Cardiovascular Disease

While no preventive measure can eliminate the chances of developing heart disease, the U.S. government has issued guidelines in an effort to aggressively treat and prevent heart disease in millions of Americans. In addition to more emphasis on low-fat diets and exercise, the guidelines call an estimated 36 million to take cholesterol-lowering drugs.

The guidelines include:

• Treating patients with at least a 20% risk of having a heart attack in 10 years as aggressively as those who already have heart disease.
• Treating high cholesterol more aggressively in people with diabetes.
• Using a lipoprotein profile as the first test for high cholesterol.
• Modifying the current HDL ("good") cholesterol level guideline to 40 mg/dL.
• Emphasizing the need for nutrition, exercise, and weight control in treating high cholesterol.
• Identifying people with "metabolic syndrome" and treating them aggressively to prevent heart attacks (a condition characterized by abdominal obesity, high triglycerides, high blood pressure, high blood-sugar levels, and low HDL ("good") cholesterol)
• Treating people with high triglyceride levels more aggressively.
• Advising to take cholesterol-lowering drugs to lower cholesterol instead of hormone replacement therapy (the American Heart Association recently endorsed this recommendation too).

Heart Disease in world

More than two of every five Americans die from some form of cardiovascular disease. Statistics show coronary artery disease to be the leading cause of death among both men and women in the United States and Europe. However, deaths from coronary artery disease and other heart diseases continue to decline, due to improved treatment options and advances in drug therapies that lower cholesterol, high blood pressure, and so forth. This section discusses prevention, diagnosis, treatment, and rehabilitation for several different heart diseases.
Heart Disease in Women.

An American Heart Association survey taken several years revealed that women tend to underestimate their risk of heart disease and mistakenly believe that they are are greater risk of dying from other disease, such as breast cancer (click here to read about the survey). However, it is important to note coronary artery disease is the number one cause of death in the United States among both men and women.

Over 500,000 (one-half million) American women die of cardiovascular disease each year. This is twice the number of deaths from all cancer combined; lung cancer, the leading cause of cancer deaths, claims approximately 65,000 deaths per year, and breast cancer kills around 40,000 women. Other statistics from the American Heart Association:

• One in five women have some form of heart or blood vessel disease.
• 38% of women who have heart attacks die within the first year compared to 25% of men.
• 35% of women have a second heart attack within six years of the first attack compared to 18% of men.
• Over 60,000 women die of stroke each year; approximately 60% of stroke deaths occur in women.

Men have a greater risk of heart attack than women and are more likely to have heart attacks earlier in life than women. However, women are also at risk for heart disease. As a woman ages, her risk of heart disease increases: 9,000 American women under age 45 have heart attacks each year versus 250,000 women over age 65. Medical experts are unsure why the risk of heart disease increases in older women but some believe it may be related to the depletion of the female hormone estrogen at menopause.

As men age and their arteries become blocked, the body develops new arteries to serve as back-up blood routes; these back-up routes are called collateral blood supplies. However, women do not develop these collateral blood supplies as they age since, with estrogen, their blood vessels can expand to accommodate blockage. Thus, the thought is that when a woman's estrogen production decreases significantly at menopause, her arteries tend to lose their flexibility and her risk of heart disease increases significantly since no collateral blood supply is developed. This may also explain why more women are likely to die within a year of a heart attack than men.

Many of the risk factors for heart disease are the same for women and men. These risk factors include: high blood pressure, high cholesterol, diabetes, high fat diet, excessive weight, lack of physical activity, smoking, and a family history of heart disease. However, other risk factors for women include menopause (specifically, loss of estrogen at this time) and the use of oral contraceptives among smokers or those with high blood pressure.

Breast Cancer Cases/Deaths (U.S. and World)

Breast cancer is the second leading cause of cancer deaths in women today (after lung cancer) and is the most common cancer among women, excluding nonmelanoma skin cancers. According to the American Cancer Society, about 1.3 million women will be diagnosed with breast cancer annualluy worldwide about 465,000 will die from the disease. Breast cancer death rates have been dropping steadily since 1990, according to the Society, because of earlier detection and better treatments. About 40,910 breast cancer deaths are expected in 2007.

According to the American Cancer Society, in general, breast cancer rates have risen about 30% in the past 25 years in western countries, due in part to increased screening which detects the cancer in earlier stages. In the United States, though, breast cancer rates decreased by 10% between 2000-2004, due in part to a reduction in the use of hormone replacement therapy. Although breast cancer rates are rising in many western countries, deaths from the disease have decreased in some countries as a result of improved screening and treatment.

The lifetime probability of developing breast cancer in developed countries is about 4.8%, according to the American Cancer Society (the probability is about 13% for any type of cancer). In developing countries, the lifetime probability of developing breast cancer is about 1.8%.

Breast Cancer Worldwide
Breast (All ages)	Incidence	Deaths
China Zimbabwe India Japan Brazil Singapore Italy Switzerland Australia Canada Netherlands UK Sweden Denmark France United States	18.7 19 19.1 32.7 46 48.7 74.4 81.7 83.2 84.3 86.7 87.2 87.8 88.7 91.9 101.1	5.5 14.1 10.4 8.3 14.1 15.8 18.9 19.8 18.4 21.1 27.5 24.3 17.3 27.8 21.5 19

Swine flue in world .

• Hong Kong The first case of swine flu in Asia was confirmed by the Hong Kong government today as the virus continued to spread around the globe. The government's chief executive, Donald Tsang, said a Mexican citizen, who flew into the territory on Thursday, had been isolated in hospital after developing a fever. Police officers wearing masks and gloves guarded the hotel where he had been staying. It will be quarantined for a week and all the guests are being treated with the antiviral drug Tamiflu.

• Germany Germany's centre for disease control confirmed the first case of human-to-human transmission of the H1N1 virus. A 42-year-old Bavarian nurse was infected after coming into contact with one of the three people who have swine flu in Germany. The health ministry said she had made a full recovery. Authorities in Landshut, north of Munich, said the nurse was infected while working with a 37-year-old man who had recently travelled to Mexico.

• Egypt The government's decision to order the slaughter of all pigs in response to the threat of swine flu was condemned by international health experts. The UN Food and Agriculture Organisation's chief veterinary officer, Joseph Domenech, described the cull of 300,000-400,000 pigs as "a real mistake". There has not been a single suspected case of the H1N1 virus in Egypt.

• New Zealand Catholic and Maori leaders issued advice as a fourth person in the country was confirmed as having swine flu. The Roman Catholic church told priests not to place communion wafers on worshippers' tongues or to allow them to share communion wine from a single chalice during mass because it could spread germs. Maori politician Rahui Katene urged a temporary halt to the hongi, a traditional greeting where two people press their noses and foreheads together and exchange breath, the New Zealand Herald reported.

Swine flue situation.

Recommendations for travellers.

Please note: These recommendations also apply to all business travellers and travellers attending special events such as conferences and large-scale gatherings such as concerts.

1. Wash your hands frequently
   1. By washing your hands with soap under warm running water, you will reduce your chance of getting the flu.
   2. Alcohol-based hand gel can also be used if soap and water are not readily available. It's a good idea to keep some with you in your pocket or purse when you travel.
2. Practice proper cough and sneeze etiquette
   1. Cover your mouth and/or nose to reduce the spread of germs. Remember to wash your hands afterwards.
3. Try to avoid close contact with people who appear to have a respiratory illness.
4. Monitor this website and World Health Organization website frequently for updates on the situation and recommendations.
5. If you are travelling to a country where it is flu season (southern hemisphere), get your flu shot.
6. If you are at risk of severe illness from influenza (for example, persons with chronic conditions such as diabetes, lung disease, heart disease, elderly or children under 2 years of age), see your health care provider before you travel.
7. Travellers returning to Canada from countries where the H1N1 flu virus (human swine flu) is occurring and who develop symptoms of H1N1 flu virus (human swine flu), especially high fever, are advised to seek medical attention immediately.

Associated Conditions

• A rash is a common HIV symptom. A rash can also be related to medications. Here are some quick tips on how this HIV symptoms - an HIV rash.

• Diarrhea can be a life threatening problem if not treated correctly and rapidly. It's one of the most annoying HIV symptoms. Here are some diarrhea cures that can help.

• Gonorrhea is one of several sexually transmitted infections. Almost a million new cases appear in the US each year. Here is some important information about the sexually transmitted disease gonorrhea.

• Syphilis is the most deadly sexually transmitted disease apart from AIDS. Also known as a sexually transmitted infection, syphilis cases are on the rise. Here are some facts about syphilis.

• Chlamydia is the most common sexually transmitted disease in the world. This is a brief synopsis of facts about Chlamydia.
• Depression is a common problem in HIV and AIDS. Here are a few quick tips to be aware of.
  

• Dry mouth is a symptom that can be mild and uncomfortable or it can be a sign of a serious problem like dehydration. Dry mouth can be related to certain types of medications or can be the result of vomiting and diarrhea. Here are some quick tips on how to ease dry mouth.

• Nausea not only makes you feel uncomfortable and sick, it can be dangerous when associated with vomiting. What can you do to relieve your nausea and vomiting?
  

• Sexually transmitted diseases (STDs or STIs) complicate the treatment of an already complicated illness. STDs can increase your risk of HIV and can even be fatal if not treated.

• Weight loss is a common problem in HIV and AIDS. Here are some quick tips on how to handle weight loss and AIDS Wasting.

• Peripheral neuropathy is a condition resulting from damage to the nerves of the hands and feet. HIV Medication side effects are often responsible for these HIV symptoms.

• Fatigue is a common problem in those living with HIV and AIDS. What are some solutions for fatigue? Are there any treatments for fatigue?
• This parasitic infection can lead to vaginitis and vaginal discharge in women. Usually, however, there are no symptoms.
• Fever is the body's normal reaction to infection. Here are some quick tips on dealing with a fever.

HIV Spreading in NYC

A study released this week finds that the virus that causes AIDS is spreading in New York City at three times the rate in the United States. Health officials say New York has long been the epicenter of the U.S. AIDS epidemic because the city is home to sizable populations considered most at-risk for contracting the virus.

New York City's Department of Health and Human Hygiene said the report is the "most precise estimate yet" of annual infections of the HIV virus in New York City.

The report says in 2006, nearly 4,800 New Yorkers contracted HIV, the virus that causes AIDS. This means there were 72 new infections per 100,000 people. That number is three times higher than the national rate, in which the incidence of new infection is 23 per 100,000 people. Overall, an estimated 100,000 New Yorkers are known to be HIV positive.

Dr. Monica Sweeney, the Health Departments Assistant Commissioner for HIV Prevention and Control, said New York City has long been considered the epicenter of the U.S. epidemic.

"The incidence is higher because the groups that are most impacted are highly represented in New York City: Men who have sex with men, immigrants from certain parts of the world," she said. "They are highly represented here and for that reason we have three times the incidence of the rest of the United States."

The findings in the report are based on a new diagnostic formula created by the Centers for Disease Control and Prevention that determines when people became positive within 180 days of contraction.

City officials stress that because the tool is new, it is not yet possible to determine whether infections in the city have increased or decreased from previous years.

The report found that men who have sex with other men was the group most at risk in 2006, accounting for more than three quarters of new infections. Other high risk groups include intravenous drug users and sex workers.

Dr. Sweeney said city officials and partner programs are devising new methods to try and focus prevention and screening at high-risk populations.

"We are doing additional things to make sure we are reaching the target populations," she said. "One of our new prevention efforts is social network testing, where we take people who are highly impacted - sex workers, men who have sex with men, gay men and Hispanics, and ask people to bring their friends in to be tested. That serves two functions. One is to get people into treatment if they're positive, and the other is to interrupt the epidemic through knowing their status [so they] are not giving it out inadvertently to other people."

Sweeney said New York health officials want to make HIV screening a routine part of care. A pilot program in the Bronx offers free testing and encourages all people to get screened.