FYI from the NHLBI Index
January 2004: Vol. 4, Issue 3 In the News
News from Capitol Hill
Recent Advances from the NHLBI
- PAD by Trained Community Volunteers Increases Survival
- Moderate Physical Activity Promotes Weight Loss As Well As Intense
Exercise
- Hostility and Impatience Increase Long-term Risk of Developing Hypertension
Laws
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.
L. 108-173)
In addition to establishing a voluntary prescription drug benefit under the
Medicare program and requiring Medicare to cover a “preventive physical
examination” for beneficiaries, the Act requires the NIH to expand its
support for the evaluation of medical technologies to improve the foundation
for evidence-based practice.
Pediatric Research Equity Act of 2003 (P.L. 108-155)
The Act authorizes the Food and Drug Administration to require research into
pediatric uses for drugs and biological products.
Bills
Hepatitis C Epidemic Control and Prevention Act (H.R. 3539)
Sponsor: Representative Heather Wilson (R-NM)
Latest action: November 19, 2003 - Referred to House Committee
on Energy and Commerce.
Highlights: If passed, the bill would direct the Secretary
of Health and Human Services (HHS), in consultation with the Directors of the
Centers for Disease Control and Prevention (CDC) and the NIH, to develop a plan
to prevent, control, and manage hepatitis C infection. It also would require
the NIH Director to create a Liver Disease Research Advisory Board.
Improved Nutrition and Physical Activity (IMPACT) Act (S.
1172)
Latest action: December 9, 2003 - Passed by the Senate.
Highlights: If signed into law, this version of IMPACT would
establish grants to provide services that would improve nutrition, increase
physical activity, and prevent obesity. Earlier in 2003, Representative Mary
Bono (R-CA) introduced H.R. 716, a slightly different measure that also is called
the IMPACT Act.
National Bone Marrow Donor Registry Reauthorization Act (H.R.
3034)
Latest action: October 2, 2003 - Referred to the Senate Committee
on Health, Education, Labor, and Pensions (HELP) after passage by the House.
National Cord Blood Stem Cell Bank Network (S. 1717)
Sponsor: Senator Orrin G. Hatch (R-UT)
Latest action: October 3, 2003 - Referred to Senate HELP Committee.
Highlights: If passed, the bill would establish a network responsible
for preparing, storing, and distributing human umbilical cord blood stem cells
for patients needing transplants and to support peer-reviewed research using
such cells.
Organ Donation and Recovery Improvement (S. 573)
Latest action: December 8, 2003 - Received in the House after
passage by the Senate.
Protection for Participants in Research Act of 2003 (H.R.
3594)
Sponsor: Representative Diana DeGette (D-CO)
Latest action: November 21, 2003 - Referred to House Committee
on Energy and Commerce.
Highlights: A main provision of the bill is the extension of
protections to all participants in human subjects research, regardless of funding
source.
Stroke Treatment and Ongoing Prevention Act (H.R. 3658 and
S. 1909)
Sponsors: Representative Lois Capps (D-CA) and Senator Thad
Cochran (R-MS)
Latest actions: H.R. 3658 - December 8, 2003 - Referred to
House Committee on Energy and Commerce.
S. 1909 - November 20, 2003 - Referred to the Senate HELP Committee.
Recent Advances from the NHLBI
PAD by Trained Community Volunteers Increases Survival
The number of survivors of sudden cardiac arrest markedly increased when the
victims were helped by community volunteers trained not only to perform CPR
but also to use an automated external defibrillator (AED), a device that shocks
an ineffectively beating heart back into normal rhythm, according to the results
of a large multi-center study funded by the NHLBI in collaboration with the
American Heart Association.
The Public Access Defibrillation (PAD) Trial compared survival of cardiac arrest
victims in areas where community volunteers were trained in CPR only, to areas
where volunteers were trained in both CPR and the use of an AED. The PAD Trial
trained approximately 20,000 volunteer rescuers at 24 sites in the U.S. and
Canada. “Sudden cardiac arrest is a major cause of death of Americans.
This important study shows that lives can be saved by training community volunteers
to use external defibrillators,” said Acting NHLBI Director Barbara Alving,
M.D.
An important next step in research on the use of AEDs, is to test the safety
and effectiveness of home use of these devices. The NHLBI is currently funding
a multi-center 7,000 patient study designed to evaluate whether providing the
devices to families of heart attack patients will improve survival if a cardiac
arrest occurs while the patient is at home.
Moderate Physical Activity Promotes Weight Loss As Well As
Intense Exercise
Women trying to lose weight can benefit as much from a moderate physical activity
as from an intense workout, according to a study supported by the NHLBI. The
“Effect of Exercise Duration and Intensity on Weight Loss in Overweight,
Sedentary Women: A Randomized Trial” involved 201 overweight but otherwise
healthy women ages 21-45.
Participants were provided with meal plans and instructed to limit their food
calories to 1,200 to 1,500 kcal per day. Additionally, participants were randomly
assigned to one of four physical activity regimens, which varied by intensity
and duration. The regimens consisted of either a moderate- or vigorous-intensity
physical activity performed for either a shorter (2 ½ to 3 ½ hours
per week) or longer (3 ½ to 5 hours per week) duration. The physical activity
consisted primarily of brisk walking, and the regimens used about 1,000 or 2,000
kcal per week.
Women in all four groups lost a significant amount of weight–about 13
to 20 pounds–and maintained their weight loss for a year. They also improved
their cardiorespiratory fitness. However, the amount of weight loss or fitness
improvement did not differ among the four physical activity regimens.
Hostility and Impatience Increase Long-term Risk of Developing
Hypertension
Hostility and impatience (two features of the so-called Type A personality)
increased young adults’ long-term risk of developing hypertension (high
blood pressure) based on findings from the NHLBI funded Coronary Artery Risk
Development in Young Adults (CARDIA) study. Although hostility and impatience
increased risk, the other psychological and social factors examined, such as
competitiveness (another Type A feature), depression, and anxiety, did not increase
risk.
These findings will help researchers to identify behavioral characteristics
that require further study. They also highlight the need for people to be able
to recognize, modify, and manage harmful psychosocial behaviors so that they
can thrive in the fast-paced U.S. society without compromising their cardiovascular
health.
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