SUNDAY, Nov. 9 (HealthDay News) -- A widely used cholesterol-lowering drug appears to protect against heart attacks, stroke and other adverse outcomes in people who do not have high cholesterol.

The patients receiving the drug, Crestor (rosuvastatin), did have high levels of C-reactive protein (CRP), a marker for the inflammation process which is implicated in hardening of the arteries.

The study, sponsored by drug maker AstraZeneca and conducted by researchers at Brigham and Women's Hospital in Boston and colleagues, was presented Sunday at the American Heart Association's annual scientific sessions, in New Orleans. It will also be published in the Nov. 20 issue of the New England Journal of Medicine.

Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at New York University's Langone Medical Center, believes these results will change practice and will expand the universe of people who can benefit from the drug.

"This article conveys clearly that if all you do is use LDL cholesterol as a discriminator for cardiovascular risk, you are going to underestimate cardiovascular risk substantially," he said. "Individuals even with modest LDL can have considerable cardiovascular risk when other factors are present."

One of the study authors agreed. "This shifts the paradigm for evaluating risk and treatment," said Dr. Antonio M. Gotto Jr., dean of Weill Cornell Medical College in New York City.

In a statement, Dr. Elizabeth G. Nabel, director of the U.S. National Heart, Lung, and Blood Institute (NHLBI), acknowledged this study and two others concerning CRP.

"New results from three studies being presented at the American Heart Association (AHA) Scientific Sessions in New Orleans and published in scientific journals today provide the strongest evidence to date that a simple blood test for high-sensitivity C-reactive protein (hsCRP) is a useful marker for cardiovascular disease," she said.

But other experts urged caution.

"We have to really not lose sight of traditional guidelines," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "This is very interesting, but I think we have to wait and see."

According to the NHLBI, about 450,000 Americans will die of coronary heart disease, which is the leading cause of death for both men and women.

People with increased levels of CRP, a marker of inflammation, have a higher risk for cardiovascular events. And about half of all heart attacks and strokes occur in apparently healthy people with lower LDL levels.

Statins are known to lower CRP levels, in addition to cholesterol levels.

The JUPITER trial randomized almost 18,000 men and women with LDL cholesterol levels less than 130 milligrams per deciliter (130 is considered "borderline high") and CRP levels of 2 milligrams per liter or higher (considered average risk) to take 20 milligrams of Crestor daily or a placebo.

Men were 50 years or older, while women were 60 or older, with no history of cardiovascular disease, no diabetes and no uncontrolled hypertension.

"These people would not have been candidates for statins," Weintraub said. "The use of statins right now is entirely related to LDL cholesterol."

The trial was halted after only two of four planned years of follow-up, when researchers noted a significant reduction (44 percent) in the primary endpoint -- a composite of cardiovascular events including heart attack, stroke and death.

Crestor reduced LDL levels by 50 percent and CRP levels by 37 percent.

"We estimate that the application of this simple screening and treatment strategy, when used over a five-year period, would prevent more than 250,000 heart attacks, strokes, revascularizations and cardiovascular deaths in the U.S. alone," said study author Dr. Paul Ridker.

However, one expert was more cautious.

"We cannot say cannot say CRP is a risk factor nor a causal mediator," said Dr. Andrew Tonkin, head of the cardiovascular research unit at Monash University in Melbourne, Australia. "I don't think we would screen everyone, not at all at this time. We need to know the absolute risk reductions."

The findings do indicate that women could be taking statins for primary prevention, Gotto said. But the specific age group these findings relate to needs to be kept in mind.

Weintraub doubted that the benefit would be seen with all drugs in the class of statins. "There are features in each of the drugs that makes it better or not as good an anti-inflammatory agent," he said.

More information

The American Heart Association   has more on C-reactive protein.

SUNDAY, Nov. 9 (HealthDay News) -- Hospitalization rates for heart failure among older Americans have increased dramatically in the past three decades, an epidemic that represents a mounting burden on the health-care system, a new study has found.

In 2006, an estimated 807,082 men and women over 65 were hospitalized for heart failure, up from 348,866 in 1980 -- a 131 percent increase.

And the increase in hospitalization rates has been more dramatic among women than men, according to the Drexel University study, to be presented Sunday at the American Heart Association's annual scientific sessions in New Orleans.

"You could probably talk to any cardiologist, no matter what practice setting they're in, and even primary-care physicians who do hospital work, and you're going to find this is an extremely common scenario," said Dr. John Erwin III, an associate professor of internal medicine at the Texas A&M Health Science Center College of Medicine and a senior staff cardiologist with Scott & White Hospital in Temple.

"By far, heart failure is the leading diagnosis code when patients are admitted to the hospital, especially in those over 65," he said.

"Clearly we know that patients who are older in age require longer hospital stays and usually have other co-morbidities [illnesses] such as renal failure or anemia," Erwin added. "This is going to put a huge burden on the health-care system. It already is."

Heart failure occurs when the heart muscle can no long pump enough blood to the different parts of the body. More than 5 million Americans are thought to live with heart failure, with another 660,000 cases diagnosed each year.

Medical advances have, ironically, led to more heart failure, Erwin said. "Patients that used to come into hospitals with heart attacks and died in years past are living, but are living with heart failure," he said. "While we're successful now with heart attacks more frequently, this is part of what's left over."

The heart failure epidemic is mirrored by a number of other epidemics, such as high blood pressure, obesity and diabetes, all of which are also risk factors for heart failure, the study authors said.

The study, the first to look at heart failure hospitalization rates over the past three decades, examined hospital discharge data on more than 2.2 million people aged 65 and older from 1980 through 2006.

The researchers, from Drexel's School of Public Health in Philadelphia, found that:

• The hospitalization rate for heart failure jumped 131 percent between 1980 and 2006.
• The number of women hospitalized for heart failure increased 55 percent annually, compared to 20 percent annually for men.
• The relative risk of being hospitalized for heart failure was 37 percent higher for those living from 2002 to 2006 than for those living from 1980 to 1984.
• People aged 85 and older had four times the risk of being hospitalized with heart failure, compared to those aged 65 to 74. People aged 75 to 84 had double the risk of hospitalization compared to those a decade younger.
• Hospitalization rates for coronary heart disease and stroke have decreased since the mid-1980s; heart failure is the only one of three major forms of cardiovascular disease to show an increase.

The trend is likely to get worse as the U.S. population continues to age, the study authors said.

But there are some efforts under way to lessen the current and future burden, Erwin said.

"Several organizations are working hard to develop disease management strategies, very basic things we can do for heart failure that, if we adhere to them, the likelihood that a patient will be readmitted due to exacerbation is very much lower," he said. "Those are going to be key, and national efforts to get diabetes and blood pressure and obesity under control are going to be key."

More information

The American Heart Association   has more on heart failure.

SUNDAY, Nov. 9 (HealthDay News) -- Consuming too little potassium may be as big a risk factor for high blood pressure as eating too much sodium, especially for blacks, new research says.

The study also identified a gene that may influence potassium's effects on blood pressure.

The findings, based on a Texas heart study done on the urine samples of 3,300 people, support previous studies that made similar conclusions about potassium and blood pressure.

The new study was to be presented Saturday at the American Society of Nephrology's annual meeting, in Philadelphia.

"The lower the potassium in the urine, hence the lower the potassium in the diet, the higher the blood pressure," lead study author Dr. Susan Hedayati, of the University of Texas Southwestern Medical Center at Dallas, said in a news release issued by the conference organizers. "This effect was even stronger than the effect of sodium on blood pressure."

The link between high blood pressure and low potassium was strong even when age, race, and other cardiovascular risk factors, such as high cholesterol, diabetes and smoking, were factored in. About half the study participants were black, and they tended to consume the least amount of potassium in their diet, Hedayati said.

Laboratory research for the study suggests that the WNK1 gene may be responsible for potassium's effects on blood pressure. More research is being done to test how fixed levels of potassium in a diet affect blood pressure and the gene's activity.

Meanwhile, the researchers urged people to consume more potassium and less sodium. "High-potassium foods include fruits such as bananas, and citrus fruits and vegetables," Hedayati said. "Consuming a larger amount of these foods in the diet may lower blood pressure."

More information

The American Academy of Family Physicians has more about lowering your blood pressure  .

WEDNESDAY, Nov. 5 (HealthDay News) -- Keep eating whole grains and reduce your consumption of eggs and high-fat dairy food to improve your odds against suffering heart failure, a new long-term study shows.

The study, which looked at more than 14,000 people over 13 years, found that participants had a 7 percent lower risk of heart failure (HF) per one-serving increase in whole grain consumption. The risk increased by 8 percent per one-serving increase in high-fat dairy intake and by 23 percent per one-serving increase in egg consumption. Other food groups did not appear to directly affect risk of heart failure.

The findings were published in the November issue of the Journal of the American Dietetic Association.

"The totality of literature in this area suggests it would be prudent to recommend that those at high risk of HF increase their intake of whole grains and reduce intake of high-fat dairy and eggs, along with following other healthful dietary practices consistent with those recommended by the American Heart Association," article co-author Jennifer A. Nettleton, an assistant professor in the Division of Epidemiology and Disease Control at the University of Texas Health Sciences Center at Houston, said in an association news release.

More information

The American Heart Association has more about heart failure  .