WEDNESDAY, Jan. 9 (HealthDay News) -- Drinking in moderation and keeping physically active is the formula for keeping heart disease at bay, Danish researchers report.

In fact, people who didn't drink and weren't physically active had a 30 percent to 49 percent higher risk of developing heart disease than people who drank, exercised or did both.

"This study is consistent with a number of prior studies which have shown that leisure-time physical activity and moderate alcohol consumption are associated with a lower risk of cardiovascular and all-cause mortality," said Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles.

"However, it is very important to note that these findings, especially with regards to alcohol consumption, have never been confirmed in randomized clinical trials and need to be before any recommendations can be made regarding the use of alcohol for cardiovascular risk reduction," Fonarow cautioned.

In the study, Morten Gronbaek, director of research at the National Institute of Public Health at the University of Southern Denmark in Copenhagen and his colleagues collected data on 11,914 Danish men and women aged 20 and older who took part in the Copenhagen City Heart Study.

During an average of 20 years follow-up, 1,242 people died from heart disease and 5,901 died from other causes, according to the report in the Jan. 9 issue of the European Heart Journal.

Among both men and women, being physically active was associated with a significantly lower risk for fatal heart disease and dying from any other cause compared with being physically inactive.

In addition, drinking was associated with a lower risk of fatal heart disease than not drinking. Moderate drinking reduced the risk of death among men and women. However, among heavy drinkers the risk of dying was similar to non-drinkers, the researchers found.

Among people who were physical active, those who didn't drink had a 30 percent to 31 percent higher risk of fatal heart disease compared with moderate drinkers.

However, among people who didn't drink but had a moderate or high level of physical activity, their risk of fatal heart disease was reduced up to 33 percent compared to those who didn't exercise or drink.

In fact, those who had at least one drink a week and were physically active had a 44 percent to 50 percent lower risk of dying from heart disease than those who were physically inactive and didn't drink.

Moreover, people who were physically active and had a drink a week had up to a 33 percent lower risk of dying from any cause, Gronbaek's group found.

"Physical activity and a moderate alcohol intake can lower the risk of fatal heart disease and all-cause mortality. But neither physical activity alone nor alcohol intake can completely reverse the increased risk associated with physical inactivity and alcohol abstention. Thus, both physical activity and alcohol intake are important to lower the risk of fatal heart disease and all-cause mortality," the researchers concluded.

One expert sees physical activity and moderate drinking as parts of a healthy lifestyle.

"The key messages of this study, based on a large cohort, are reaffirmations of what we already know, not revelations," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. "Moderate alcohol intake reduces the risk of heart disease. Moderate physical activity does so, too, and even more powerfully. Combine the two, and the benefits are additive."

However, Katz stressed that practices that promote health are most powerful when combined into an overall pattern of healthful living.

"Combing regular physical activity with not just moderate alcohol intake, but a healthful dietary pattern, adequate sleep, effective management of stress, and avoidance of tobacco, and you can slash your risk of heart disease and premature death from any cause, dramatically," Katz said.

More information

For more on heart disease, visit the American Heart Association  .

TUESDAY, Jan. 8 (HealthDay News) -- Older men who suffer from chronic anxiety substantially increase their risk of having a heart attack, a new study reports.

While stress has been linked to an increased risk of heart problems, this is the first time that chronic anxiety has been identified as a risk factor also.

"There is an independent contribution of anxiety that can predict the onset of a heart attack among healthy older men," said lead researcher Biing-Jiun Shen, an assistant professor of psychology at the University of Southern California in Los Angeles.

Even after accounting for anger, hostility, depression and type A personality, anxiety still predicted the onset of a heart attack, Shen said. "The relationship between anxiety and heart attack cannot be explained by depression, hostility or type A personality," he said.

In the study, Shen's group collected data on 735 men who participated in the Normative Aging Study, which assesses medical and psychological changes associated with aging. Each of the men completed psychological testing in 1986 and had no heart problems at the time. The men were followed for an average of 12 years.

The report appears in the Jan. 15 issue of the Journal of the American College of Cardiology.

During follow-up, the researchers found men who had chronic anxiety had a 30 percent to 40 percent increased risk of heart attack. Those with the highest levels of anxiety on psychological testing had an even higher risk of heart attack.

The risk posed by anxiety remained even after the researchers adjusted their data to account for standard cardiovascular risk factors, health habits, and negative psychological and personality traits, Shen said.

Whether treating anxiety reduces the risk of heart attack isn't known, Shen said. "But the implication is there," he added. "It is something that doctors can look out for."

Shen's team is hoping to study that possibility. "Hopefully, that will reduce the risk for heart disease," he said.

In addition, it isn't known if women are also at risk for heart attack from chronic anxiety, Shen noted.

One expert agreed that psychological factors play a significant role in the risk for having a heart attack.

"Psychological characteristics including anxiety, anger, hostility and type A personalities have been associated with increased risk of heart attack in a number of prior studies, and this study again shows that chronic anxiety appears to raise an individual's heart attack risk," said Dr. Gregg C. Fonarow, a cardiology professor at the University of California, Los Angeles.

"An important finding of this study is that anxiety not only represents an independent risk factor for heart attack but may also explain the associations between heart attack risk with other psychosocial risk factors," Fonarow said.

Exaggerated response to acute and chronic stress in anxious individuals may trigger a number of pathways which increase the risk of developing coronary artery disease and being stricken with a heart attack, Fonarow said.

"Highly anxious individuals should be aware they may face an increased risk of a heart attack and take proactive steps under physician supervision to control those cardiovascular risk factors which are modifiable including blood pressure, lipid levels, activity level and weight," Fonarow added.

More information

There's more on anxiety disorders at the U.S. National Institute of Mental Health.

WEDNESDAY, Jan. 2 (HealthDay News) -- About a third of patients who suffer cardiac arrest in hospitals don't get a defibrillator-delivered shock to start the heart beating again within the two minutes recommended by the American Heart Association, a new study found.

This delay significantly reduces a patient's chance of survival, the study authors said.

"Until now, the recommendation for defibrillation within two minutes was based on expert opinion," said Dr. Paul S. Chan, who led the study while at the University of Michigan and now is a cardiologist with Saint Luke's Mid-America Heart Institute in Kansas City, Mo. "There were no clear standards established. This study helps support the two-minute recommendation."

The findings are published in the Jan. 3 issue of the New England Journal of Medicine.

Cardiac arrest is a too-common hospital problem. An estimated 750,000 patients experience cardiac arrest in U.S. hospitals each year, the study authors said.

Chan and his collaborators identified almost 6,800 people who had cardiac arrest at 369 hospitals participating in the National Registry of Cardiopulmonary Resuscitation. Overall, the response time seemed impressive, with defibrillation typically beginning an average of one minute after the heart stopped.

But defibrillation did not begin for two or more minutes in 2,045 cases, 30.1 percent of the total. Just 22.2 percent of that subgroup of patients survived to leave the hospital, compared to 39.3 percent of those who got early defibrillation, the study found.

"If we had the ability to look at all the hospitals across the country, the numbers probably would be worse," said Chan, referring both to the time defibrillation begins and chance of survival. "These are the better-performing hospitals, ones that issue quarterly reports."

Delayed defibrillation was more likely in hospitals with fewer than 250 beds; in hospital units where patients were not continuously monitored; for patients admitted with diagnoses other than heart disease; during "off hours" (nights and weekends); and for black patients, the study showed.

"But we found delays across all types of hospital beds and units," Chan said. It's not clear what can be done to speed up the response across-the-board in all hospitals, he said.

Monitoring all patients' heart function might make a difference, he said, "but we can only speculate because we don't have interventional trials to see if that would make a difference."

Changes in practice at some hospitals might also lead to improvements, Chan said. For example, some hospitals do not allow nurses who detect a problem to use a defibrillator; they must call a physician or a specially trained nurse, he said.

"We might make external defibrillators available to more units," Chan said. "That is one potential solution that might have a significant impact over time. And hospitals might set up emergency teams to intervene when there is a cardiac arrest code."

The effect of such measures will have to be tested in real life, Chan said. Trials of rapid intervention teams are being planned, he said.

A different approach to the problem is proposed in an accompanying editorial in the journal by Dr. Leslie A. Saxon, chief of cardiology at the University of Southern California -- continuous monitoring of all hospitalized patients.

"We have to monitor them wherever they are," Saxon said. "They don't have to be in a specialized unit. We can go to an automated system with electrodes for rapid detection of heart arrhythmias. The detection development devices are out there."

The study is important, she said, "because it points out a need in hospitalized patients. You've got to have these things [defibrillators] in every patient's room. Even the housekeeping person in the room can be trained to use them. I spend a lot of time thinking about ways to avoid sudden death."

More information

For more on defibrillators, visit the American Heart Association  .

TUESDAY, Nov. 13 (HealthDay News) -- Eating nitrite/nitrate-rich foods such as vegetables and cured meats may help improve the chances of surviving a heart attack and of recovering more quickly.

That's the finding of a preliminary study in the Nov. 12 online edition of the Proceedings of the National Academy of Sciences.

Researchers found that mice fed extra nitrite and nitrate had 48 percent less cell death in the heart following a heart attack than mice fed a regular diet. Mice fed a low nitrite/nitrate diet had 59 percent greater cell death.

The study also found that 77 percent of mice fed extra nitrite survived a heart attack, compared with 58 percent of mice fed a low nitrite diet.

"This is a very significant finding, given the fact the simple components of our diet -- nitrite and nitrate -- that we have been taught to fear and restrict in food can now protect the heart from injury," lead author Nathan S. Bryan, a cardiovascular physiologist at the University of Texas Health Science Center at Houston, said in a prepared statement.

"Simple changes in our daily dietary habits such as eating nitrite and nitrate-rich foods such as fruits and vegetables and some meats in moderation can drastically improve outcome following a heart attack," said Bryan, who is also an assistant professor at the university's Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases.

He explained that nitrite forms nitric oxide gas during a heart attack, which reopens closed or clogged arteries and reduces the amount of permanent damage to the heart muscle.

"This paper provides the first demonstration of the consequences of changes in dietary nitrite and nitrate on nitric oxide biochemistry and the outcome of heart attack," Bryan said.

The next logical step in this line of research would be to determine if increasing nitrite/nitrate intake in patients with known cardiovascular risk factors would decrease the incidence and severity of heart attack and stroke, or enhance recovery, he said.

While some studies have linked nitrites/nitrates with cancer, Bryan said many of those study findings were based on weak epidemiological data.

More information

HeartHealthyWomen.org has explains the use of nitrate medicines  .