THURSDAY, May 15 (HealthDay News) -- Stroke patients have a high risk of falling after they leave the hospital, a New Zealand study shows.

The University of Auckland researchers added that prevention programs may help lower that risk.

"People who have had a stroke fall almost twice as often as people who haven't had a stroke. Falls are very common, and risk factors for falls are easy to identify. We need to emphasize fall prevention during stroke services when patients resettle at home," lead author Ngaire Kerse, an associate professor in the department of general practice and primary health care at the School of Population Health, said in a prepared statement.

Kerse and colleagues found that 37 percent of 1,104 stroke survivors reported at least one fall during the first six months after their stroke. Of the 407 who fell, 37 percent suffered an injury that required medical treatment, and 8 percent suffered a fracture.

Among those who fell, about half fell only once, but 12 percent fell more than five times. The study also found that 77 percent of the patients fell at home and of the 93 patients who fell away from home, 42 fell indoors.

"This is much higher than reported previously. The incidence of falls in the study is even higher than for older people in long-term residential care," Kerse said.

Among the other findings:

• Older age, a prior fall, previous stroke, prior dependency before stroke, poor cognitive status and low mood such as depression were associated with either a higher risk of falls or injury after stroke.
• Women were more likely than men to suffer an injury due to falling.
• People who fell in the year prior to stroke were 1.6 times more likely to fall after a stroke.
• Patients with higher levels of functioning were 80 percent less likely to suffer an injury after stroke.
• Patients who were more dependent were twice as likely to fall after a stroke.
• Those who were depressed were almost 1.5 times more likely to fall than those who weren't depressed.

The study was published in the May 16 issue of Stroke.

"Falls are important for all older people. But in people with stroke, falls add to the consequences of stroke. There is an opportunity to offer fall prevention strategies as part of the initial rehabilitation for stroke patients and as part of ongoing rehabilitation in the home," Kerse said.

Fall prevention strategies should include:

• Lower leg strengthening, balance retraining and exercise programs.
• Assessment of fall hazards in the home and improvements such as appropriate lighting, removal of obstacles and installation of hand rails.
• Increased awareness of fall prevention among family members.

More information

The American Heart Association has more about the effects of stroke  .

THURSDAY, May 15 (HealthDay News) -- Weight-loss supplements widely available for purchase online often include ingredients that are potentially hazardous to your heart, and a new study shows the labels often don't include this warning.

One of the hazardous ingredients that was found in the products has been banned on the U.S. market since 2004, according to study author Dr. Alireza Nazeri, an internist and cardiology research fellow at the Texas Heart Institute at St. Luke's Episcopal Hospital, in Houston.

The study was expected to be presented Thursday at the Heart Rhythm Society's annual meeting, in San Francisco.

Nazeri and his colleagues reviewed the ingredients of 12 different brands of weight-loss supplements. They found the brands by entering the common search terms "diet pills" and "weight-loss supplements" into popular Internet search engines, including Google, MSN and Yahoo.

"We were trying to find out if the weight-loss supplements have any ingredients with life-threatening cardiac side effects," Nazeri said.

Next, they made a list of the ingredients on each label. In all, there were 60 different ingredients, for an average of 7.25 ingredients per bottle. Most were herbal extracts, while others were minerals, vitamins and other substances.

Next, the researchers scoured medical databases, including Medline, Pubmed and Natural Medicines Comprehensive Database, to find out if there was any significant association between the ingredients and cardiac problems.

They identified 11 ingredients with at least one report of life-threatening cardiac side effects. Eight of the 12 brands contained a potentially hazardous ingredient.

To their surprise, the researchers found one brand included ma huang, also known as Chinese ephedra, even though the U.S. Food and Drug Administration banned it in 2004.

The other ingredients that may be potentially dangerous to the heart included: bitter orange, Camellia sinensis, green tea, buckwheat, guarana, Korean ginseng, licorice root, Synephrine HCl, caffeine anhydrous and citrus aurantium.

"We are not releasing any names of products," said Nazeri. "That was part of our protocol."

The products chosen may be just the tip of the iceberg, and releasing the names may give people the idea the problem is confined to just those brands, said study senior author Dr. Mehdi Razavi, director of the institute's clinical arrhythmia research lab and a clinical associate professor of medicine at Baylor College of Medicine, in Houston.

The study results make sense to Elisa Odabashian, director of the West Coast office of Consumers Union, publisher of Consumer Reports. "It doesn't surprise me at all," she said.

Especially dangerous, she said, is that people often combine these products with coffee or other caffeine-containing drinks, which affect the heart even more.

Odabashian worked on efforts to get ephedra-containing products banned in California. Her advice for consumers thinking of buying weight-loss products over the Internet? "I think it's a crapshoot. I don't think you should be doing it."

More information

To learn more about how to evaluate a weight-loss product, visit American Dietetic Association  .

THURSDAY, May 15 (HealthDay News) -- Two new surveys suggest that many heart patients with implanted devices aren't aware of recent recalls and don't understand the dangers they might face.

The surveys are small, but they point to a lack of understanding among both doctors and patients about heart disease and the devices used to treat it, said Dr. Bruce Wilkoff, director of cardiac and tachyarrhythmia devices at Cleveland Clinic.

"There are fundamental problems with even the physician's understanding of the situation and an appropriate focus on accurate information," said Wilkoff, who is familiar with the surveys.

Recent recalls of implanted defibrillators have forced some patients to have them removed. The devices deliver jolts to the heart that reset its electrical system when needed.

One of the new surveys found that almost one in five heart patients didn't know about recent recalls of their devices.

The findings, expected to be released at the Heart Rhythm Society's annual meeting, in San Francisco, came in a survey of 61 randomly selected patients at the University of Maryland and the Baltimore VA Medical Center. They were asked about recalls between October 2006 and April 2007.

Eighteen percent didn't know about any pacemaker or defibrillator recall. About half learned about them through the media, and only 24 percent heard through their doctor.

More than half said they'd be very worried if their device was recalled.

"We need to do a little better of a job and find better means of talking to our patients," said survey lead author Dr. Timm-Michael Dickfeld, director of electrophysiology at the Baltimore VA Medical Center. "They seem to like to have the physicians talk to them more, and explain these things more, and not leave it up to the media or the TV to inform them."

A second survey, by doctors at the University of Oklahoma, asked 165 patients with a variety of heart devices whether they'd want them removed if there was a recall or safety advisory.

Just 5 percent said they'd want the device removed immediately if there was a "recall," and 2.5 percent said they'd want it taken out if there was a "safety advisory."

The patients gave a variety of answers when asked what they thought the chances were that they'd experience a device recall, with 31 percent thinking it was one in 100,000.

Dr. Andrea Russo, an electrophysiologist at the University of Pennsylvania, said the results of the Maryland survey suggest that officials should stop using the word "recall" in favor of "safety device."

"The term 'recall' implies that the device will fail dramatically and the failure will be potentially 'life-threatening,' with the term implying that it should be 'taken out,'" she said. The reality, according to her, may be different.

"The types of failures may vary dramatically, and the outcome following 'failure' is also quite variable and not necessarily life-threatening," she said.

More information

Learn more about implanted defibrillators from the American Heart Association  .

WEDNESDAY, May 14 (HealthDay News) -- The path to heart disease begins in childhood, and that means preventive measures must be embraced by those at risk long before adulthood, researchers report.

Two of the biggest threats to heart health that trace back to childhood are prehypertension -- blood pressure just below the official high blood pressure reading of 140/90 -- and obesity.

"The message of the Bogalusa Heart Study is that coronary artery disease, atherosclerosis, hypertension and heart disease all begin in childhood," said study director Dr. Gerald Berenson, a professor of cardiology at the Tulane Center for Cardiovascular Health, in New Orleans.

Berenson was to present the findings Wednesday at the American Society of Hypertension annual meeting, in New Orleans.

The goal of the Bogalusa (Louisiana) Heart Study is to tease out the early natural history of cardiovascular disease. It's the longest and most detailed study of a biracial population of children and young adults in the world.

One aspect of the study was to evaluate the importance and impact of prehypertension, a term Berenson dislikes because "it may give somebody an idea that they don't have a disease and don't need to be treated for it. It should not be looked on as innocuous."

Indeed, people in the study with prehypertension had more risk factors for cardiovascular disease, including obesity, high levels of blood fats such as cholesterol, and diabetes.

A report on a group of 1,379 young adults in the study showed that 27 percent of them had prehypertension, while 13 percent had true high blood pressure. There were significant gender and racial differences, with prehypertension found in 35 percent of the men compared with 22 percent of the women. Black males were more likely to have high blood pressure -- 28 percent -- than while males, 12 percent.

"One of the unique things about this study is that it has a black and a white population," Berenson said. "Blacks tend to have more high blood pressure and diabetes, while whites have more coronary artery disease at an early age."

A second report on 824 young adults in the study (average age 36) concerned potentially dangerous changes in heart structure over time, such as left ventricular hypertrophy, or overgrowth of one heart chamber. "The heart starts to get big, dilated," Berenson said. "It also becomes concentric, and the muscle walls are thick."

Such cardiac abnormalities were more common in adults who had diabetes and high blood pressure in childhood. But the major cause was obesity, Berenson said.

"Obesity in childhood is the only consistent factor predicting cardiac enlargement in adults," he said. "It also predicts adult vascular stiffness." That is a formal medical term for what most people call hardening of the arteries.

"These observations give a compelling reason for pursuing preventive, personalized intervention strategies at an early age in order to evaluate obesity and underlying cardiovascular disease risk factors," Berenson said in a statement.

Dr. Keith Ferdinand, a clinical professor of medicine at Emory University and a board member of the American Society of Hypertension, called the new findings important because they show that "heart disease and hypertension start early in life, in adolescence and even in the pre-teen years."

"In clinical medicine, we focus on patients who have documented heart disease and left ventricular hypertrophy," Ferdinand said. "Based on this new research, which confirms prior findings, in order to decrease the rates of hypertension and heart disease, we should target our young people."

The racial disparities seen in the study "are probably due to early and younger exposure to an adverse lifestyles, including less intake of fruits and vegetables and high intake of salty foods," he said.

More information

Learn more about prehypertension from the U.S. National Heart, Lung, and Blood Institute.