The Therapeutic Goods Administration (TGA) has granted approval for semaglutide 2.4mg (Wegovy) as an adjunct therapy to reduce major adverse CVD events, including cardiovascular death, non-fatal heart attacks, and non-fatal strokes.

The approval follows findings from the SELECT trial, a global study involving more than 17,000 participants across 41 countries, including Australia.

Results published in late 2023 showed that Wegovy reduced cardiovascular events by 20% in people with pre-existing heart disease who were overweight or obese but did not have diabetes.

Professor Stephen Nicholls, lead of the Australian arm of the SELECT trial and Director of the Victorian Heart Institute at Monash University, emphasises the significance of the approval.

“This approval highlights the critical role of overweight and obesity as major drivers of heart disease — on par with cholesterol, blood pressure, diabetes and smoking,” he says.

“It reinforces that these risks can be actively reduced with targeted therapies.

“The SELECT trial demonstrated that the cardiovascular benefits of semaglutide extend beyond weight loss.

“This drug also positively impacts inflammation, blood lipids and blood pressure, which are all crucial in preventing heart attacks and strokes.

“What this tells us is that if you have heart disease and are overweight or obese, not only are you at a higher risk of another cardiovascular event, but that risk can now be significantly reduced.

“This is a groundbreaking result for patients.”

The post ‘Groundbreaking’: TGA approves weight loss drug for CVD appeared first on Retail Pharmacy.

Gum inflammation leads to periodontitis, which is linked with CVD, and the team used a simple oral rinse to see if levels of white blood cells — an indicator of gum inflammation — in the saliva of healthy adults could be linked to warning signs for CVD. They found that high levels correlated with compromised flow-mediated dilation, an early indicator of poor arterial health.

“Even in young healthy adults, low levels of oral inflammatory load may have an impact on cardiovascular health — one of the leading causes of death in North America,” said Dr Trevor King of Mount Royal University in Calgary, corresponding author of the study published in Frontiers in Oral Health.

Tooth care for heart health 

Periodontitis is a common infection of the gums that has previously been linked to the development of CVD. Studies into the inflammation that precedes periodontitis have found that increased inflammation, reflected by higher levels of white blood cells in saliva, is linked to less healthy arteries and a potentially higher risk of CVD even in young, apparently healthy people. Scientists suspect that inflammatory factors may enter the bloodstream through the gums and damage the vascular system.

Dr King and his colleagues set out to study currently healthy young people without diagnosed periodontal issues to determine whether lower levels of oral inflammation can be clinically relevant to cardiovascular health.

“We’re starting to see more relationships between oral health and risk of cardiovascular disease,” said Ker-Yung Hong, first author of the study, now studying dentistry at the University of Western Ontario. “If we’re seeing that oral health may have an impact on the risk of developing cardiovascular disease even in young healthy individuals, this holistic approach can be implemented earlier on.”

The team chose pulse-wave velocity, which can measure the stiffness of arteries, and flow-mediated dilation, a measure of how well arteries can dilate to allow for increased blood flow, as key indicators of cardiovascular risk. These measure arterial health directly: stiff and poorly functioning arteries raise patients’ risk of CVD.

The scientists recruited 28 non-smokers aged between 18 and 30, with no comorbidities or medications that could affect cardiovascular risk and no reported history of periodontal disease. They were asked to fast for six hours, except for drinking water, before visiting the study lab at McMaster University in Hamilton, Ontario.

At the lab, participants rinsed their mouths with water then with saline, which was collected for analysis. Participants then lay down for 10 minutes for an electrocardiogram and stayed lying down for another 10 minutes so that the scientists could take their blood pressure, flow-mediated dilation, and pulse-wave velocity.

“The mouth rinse test could be used at your annual check-up at the family doctors or the dentist,” said Dr Michael Glogauer of the University of Toronto, a co-author of the study. “It’s easy to implement as an oral inflammation measuring tool in any clinic.”

The heart of the matter 

The scientists found that high white blood cells in saliva had a significant relationship to poor flow-mediated dilation, suggesting these people may be at elevated risk of CVD. However, there was no relationship between white blood cells and pulse wave velocity, so longer-term impacts on the health of the arteries had not yet taken place.

The scientists hypothesised that inflammation from the mouth, leaking into the vascular system, impacts the ability of arteries to produce the nitric oxide that allows them to respond to changes in blood flow. Higher levels of white blood cells could have a greater impact on vascular dysfunction; the levels found in the participants are usually not considered clinically significant.

“Optimal oral hygiene is always recommended in addition to regular visits to the dentist, especially in light of this evidence,” Dr King said. “But this study was a pilot study. We’re hoping to increase the study population and explore those results. We’re also hoping to include more individuals with gingivitis and more advanced periodontitis to understand the impact of different levels of gingival inflammation more deeply on cardiovascular measures.”

The post Simple mouth rinse could spot early CVD risk appeared first on Retail Pharmacy.

The Heart Health Check (HHC) Recall pilot study was rolled out in more than 200 GP clinics across the country, where about 42,000 at-risk Australian patients received an invitation from their GP to come in for a HHC via SMS, which led to a 14-fold increase in HHCs compared to control practices.

Results were recently published in the Australian Journal of General Practice.

The pilot is the largest targeted cardiovascular disease (CVD) screening trial of its kind in Australian general practice, potentially paving the way for a structured Australian CVD screening program in the future.

“This is the most robust Australian evidence that shows a targeted CVD screening program could be both effective and feasible in general practice,” says Heart Foundation Healthcare Programs Manager Natalie Raffoul.

“Just like Australia has dedicated screening programs for many cancers, we need to consider one of Australia’s leading causes of death, heart disease.”

Avoiding potentially life-threatening events

New South Wales GP Dr Raya Grishina-Gunn says the pilot program allowed her to treat patients at high risk of having a heart attack or CVD event, unbeknown to them.

“Thanks to the HHC Recall pilot program, I identified several high-risk patients after conducting their Heart Health Checks,” says Dr Raya.

“Based on their results, some patients were then referred to cardiologists for further investigation and procedures.”

While patients avoided potentially life-threatening events, the pilot program also afforded the clinic the opportunity to discuss and highlight the importance of a healthy heart.

“Thanks to the pilot program, it was found that some patients needed stents to rectify blocked arteries, some patients who were found to be at high risk of having a heart attack or stroke in the next five years were prescribed medication, while I worked with others to help them make lifestyle changes to lower their risk and keep on top of their heart health,” says Dr Raya.

After the personalised messages were sent to those patients who met the program’s criteria, Dr Raya’s clinic was surprised by the number of booking requests that came through.

“Our patients were really excited to be recalled in for a HHC, and our phone lines were very busy with people wanting to book a check after the messages went out,” she says.

Early detection key

Being at high risk of heart disease can be almost completely symptomless until it’s too late.

Quite often, the first sign of heart disease is a heart attack.

“International CVD and chronic disease screening programs have been rolled out in the UK and New Zealand, helping to boost early detection of CVD and help people better manage their risk factors,” says Ms Raffoul.

“The time has come for Australia to reap the health and economic benefits of developing its own CVD screening program.”

The post Targeted cardiovascular screening program effective appeared first on Retail Pharmacy.

Pulling together 20 previous clinical trials the researchers found benefits from switching to a vegetarian diet for 6 months. However, the study authors say more high-quality trials will help clarify the effects of healthy plant-based diets in people with cardiovascular disease.

The results of this study suggest that consuming a vegetarian diet may modestly but significantly improve cardiometabolic outcomes beyond standard pharmacological therapy in individuals at high risk of cardiovascular diseases (CVDs), highlighting the potential protective and synergistic effects of vegetarian diets for the primary prevention of CVD.

For more information, visit: jamanetwork.com/journals/jamanetworkopen/fullarticle/2807597

The post A plant-based diet could help CVD risk appeared first on Retail Pharmacy.

In fact, cardiologists at the Victor Chang Cardiac Research Centre want more people aware of what’s referred to as metabolic syndrome, or syndrome X, which includes a cluster of conditions that increase cardiovascular disease risk.

Syndrome X (which is also known as insulin-resistance syndrome) is said to affect approximately 30% of Australians and is known to increase the risk of heart disease, stroke, and type 2 diabetes.

So, how is Syndrome X diagnosed?

The syndrome can be diagnosed if 3 any of the following risk factors are met:

• Large waist circumference (equal to or greater than 80 cm for women and 94 cm for men – though this varies for certain ethnic groups);
• High blood pressure (equal to or greater than 130 systolic or 85 diastolic);
• Reduced levels of HDL ‘good’ cholesterol (lower than 1.0 mmol/L in men and 1.3 mmol/L in women);
• High levels of blood triglycerides (equal to or greater than 1.7 mmol/L);
• High fasting blood sugar (greater than 5.5 mmol/L).

“As a cardiologist, I’ve lost count of the number of patients I have seen and treated with cardiovascular issues like heart attack that have arisen as a direct result of metabolic syndrome – it is such a pervasive and growing issue in our society,” says Cardiologist and Victor Chang Cardiac Research Institute’s Executive Director Professor Jason Kovacic.

“Most of us have heard about how carrying extra weight, particularly around the abdomen, can affect our health, but people are still largely unaware of metabolic syndrome and how damaging it can be for our hearts and blood vessels.

“With more than half of Australians already having at least one of the risk factors for metabolic syndrome, people need to be made aware of the steps they can take to avoid it.

“Unfortunately, once you have one of these risk factors, you’re more likely to develop the other risk factors. So, it can be a bit of a snowball effect,” says Professor Kovacic.

Positive lifestyle changes can help to both prevent and treat metabolic syndrome.

“We know this syndrome is largely caused by poor diet, sedentary lifestyle, smoking and the like,” says Professor Kovacic.

“This is good news because it means we also know how to reduce the risk of metabolic syndrome – this includes making healthy changes to the way we eat and the amount of physical activity we do.”

Tips to lessen your risk

Professor Kovacic advises Australians to focus on making simple lifestyle changes including:

• Maintaining a healthy diet by reducing portions, and eating more vegetables, healthy unsaturated fats from foods like olive oils, fish, and nuts, and fibre from whole grains and other plant foods.
• Upping your exercise to 30 minutes or more of moderate activity per day, five or more days per week.
• Quitting smoking.
• Reducing your alcohol intake to no more than seven standard drinks a week – though the lower the better.

“We know that changing our behaviour isn’t always easy, but whether it’s taking the kids for a bike ride on the weekend or finding ways to add more plant foods to your favourite recipes, every little bit helps reduce the risk of heart issues in the future,” says Professor Kovacic.

Undergoing regular Heart Health Checks to keep an eye on your cholesterol, triglycerides, blood pressure, and blood sugar levels are also recommended.

The post Pay attention to your waist line appeared first on Retail Pharmacy.

This is the largest trial of its kind and warrants further evaluation, especially in people taking statins or other CVD medications.

As part of the clinical trial, researchers set out to investigate whether supplementing older adults with monthly doses of vitamin D alters the rate of major cardiovascular events.

The trial was carried out from 2014-2020 and included 21,315 Australians aged 60-84 who randomly received one capsule of either 60,000 IU vitamin D (10,662 participants) or a placebo (10,653 participants) taken orally at the beginning of each month for up to 5 years.

Participants with a history of high calcium levels (hypercalcemia), overactive thyroid (hyperparathyroidism), kidney stones, soft bones (osteomalacia), sarcoidosis (an inflammatory disease) or those already taking more than 500 IU/day vitamin D were excluded from the trial.

Data on hospital admissions and deaths were used to identify major cardiovascular events, including heart attacks, strokes, and coronary revascularisation (treatment to restore normal blood flow to the heart).

The average treatment duration was 5 years and more than 80% of participants reported taking at least 80% of the study tablets.

During the trial, 1336 participants experienced a major cardiovascular event (6.6% in the placebo group and 6% in the vitamin D group).

The rate of major cardiovascular events was 9% lower in the vitamin D compared with the placebo group (equivalent to 5.8 fewer events per 1000 participants).

The rate of heart attack was 19% lower and the rate of coronary revascularisation was 11% lower in the vitamin D group, but there was no difference in the rate of stroke between the two groups.

There was some indication of a stronger effect in those who were using statins or other cardiovascular drugs at the start of the trial, but the researchers say these results were not statistically significant.

The researchers acknowledge that there may be a small underestimate of events and say the findings may not apply to other populations, particularly those where a higher proportion of people are vitamin D deficient.

However, this was a large trial with extremely high retention and adherence, and almost complete data on cardiovascular events and mortality outcomes.

As such, they say their findings suggest that vitamin D supplementation may reduce the risk of major cardiovascular events.

“This protective effect could be more marked in those taking statins or other cardiovascular drugs at baseline,” they add, and they suggest further evaluation is needed to help to clarify this issue.

“In the meantime, these findings suggest that conclusions that vitamin D supplementation does not alter the risk of cardiovascular disease are premature,” say the researchers.

The post Vitamin D supplements may reduce risk of cardiovascular events appeared first on Retail Pharmacy.

Cardiovascular disease (CVD) is one of the leading chronic health conditions in Australia, responsible for the hospitalisation of more than 600,000 people each year.

To help Australians better understand the importance of knowing what a healthy blood pressure reading continues to be a focus on World Hypertension Day (17 May).

High blood pressure is a common condition that affects an estimated 1.28 billion adults aged 30 – 79 worldwide. However, an estimated 46 per cent of adults are unaware they suffer from the condition and only one in five adults with hypertension have their blood pressure controlled.

The year’s theme for World Hypertension Day is ‘Measure Your Blood Pressure Accurately, Control It and Live Longer’, with a focus on combatting low awareness rates, particularly in low to middle-income areas, and greater education on accurate blood pressure measurement methods.

Leading community pharmacy network, Blooms The Chemist, is actively supporting patients in their communities, ensuring people understand the importance of blood pressure monitoring and control, and is encouraging them to visit their local pharmacy for a blood pressure test.

“This World Hypertension Day we’re raising awareness on the importance of keeping blood pressure in check and explaining how you can actively control and manage it,” says Blooms The Chemist Pharmacist-owner Andria Aird.
“As hypertension may cause no symptoms or symptoms like headaches, dizziness and fatigue, which can often be dismissed as something less sinister, we’re encouraging people in our communities to spare five to ten minutes in their day to pop in for a blood pressure evaluation,” she says.
“It’s a simple test conducted by the Pharmacist or a qualified nurse and takes minutes to complete.”

Importantly, Ms Aird is passionate about addressing misconceptions that high blood pressure rarely affects women, who represent nearly half of all adults suffering high blood pressure.

“Unfortunately, many of the common symptoms experienced by women who may have hypertension are dismissed as something less concerning, such as assuming it’s a side effect of hormonal imbalances during pregnancy, menopause and post-menopause,” she says.

“Left untreated, high blood pressure can lead to a range of serious health complications such as heart disease, stroke, kidney disease, eye damage and pregnancy complications.

“Whilst there are several prevention and management tools to support a healthier blood pressure, we do encourage adults of all ages to pop into their local Blooms The Chemist for advice and, if they have concerns, get a reading. It could in some cases help prevent health issues later,” explains Ms Aird.

“Unfortunately, people are often unaware of what a normal blood pressure reading is, which in most adults should be between 120/80 and 140/90 mmHg. If a reading is out of this range, we can provide timely advice on changes in lifestyle habits and discuss current medication that may be causing high blood pressure. However, if we have concerns, we will recommend to a patient that they visit their GP.”

Blooms The Chemist offers free blood pressure evaluation tests as a core health service in across their network of pharmacies.

[i] https://www.healthdirect.gov.au/high-blood-pressure-hypertension#:~:text=High%20blood%20pressure%20is%20also,18%20has%20high%20blood%20pressure

Text by: Blooms The Chemist

The post The unknown pressure affecting 1.28 billion people worldwide appeared first on Retail Pharmacy.

Published in the prestigious journal Circulation Research, the study investigated the movement of neutrophils, a type of white blood cell that is an essential part of the immune system.

Neutrophils, the first responders when there’s an injury or infection, move from blood vessels to the site of injury and initiate inflammation and healing. However, prolonged retention of neutrophils, such as at the site of vascular injury, can result in chronic inflammation and a build-up of atherosclerotic plaques that can lead to strokes and heart attacks.

Dr Joyce Chiu, the lead author of the study from the ACRF Centenary Cancer Research Centre, said that the team had uncovered the method by which neutrophils unstick from blood vessels as they move towards the site of injury. This mechanism, she said, could be potentially harnessed to reduce chronic inflammation by preventing the movement of neutrophils to certain areas of the body.

“Molecules known as integrins help neutrophils stick to the walls of blood vessels to prevent the cells from being carried away by blood flow. To move to the site of injury, neutrophils must stick and unstick from blood vessel walls. While we knew how integrins helped neutrophils stick, we did not know how they unstick,” said Dr Chiu.

According to Dr Chiu, the study discovered that a molecule called protein disulfide isomerase (PDI), secreted by neutrophils, plays a crucial role in helping the cells unstick from blood vessels as they move towards the site of injury.

Dr Chiu believes that this finding suggests that PDI could be a target for new drugs to treat chronic inflammation in diseases, including cardiovascular diseases.

“New drugs can be designed to inhibit PDI, to keep neutrophils from ‘unsticking’ and migrating from blood vessel walls. Preventing neutrophils from moving around can help prevent chronic inflammation by reducing their ability to accumulate at sites of injury or infection,” Dr Chiu said.

“Our research could pave the way for new treatments and management strategies that are able to limit the extent of inflammation and potentially improve outcomes for individuals with chronic inflammatory and cardiovascular conditions.”

Text: Centenary Institute. 

The post Key mechanism identified for reducing chronic inflammation in CVD appeared first on Retail Pharmacy.

Reducing added salt, that is skipping the salt shaker at mealtimes, is associated with a reduced risk of heart disease, heart failure and ischaemic heart disease, according to the study.

This relates even to those who are already following a DASH-style diet – behavioural interventions to lessen salt consumption could further improve heart health.

“Overall, we found that people who don’t shake on a little additional salt to their foods very often had a much lower risk of heart disease events, regardless of lifestyle factors and pre-existing disease,” says Lu Qi, MD, PhD, HCA Regents Distinguished Chair and professor at the School of Public Health and Tropical Medicine at Tulane University in New Orleans.

“We also found that when patients combine a DASH diet with a low frequency of adding salt, they had the lowest heart disease risk. This is meaningful as reducing additional salt to food, not removing salt entirely, is an incredibly modifiable risk factor that we can hopefully encourage our patients to make without much sacrifice.”

In this study, the authors evaluated whether the frequency of adding salt to foods was linked with incident heart disease risk in 176,570 participants from the UK Biobank.

The study also examined the association between the frequency of adding salt to foods and the DASH diet as it relates to heart disease risk.

The DASH-style diet was developed to prevent hypertension by limiting the consumption of red and processed meats and focusing on vegetables, fruit, whole grains, low-fat dairy, nuts, and legumes.

While the DASH diet has yielded benefits in relation to reducing cardiovascular disease risk, a recent clinical trial found that combining the DASH diet with sodium (salt) reduction was more beneficial for certain cardiac biomarkers, including cardiac injury, strain, and inflammation.

According to Sara Ghoneim, MD, a gastroenterology fellow at the University of Nebraska Medical Center, this study is promising, builds on previous reports, and alludes to the potential impact of long-term salt preferences on total cardiovascular risk.

“A major limitation of the study is the self-reported frequency of adding salt to foods and the enrollment of participants only from the UK, limiting generalisability to other populations with different eating behaviours,” said Dr Ghoneim.

“The findings of the present study are encouraging and are poised to expand our understanding of salt-related behavioural interventions on cardiovascular health.”

The post Do your heart a favour and skip the salt shaker appeared first on Retail Pharmacy.

Heart failure is said to affect one in 50 Australians, and is becoming increasingly common. 

The condition is said to claim the lives of 61,000 lives annually, and it’s the number one cause of hospitalisation in people over age 65.

“Unfortunately, dangerously low levels of awareness about heart failure are leaving Australians vulnerable,” said hearts4heart CEO Tanya Hall, who lost her father to heart failure when he was just 59.

“To help patients affected by heart failure to feel better and live longer healthier lives, GPs need to recognise heart failure symptoms and know the appropriate clinical pathway for diagnosis,” Ms Hall said.

Cardiologist A/Prof John Amerena said: “Delayed diagnosis and upward trends in Australian heart failure admissions are reasons for concern.

“When left untreated, heart failure progressively worsens, but with early diagnosis, treatment and lifestyle changes, a person with heart failure can reduce their risk of hospitalisation and improve their quality of life.”

To assist with the early identification of heart failure symptoms and provide guidance on the appropriate clinical pathway for diagnosis, hearts4heart’s Medical Advisory Committee has developed a new tool based on the Australian consensus of the recent European Society of Cardiologists (ESC) heart failure guidelines.

Recognising Heart Failure can be used to guide health professionals in their response to patients presenting with heart failure symptoms.

“As healthcare providers, we play a critical role in encouraging people aged 65 and older to be aware of symptoms and get their hearts checked regularly.

“Be heart smart. Have regular conversations about heart health with your patients, talk about possible symptoms, and be sure you understand the appropriate diagnostic pathway,” A/Prof Amarena said.

Heart failure symptoms

• Shortness of breath during minimal exercise or exertion.
• Need to use extra pillows when lying down to breathe easier.
• Irregular heartbeat or palpitations.
• Swelling of legs, feet, or stomach.
• Coughing/wheezing.
• Weight gain over a short period of time (e.g., >2kg over 2 days).
• Extreme tiredness, low energy, or no energy.
• Loss of appetite.

For more information, visit: hearts4heart.org.au/event/heart-failure-awareness-week/

The post Heart failure trends a cause for concern appeared first on Retail Pharmacy.