Monday's highlights from the Canadian Cardiovascular Congress: The latest in heart health research discoveries and innovations

VANCOUVER, Oct 23, 2017 /CNW/ - More than 2,500 heart health experts from across Canada and around the globe meet again in Vancouver today for the Canadian Cardiovascular Congress. Experts at all stages of their careers collaborate, share new ideas, and present the latest research discoveries. Participants will return to their practices and laboratories with new tools and knowledge that will have a direct impact on the health of Canadians.

MONDAY, OCTOBER 23 CONFERENCE HIGHLIGHTS

Hot in the kitchen and cold in the gym: Realistic advice for heart patients
It can be daunting for heart disease patients and those at risk of heart disease to make the first steps towards a healthier life style. This is especially true for patients for whom "working out" isn't a safe option – or others who don't have even basic cooking skills. When is exercise good? When is it risky? With all that conflicting diet advice out there, what should heart patients eat?

Dr. Andrew Pipe believes we've over-medicalized physical activity and over-complicated healthy eating. When he speaks to his heart patients, he renormalizes physical activity by putting the fun back into fitness: "You don't need expensive running shoes or a gym membership. I tell my patients to walk their dog daily − even if they don't have one − and to follow their two most important doctors: Left Foot and Right Foot." And forget complicated diets, "Eat real foods."

In this Heart & Stroke plenary session Dr. Pipe, from the division of Prevention and Rehabilitation at the University of Ottawa Heart Institute, shares the stage with experts to give more than 2,000 healthcare experts in the audience some realistic, pragmatic healthy living advice they can bring home to their patients. Guests include:

• Diane Clement: Former Olympian, chef, author of eight best-selling Chef on the Run cookbooks, and co-founder with Dr. Doug Clement of the Vancouver Sun Run, Harry Jerome Track Classic – Sharing easy, fast healthy recipes to take the guess work out of healthy eating
• Amanda Nash: Heart & Stroke health promotion and nutrition manager and registered dietitian – Dispelling nutrition myths & sharing healthy eating tips
• Krishnan Ramanathan: Cardiologist, medical director of the cardiac intensive care unit at St. Paul's Hospital – Motivating patients to exercise
• Kasia Nastalska: Clinical exercise physiologist – Breaking down the barriers to physical activity

Competitive endurance event training for cardiac patients: Is it safe? Physical activity is important to protect heart health, and is one of the most important things that heart patients can do for their recovery. Many patients have concerns about stressing their hearts with increased physical activity. How much activity is healthy and safe? Here's some good news for some runners living with heart disease: Training for a competitive endurance race as part of cardiac rehabilitation can be safe for eligible patients, according to a new study. Endurance exercise training is a core component of cardiac rehabilitation for people diagnosed with heart disease but few studies have demonstrated the safety and efficacy of training for a competitive endurance event for these patients. For this study, the cardiac rehabilitation team tailored personalized training interested in training for a local 5 km race. Their average age was 56 and 79% were male. Compared to those that didn't run the race, the trend was that the 62% who started and finished the race had increased exercise capacity immediately following the 12 week cardiac rehabilitation program and at one year follow-up, as well as a decreased BMI at one year. (Pishoy Gouda, Calgary) 

The impact of acculturation: The rising incidence of major cardiovascular events in Chinese-Canadians. Canadian-born people of Chinese ethnicity have significantly higher rates of major cardiovascular events compared to Chinese immigrants coming to Canada, according to a new study. Among the major ethnic groups in Canada, Chinese immigrants have the lowest rates of heart disease, but the study finds there is also a striking rise in the incidence of cardiovascular events the longer the duration that they live in Canada –pointing to the acculturation effects of living in a Western environment. 

Compared to their immigrant counterparts, Canadian-born people of Chinese ethnicity are more likely to have completed high school, speak English and/or French, be employed, and have a higher income, yet in spite of these demographics, the incidence of major cardiovascular events was significantly higher in those born in Canada compared to that of Chinese immigrants − even compared to those living in Canada for a longer duration. The national cohort study used census data and included 80,825 self-identified Chinese-Canadians aged 30 to 74. Dr. Chi-Ming Chow says factors contributing to the increased risk include adoption of a less-healthy Western diet and changes in their physical activity patterns. Understanding the reasons for these findings is a research priority being studied in the Alliance Chinese-Canadian Research study. Dr. Chow notes that both Chinese immigrants and Canadian-born people of Chinese descent should be made aware of their cardiovascular risks in an effort to optimize their heart health. (Chi-Ming Chow, Toronto)

Shift work and high blood pressure: Dangerous bedfellows. A 2008 Statistics Canada survey on the work-life balance of shift workers found that they are more likely to cut back on sleep, spend less time with their spouse, and worry about not spending enough time with family, compared with regular day workers. Evidence also suggests that shift workers are at increased risk for developing chronic diseases. Relatively few studies, though, have explored the relationship between shift work and the incidence of high blood pressure – the number one risk factor for stroke and a major risk factor for heart disease. Dr. Joan Tranmer examined the association between previous shift work and incidence of hypertension in Ontario working adults and found that 30% of the 2,377 shift workers studied developed high blood pressure during the 15 year follow-up. The associations between shift work and hypertension were more pronounced among men under the age of 45 and women of all ages. The study, says Dr. Tranmer, reinforces the need for sex and age specific comprehensive workplace policies relevant to mitigating the adverse effects of shift work. (Joan Tranmer, Kingston, ON)

The tale of the tape measure: Obesity and heart risks. More than 60% of adult Canadians and more than 30% of our children and youth are overweight or obese, increasing their risks for heart disease and stroke. Levels are unacceptably high. A decade ago, Dr. Jean-Pierre Després opened the Congress with a keynote lecture urging us to scale back on the weight obsession, telling us that obesity was a marker of our poor nutritional habits combined with a lack of physical activity. He went on to even propose that the word "dieting" should be banned and replaced with a focus on physical activity and healthy eating rather than weight. He returns to Congress this year as the recipient of the CIHR-ICRH/CCS 2017 Distinguished Lecturer Award in Cardiovascular Sciences, with reflections on his 31 year career as an independent investigator and one of Canada's leading experts in the study of obesity and heart disease. What needs to be done to tackle obesity and its health implications? What should individuals do? And what needs to be done at a public health level? The best step forward, he says, is to stop talking about body weight and rather emphasize abdominal obesity as a powerful risk factor for heart disease. And rather focusing on caloric restriction, he proposes to focus on what he calls the behavioural vital signs − nutritional quality and level of physical activity − and their related outcomes: waist circumference and cardiorespiratory fitness. (Jean-Pierre Després, Quebec City)

Blood pressure and heart disease risk: How low is too low?
The landmark 2015 SPRINT study found that lowering systolic blood pressure in some people with high blood pressure to 120 mmHg − rather than the standard target of 140 mmHg − resulted in significantly lower rates of fatal and nonfatal cardiovascular events and death from any cause. But in some patients this treatment strategy may also lower diastolic pressure to a very low level. Does the risk of cardiac events increase when diastolic pressure is too low? And how low is too low? Researchers at University of British Columbia and BC Centre for Improved Cardiovascular Health analyzed the data from the SPRINT study to examine the relation between the risk of cardiac events and achieved diastolic pressure under treatment. They found a diastolic pressure below 55 mmHg was associated with increased risk of cardiac events in subjects both with and without pre-existing heart disease. The study researchers advise caution in aggressively lowering diastolic pressure in patients with hypertension, and when considering intensive treatment in patients with already low diastolic pressure. (Nadia Khan, Vancouver; Yinshan Zhao, Vancouver; Karin Humphries, Vancouver)

Canadian Cardiovascular Society guidelines: Cardiovascular guidelines are an invaluable resource not only for members of the cardiovascular community but for healthcare practitioners throughout Canada. Practice guidelines play an important role in helping to improve the quality of patient care and manage limited resources.

• New CCS comprehensive heart failure guidelines: More than a million Canadians have heart disease and 50,000 new cases of heart failure are currently diagnosed each year. Depending on the severity of symptoms, heart dysfunction, age and other factors, half of those diagnosed with heart failure will die within five years, and most die within 10 years. While heart failure cannot yet be cured, it can be treated and managed, improving quality of life. The updated CCS heart failure guidelines merge 10 years of heart failure guideline publications to provide updated guidance on the diagnosis and management (self-care, pharmacologic, non-pharmacologic, device, and referral) that should aid in day-to-day decisions for caring for patients with heart failure. Recognition and treatment of advanced heart failure is an important part of this update, including how to select advanced therapies as well as end-of-life considerations. (Justin Ezekowitz, Edmonton; Eileen O'Meara, Montreal)
  
  
• Updated CCS guidelines for use of antiplatelet therapy: Antiplatelet agents are a cornerstone of therapy for patients with atherosclerotic vascular disease. The updated CCS antiplatelet therapy guidelines incorporate new evidence on how to optimally use antiplatelet therapy in outpatients who have existing, or are at risk of developing, vascular disease. (Jean-Francois Tanguay, Montreal; Shamir Mehta, Hamilton)

Protecting aging hearts. It can be a challenge to select the best treatment for seniors (age 70+) who have syncope  −  fainting due to low blood pressure −  and who also have frayed impulse conducting tissues in their hearts which, as a result, don't work properly. Similar to a frayed electrical cord, these electrical impulses in the heart may temporarily short out, causing the heart to stop. But it is hard to know if the syncope is also a result, or if it has an unrelated cause. Problems due to frayed electrical tissues can be treated with pacemakers but most other causes cannot. What are the best treatment options in these tricky cases? Researchers from the University of Calgary used a simple randomized trial to compare the use of a permanent pacemaker with an implantable cardiac monitor and found that a permanent pacemaker is the preferred strategy, as it greatly reduces the overall number of operations for patients. This is a potentially practice-changing discovery that will reduce both episodes of fainting and the need for recurrent operations. (Robert Sheldon, Calgary)

QUOTES: The Canadian Cardiovascular Congress
"The Canadian Cardiovascular Congress unites Canada's cardiovascular community, including healthcare professionals, researchers, and policy makers. The transformation and evolution of the Congress continues to put science in action, with
greater opportunities to network, learn, and collaborate."
Dr. Michelle Graham, scientific chair, Canadian Cardiovascular Congress

"Heart & Stroke is proud to partner with the Canadian Cardiovascular Society for this gathering of the brightest and most innovative minds in cardiology. Research is at the heart of all we do. We also play a critical role in advancing research discoveries into the lives of Canadians, including may discoveries presented at the Congress. The learnings and connections made at here will lead to changes in medical practice and ultimately save lives."
Dr. Cindy Yip, director of heart health, Heart & Stroke

HEART HEALTH FACTS:

• Heart disease is the second leading cause of death in Canada
• An estimated 1.3 million Canadians are living with heart disease
• There are an estimated 70,000 heart attacks in Canada; one every seven minutes
• Up to 40,000 cardiac arrests occur each year in Canada; one every 13 minutes
• Nine in 10 Canadians have at least one risk factor for heart disease; more than 24 million Canadians

The Canadian Cardiovascular Congress brings together more than 2,500 heart health experts to exchange ideas and present the latest breaking research. It is being held in Vancouver from October 21 to 24. #CCCVAN

Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CCS policy or position. Heart & Stroke and the Canadian Cardiovascular Society make no representation or warranty as to their accuracy or reliability.

Canadian Cardiovascular Congress
Co-hosted by the Canadian Cardiovascular Society and Heart & Stroke, CCC provides a broad spectrum of cardiovascular health professionals with current scientific information, accredited education opportunities and an ideal forum to connect with other cardiovascular health and care colleagues. This annual conference unites Canada's cardiovascular community to network, learn and showcase the latest in research and innovations.

Canadian Cardiovascular Society 
The national voice for cardiovascular physicians and scientists. Its mission is to promote cardiovascular health and care through knowledge translation, professional development, and leadership in health policy.

Heart & Stroke
Life. We don't want you to miss it. That's why Heart & Stroke leads the fight against heart disease and stroke. We must generate the next medical breakthroughs, so Canadians don't miss out on precious moments. Together, we are working to prevent disease, save lives and promote recovery through research, health promotion, and public policy.

SOURCE Heart and Stroke Foundation

For media interviews: Diane Hargrave, [email protected], 416-467-9954, ext. 102; After October 25, 2017, contact: Jane-Diane Fraser, Heart & Stroke, [email protected], Cell from Oct 20 to 24: 613-406-3282

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