular professor at the Jiangsu People's Hospital in Nanjing, capital of northern China's Jiangsu province, who did not participate in the study.

"Whereas 20 years ago, people took naps during the work week, people are now faced with the stress of making more money to support a family and a buy a house."

Previous studies over three decades have shown a gradual climb in China's diabetes rates. The sharp rise in the latest study, conducted from 2007-2008, is largely explained by more rigorous testing methods, said lead author Dr. Wenying Yang from the China-Japan Friendship Hospital in Beijing.

Earlier nationwide studies relied only on one blood sugar tolerance test, while this survey of nearly 50,000 people caught many more cases by checking levels again two hours later, an approach recommended by the World Health Organization.

More than half of the people with diabetes didn't know they had it, the study found.

The study did have some limitations, sampling more women and city residents — 152 urban districts compared to 112 rural villages. Yang said she was alarmed by the findings, and China's Ministry of Health has been alerted. She said there are plans to promote a national prevention strategy.

"I don't think it's unique to China, but it's certainly a concern that the rates are high," said Colin Bell, a chronic disease expert at WHO's regional office in Manila. "It emphasizes the need for strong prevention and treatment programs."

The Asia-Pacific, the world's most populous region, was highlighted in another study last year estimating that by 2025, it would be home to more than 60 percent of the 380 million diabetes cases globally.

And while the world's giants, China and India, already have the highest number of cases worldwide, the per capita rate is higher in several other countries — up to 30 percent of all people living on the tiny Pacific Island of Nauru have the disease, according to estimates from the International Diabetes Federation.

The Chinese study sampled people from June 2007 to May 2008 across 14 cities and provinces. It revealed that men were slightly more affected and there were more diabetes cases in cities than in the countryside — one in 11 city dwellers were diabetics, compared with one in eight in rural areas. However, the number of people on the verge of developing diabetes was higher in rural areas.

The WHO estimates that diabetes, heart disease and stroke will cost China $558 billion between 2006-2015.‹

[DewDiligence]

Chronic diseases are killing people younger in emerging markets:

http://www.nytimes.com/2014/12/04/world/asia/chronic-diseases-are-killing-more-in-poorer-countries.html

Chronic diseases like cancer and heart disease are rising fast in low- and middle-income countries, striking far younger populations than in rich countries… Deaths from chronic diseases have risen by more than 50 percent in low- and middle-income countries over the past two decades, according to [a] report by the Council on Foreign Relations.

…Working-age people in poorer countries have little access to preventive care and more exposure to health risks, such as air pollution, poor nutrition and lax antismoking laws, than their counterparts in rich countries, and are more likely to develop a chronic disease. In lower-income countries in particular, about 40 percent of the deaths from chronic diseases occur in people younger than 60, compared with 13 percent in rich countries.

If the trend continues unabated, it could have far-reaching consequences…[LOL—no kidding].

I first posted about this subject almost eleven years ago in #msg-2934280.