Health News, Wellness, and Medical Information

People who cut out saturated fatty acids while upping their intake of white bread, pasta and other refined carbohydrates that can cause blood sugar to spike aren’t doing their heart any favors, new research from Denmark shows.

But reducing saturated fatty acid intake while eating more whole grain bread, vegetables (aside from potatoes), and other carbohydrates with a less dramatic effect on blood sugar may improve heart health, Dr. Marianne U. Jakobsen of Aarhus University Hospital and her colleagues found. “The type of carbohydrate matters,” Jakobsen told Reuters Health.

A recent analysis of 21 studies including 350,000 people found “no significant evidence” that saturated fat in and of itself increased heart disease risk, but the authors of that analysis suggested that what people replaced those saturated fat calories with might be more important. A subsequent study found that this was indeed the case; people who upped their polyunsaturated fatty acid intake while cutting saturated fat showed improved heart health.

In the current study, Jakobsen and her team looked at the carbohydrate side of the equation. Specifically, they accounted for the “glycemic index” of different types of carbohydrates.

Glycemic index is a measure of how quickly blood sugar jumps after eating a particular type of carbohydrate. Low glycemic index foods tend to be high in fiber and less refined, such as foods made from whole grains; high glycemic foods are often lower in fiber and more highly refined, and include white bread, pasta made from white flour, and bananas.

To investigate how increasing carb intake while reducing saturated fatty acid intake affected the heart, the researchers looked at 53,644 men and women who had never suffered heart attacks. During follow-up, which averaged about 12 years, nearly 2,000 heart attacks were documented.

Jakobsen and her team divided the study participants into three groups based on the average glycemic index of the carbohydrates in their diet, and then calculated heart attack risk based on the composition of their diet.

They found that heart attack risk fell by 12 percent for every additional 5 percent of a person’s total calorie intake that came from carbohydrates — if a person’s average dietary glycemic index was low. However, this reduction wasn’t statistically significant, meaning it could have been due to chance.

But among the people with the highest average dietary glycemic index, every 5 percent increase in carbohydrate calories upped heart attack risk by 33 percent. For people whose average glycemic index fell in the middle, an increase in carb intake along with a reduction in saturated fatty acid intake had no effect on heart risk.

“We cannot say that saturated fatty acids are not associated with increased risk of coronary heart disease because it depends on what you compare,” Jakobsen told Reuters Health.

Unfortunately, she added, figuring out the glycemic index of a particular food is not straightforward. “It’s a scientific way of classifying foods, so it’s not really public-health-friendly,” she said.

Nevertheless, the researcher added, people can likely decrease their glycemic index by eating “less refined foods.”

SOURCE: American Journal of Clinical Nutrition.

A routine screening test for several metabolic and genetic disorders in newborns, the heel-stick procedure, is not effective in screening for cytomegalovirus (CMV) infection, a leading cause of hearing loss in children, according to research published in the April 14 online issue of the Journal of the American Medical Association.

About 20,000-30,000 infants are born infected with CMV each year, 10-15 percent of whom are at risk for eventually developing hearing loss.

The study, funded by the National Institute on Deafness and Other Communication Disorders (NIDCD), one of the National Institutes of Health, is part of a multicenter research project headed by the University of Alabama at Birmingham that is seeking to find the most effective screening test for CMV infection in newborns. The standard method for detecting CMV infection in newborns is labor-intensive and not conducive to a widespread screening program.

“The heel-stick test is a simple test that is already being used to screen for other diseases in newborns across the United States, so it seemed like a good candidate for a possible universal screening program for CMV,” said James F. Battey, Jr., M.D., Ph.D., director of the NIDCD. “However, these findings show us that, at least with current technologies, the heel-stick test should not be used as a primary newborn screening tool for CMV.”

CMV is the most common infection passed from a mother to her unborn child. The vast majority of CMV-infected babies show no initial symptoms, and many babies will never develop health problems. But in some CMV-infected babies, serious problems can develop over time. Hearing loss is the most common deficit to emerge later on. The earlier doctors can identify CMV infection, the better they can monitor a child’s hearing. If signs of hearing loss are present, appropriate intervention should be provided as soon as possible.

Between March 2007 and May 2008, the researchers analyzed dried blood samples obtained using the heel-stick procedure from babies born at the University of Alabama at Birmingham, and six other participating medical centers across the United States. The heel-stick procedure involves pricking a newborn’s heel, drawing a small amount of blood, and placing the blood on filter paper to dry so that it can be analyzed for several diseases, including hypothyroidism and sickle cell disease.

To test for CMV infection, the researchers removed the babies’ DNA from the filter paper and then used a common molecular diagnostic technique to quickly and efficiently detect whether any CMV DNA was mixed in. The procedure, called real-time polymerase chain reaction, or PCR, uses special molecules, called primers, to seek out a tell-tale portion of CMV DNA and churn out lots of fluorescent copies of that segment so it can be easily detected. For the initial group of babies, the researchers used a single set of primers targeting one section of CMV DNA. As the study progressed, they added a second primer set targeting an additional section in hopes of increasing accuracy, or sensitivity, of the test.

The team also compared their results to the standard method of detecting CMV in newborns. CMV rapid culture is a highly effective procedure that uses saliva or urine instead of dried blood samples to make the identification. The rapid culture method is labor-intensive and requires a tissue culture facility on site, so it would be difficult to adapt this technology to a widespread screening program.

Many studies have found that dried blood spot PCR is able to identify babies with congenital CMV infection, so some researchers have suggested that it be used for a universal screening program. However, none of the earlier studies compared dried blood spot PCR results to the rapid culture method and therefore could not determine if the PCR procedure was as good as the standard or if it fell short and missed truly infected babies or falsely identified babies as being CMV-infected when they were not infected.

In this study, 20,448 babies were screened, 92 of whom were confirmed to have congenital CMV infection. The rapid culture method identified 91 of the 92 infants, for nearly 100 percent sensitivity. For the 11,422 infants who were screened with the single-primer PCR assay derived from dried blood spots, only 17 out of 60 infected children were identified, a 28.3 percent sensitivity. Of the 9,026 infants who were screened with the two-primer PCR method, 11 out of 32 infected children were identified, a sensitivity of 34.4 percent.

“In order to be included as part of a screening test, the minimum sensitivity should be at least 95 percent,” said Suresh Boppana, M.D., a co-principal investigator on the study with Karen Fowler, Ph.D., both of whom are with the University of Alabama at Birmingham. “Our findings indicate that dried blood spot PCR will only detect 30-40 percent of babies with CMV infection. More than half of babies who are infected would be missed.”

The researchers are now assessing whether analysis of saliva samples using real-time PCR technology can do a better job than dried blood spots when compared with the rapid culture method. They believe that the use of saliva may be beneficial since babies with congenital CMV infection are known to have a lot of virus in their saliva, compared to the blood, where amounts can vary depending on when the infant was infected during development. In addition, saliva samples require minimal processing and are noninvasive.

Other participating institutions are Saint Peter’s University Hospital, New Brunswick, N.J.; University of Mississippi Medical Center, Jackson; Carolinas Medical Center, Charlotte, N.C.; University of Pittsburgh and the Children’s Hospital of Pittsburgh; University of Texas Southwestern Medical Center, Dallas; and University of Cincinnati and Cincinnati Children’s Hospital Medical Center.

U.S. hospitals are making little progress in eliminating infections that can harm or kill patients, according to reports released April 13 by the federal Agency for Healthcare Research and Quality.

The 2009 National Healthcare Quality Report and the National Healthcare Disparities Report track contains information on infection rates for 2007, the latest year data has been available.

Researchers found that rates of bloodstream infections after operations (postoperative sepsis) increased by 8 percent, rates of catheter-associated urinary tract infections following surgery increased by 3.6 percent, and rates of certain infections due to medical care increased by 1.6 percent. However, rates of pneumonia that developed after surgery (postoperative pneumonia) fell by 12 percent.

There was no change in the rate of bloodstream infections associated with central venous catheter placements. These are tubes placed in a large vein in a patient’s neck, chest or groin to give medication or fluids, or to collect blood samples.

The reports also found that blacks, Hispanics, Asians, and American Indian patients were less likely than whites to receive preventive antibiotics before surgery in a timely manner.

In an effort to reduce infections associated with healthcare, the AHRQ last year announced funding for nationwide implementation of a program used by more than 100 hospitals in Michigan that cut rates of central line-associated bloodstream infections to near zero.

The AHRQ reports include data on more than 200 health care measures categorized in four areas of quality: effectiveness, patient safety, timeliness, and patient-centeredness.

“Despite promising improvements in a few areas of health care, we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access,” ARHQ Director Dr. Carolyn M. Clancy, said in an agency news release.

Among the other findings from the reports:
One-third of obese adults have never received exercise advice from a doctor.
Obese adults who are black, Hispanic, poor or have less than a high school education are less likely to receive diet advice from a doctor.
One-third of obese adults and most overweight children have not been told by their doctor that they have a weight problem.
Most American children have never received exercise counseling from a doctor and nearly half have never received counseling about healthy eating.

The reports also found that improvements in health care quality and reduction of disparities are slowed by lack of health insurance. For many health services, having no insurance is the single strongest predictor of poor quality care — stronger than race, ethnicity, income or education.

People with no insurance are much less likely than those with private insurance to receive recommended care, especially preventive services and management for diabetes. In the past decade, insurance coverage differences between blacks and whites have narrowed but there are still large disparities related to ethnicity, income and education, the reports said.

SOURCE: U.S. Agency for Healthcare Research and Quality, news release

Walking for 45 minutes a few times a week may help women in the “battle of the bulge” that often accompanies menopause, and at the same time improve overall well being, hints new research from Canada.

Pointing out that the 45 minutes can be broken up into shorter jaunts, researcher Dr. Pascale Mauriège, of Quebec’s Laval University, told Reuters Health in an email it’s a program that could be “easily incorporated” into a woman’s daily life.

The researchers wanted to know if a 16-week walking program would help older overweight inactive women lose some weight, increase their lean body mass and experience a better health-related quality of life.

They enrolled 35 moderately obese and sedentary white women who were either nearing menopause or newly post-menopausal. Thirty women finished the program – 16 premenopausal and 14 postmenopausal.

The women, guided by trainers, walked for 45 minutes on an indoor track every other day for 16 weeks. The intensity of the walking was not unlike the intensity of walking a dog, Mauriège said. While moderately obese, all participants were healthy.

Of the five participants who dropped out of the study early, three bristled at the program’s restrictions and wanted to walk more than three days a week.

At the beginning of the study, post and premenopausal women tended to have similar health-related quality of life ratings on such things as body pain, health, vitality, physical and social functioning and emotional and mental health.

At the end of the program, both groups of women appeared to benefit physically and mentally although in different ways, the researchers report in the journal Menopause.

Greater weight loss was achieved by the premenopausal women who lost an average of about 4.4 pounds compared to 1.5 pounds for the postmenopausal women. They also tended to lose more fat mass. Postmenopausal women, however, tended to benefit with a larger drop in their waist size and from gains in lean body mass.

The program also appeared to have a “non-negligible impact” on both groups’ sense of physical and mental well being, the researchers report.

Postmenopausal women had the larger gains in health-related quality of life scores in bodily pain, daily physical functioning, general health, emotional and mental health while premenopausal women had the greater gains in all physical activities of life, vitality and social functioning.

Mauriège said, to her knowledge, this is the first study to test the impact of a walking program on the various mental functioning scores in pre- and postmenopausal women.

But the study’s small size and lack of a control group (a group of women similar to participants who did not take part in the study’s exercise regimen) limits the validity of the findings.

Still, the findings do suggest that “moderate-intensity and moderate-frequency exercise” easily integrated in life habits seems to be enough to improve health-related quality of life in both premenopausal and early postmenopausal women, the researchers conclude.

Focused ultrasound is an effective way to get rid of uterine fibroids, the noncancerous but troublesome tumors that can grow inside the uterus, new research shows.

Uterine fibroids are a common condition that can lead to a host of problems, including prolonged, heavy menstrual bleeding that can be severe enough to cause anemia or require blood transfusion; severe pelvic pain and pressure; urinary frequency; pain during intercourse; problems with becoming pregnant, miscarriage and complications during pregnancy.

About 20 percent to 40 percent of women aged 35 and older have uterine fibroids. The problem is even more common among black women, about half of whom have fibroids, according to background information in the study.

There are several treatment options for fibroids, ranging from taking birth control pills to getting a hysterectomy. More recently, other techniques have been developed, including myomectomy, in which doctors surgically remove the fibroids, and uterine fibroid embolization (UFE), also called uterine artery embolization, which starves fibroids by blocking their blood supply using particles inserted into the uterus using a tube threaded through an artery in the groin.

The most recently developed — and least invasive technique — is focused ultrasound, in which interventional radiologists guided by MRI zap fibroids using tightly focused ultrasound.

In the study, researchers from the Mayo Clinic treated 119 women with focused ultrasound. One year after the treatment, 74 percent of women said their improvement of symptoms was “excellent,” while 16 percent said the improvement was “considerable.”

About 8 percent of women needed to have another form of fibroid treatment within a year, said study author Dr. Gina Hesley, an assistant professor of interventional radiology at the Mayo Clinic in Rochester, Minn.

That’s about the same percentage of women that previous studies have shown need to be re-treated after myomectomy or UFE, Hesley said.

“Focused ultrasound is another viable alternative treatment option for women who have uterine fibroids,” Hesley said.

The study is to be presented Monday at the Society of Interventional Radiology’s annual meeting in Tampa, Fla.

Researchers plan to continue following the women who received focused ultrasound. If fibroids aren’t completely destroyed, they can grow back and cause problems again. In addition, new ones can form.

Focused ultrasound was approved by the U.S. Food and Drug Administration for treating uterine fibroids in October 2004. However, the technique is only available in a limited number of hospitals nationwide, and not all insurance companies cover it, Hesley said.

Benefits of the technique are that it is minimally invasive, recovery time is quick — women can often return to their normal activities the next day — and it’s not painful. The most women usually feel is warmth from the ultrasound, Hesley noted.

Drawbacks of the technique are that it takes several hours, during which women lay on their belly in an MRI while lightly sedated.

Dr. John Lipman, director of interventional radiology and the Center for Image-Guided Medicine at Emory-Adventist Hospital in Atlanta, called the technique promising, but noted that it’s not for every woman and does not replace the techniques currently in use.

“It’s very exciting and innovative, but there are some limitations,” said Lipman, who offers focused ultrasound at his hospital. “It’s important to keep in mind this treatment can only address a small fraction of the symptomatic fibroid population.”

Because it takes two to three hours to zap each fibroid, it’s not practical to offer the technique to women who have a uterus full of larger fibroids.

Focused ultrasound can only penetrate a limited distance beneath the skin, so the location of the fibroids, the anatomy of the uterus, as well as excess weight, can make ultrasound not the best option.

One group of women who may be particularly helped by focused ultrasound is those who are having trouble getting pregnant because of fibroids, Lipman said. Myomectomy, which involves cutting into the uterus, can damage it, further compromising fertility, and there’s a small risk of a woman needing a hysterectomy afterward. These complications aren’t an issue with focused ultrasound.

Concerns about altering or damaging the uterus in some way also led many doctors to steer women who wanted to become pregnant away from UFE, Hesley added.

But a second study to be presented at the same meeting found that women who had it done were just as likely to conceive as those who underwent myomectomy.

Of the women who had UFE, 58 percent got pregnant, compared to 57 percent of those getting myomectomy, according to a study by researchers at St. Louis Hospital in Lisbon, Portugal.

SOURCES: Gina Hesley, M.D., assistant professor, interventional radiology, Mayo Clinic, Rochester, Minn.; John Lipman, M.D., director, interventional radiology and the Center for Image-Guided Medicine, Emory-Adventist Hospital, Atlanta;  presentation, Society of Interventional Radiology’s annual meeting, Tampa, Fla.

New chemotherapy agents for metastatic colon cancer improve patient survival but are costly, says a new study.

Researchers at Emory University in Atlanta analyzed data from 4,665 patients, aged 66 and older, diagnosed with metastatic colon cancer between 1995 and 2005. Compared to those who received older chemotherapy agents, patients who received one or more of the six chemotherapy agents approved in the United States between 1996 and 2004 lived an average of 6.8 months longer.

That increase in survival was associated with a lifetime cost increase of $37,100, which equates to $66,200 per year of life gained. After they made additional adjustments, the researchers calculated that the cost for each quality-adjusted life-year (a year of life in perfect health) gained was $99,100.

The study was published in the March 16 online edition of the journal Archives of Internal Medicine.

“New chemotherapeutic agents for colorectal cancer have been singled out as examples of high-cost/low-value medical care; no doubt they are the types of therapies that would receive close scrutiny if Medicare and other payers were to consider cost-effectiveness in coverage decisions,” wrote David H. Howard and colleagues.

“Our estimate of the cost per quality-adjusted life-year gained, $100,000, is below most estimates of the willingness to pay for a life-year. However, continuation of Medicare’s open-ended coverage policy for new chemotherapeutic agents and other expensive technologies will prove difficult to sustain as costs for the program continue to rise,” they concluded.

SOURCE: JAMA/Archives journals, news release.

Blood vessel function rapidly recuperates after smokers kick the habit, leading to a reduced risk of heart disease and heart attack, new research shows.

The study included more than 1,500 people taking part in a clinical trial to help them quit smoking. Before and one year after the participants stopped smoking, doctors used ultrasound to measure the patients’ flow-mediated dilation (FMD), a gauge of the health of the brachial artery, the main artery of the upper arm.

The ability of the brachial artery to relax is closely related to the ability of the heart arteries to relax, and predicts risk for future heart and blood vessel disease, explained the University of Wisconsin researchers.

They compared the FMD readings from patients who successfully quit with those who quit and then resumed smoking.

“Individuals who quit smoking had improved blood vessel function, even though they gained weight, which is a common side effect of smoking cessation,” study author Dr. James Stein, an associate professor of medicine at UW School of Medicine and Public Health, said in a university news release. “This confirms that quitting smoking is good for your blood vessels and reduces risk for heart attacks and cardiovascular disease.”

FMD improved by as much as 1 percent among patients who had quit smoking for a full year. That’s a significant improvement, according to Stein.

“It’s statistically significant, but more important, it’s also clinically relevant,” he said. “A 1 percent change in FMD is associated with an approximately 14 percent lower rate of cardiovascular disease events. That means patients who permanently quit smoking are less likely to have a heart attack and heart disease.”

The study was presented this week at the American College of Cardiology annual meeting in Atlanta and published simultaneously in the Journal of the American College of Cardiology.

Cardiovascular disease is the cause of about one-third of smoking-related premature deaths in the United States.

SOURCE: University of Wisconsin, news release.

A simple genetic test that helps doctors determine the best dose of the blood-thinner drug warfarin for individual patients could reduce hospitalizations by one-third during the early dose-adjustment phase, a new study has found.

The test identifies variations in two genes that strongly influence sensitivity to warfarin (Coumadin), which is used to prevent blood clots in people with high-risk conditions, such as atrial fibrillation, or after surgery to replace a heart valve.

“Genetic testing is a tool clinicians can use to more accurately predict the best warfarin dose early on,” Dr. Robert S. Epstein, chief medical officer and president of the Medco Research Institute in Franklin Lakes, N.J., said in a news release from the American College of Cardiology. “Patients may get to a stable dose more quickly and, therefore, have a lower risk of negative outcomes, such as excess bleeding or unwanted blood clotting.”

The findings were to be presented Tuesday at the college’s annual meeting in Atlanta.

The study included 896 people who, shortly after beginning warfarin therapy, gave a blood sample or cheek swab that was analyzed for expression of two genes — CYP2C9 and VKORC1 — that revealed sensitivity to warfarin. People with high sensitivity were put on a reduced dose of warfarin and had frequent blood tests. People with low sensitivity were given a higher dose of warfarin.

During the first six months that they took warfarin, those who underwent genetic testing were 31 percent less likely to be hospitalized for any reason and 29 percent less likely to be hospitalized for bleeding or thromboembolism than were a group that did not have genetic testing.

Epstein said that the cost of the genetic testing — $250 to $400 — would be justified by reduced hospitalization costs.

“If we reduce just two hospitalizations per 100 patients tested, that more than compensates for the cost of genotyping,” he said.

SOURCE: American College of Cardiology.

Recovering stroke patients whose physical therapy regimen is built around Wii video games appear to improve better than patients treated with standard therapies, a new Canadian study reveals.

The finding suggests that the enormously popular virtual reality programs could move beyond fun and games into the serious business of physical rehabilitation.

“This is new technology that may potentially help patients with a stroke,” said study lead author Dr. Gustavo Saposnik, director of the Stroke Outcomes Research Unit at St. Michael’s Hospital at the University of Toronto, Canada. “We ran a pilot study to see whether this is doable, safe, and more effective than routine therapy,” he said. “And we found it was.”

The findings are scheduled for presentation Thursday at the international conference of the American Stroke Association in San Antonio, Texas.

The Wii gaming system — produced by Nintendo, which did not fund the study — allows players to physically interact in real-time with images displayed on TV screens through the use of wireless motion-detection remote controls.

To gauge the promise of a Wii-based rehabilitation program, Saposnik and his colleagues focused on 20 stroke survivors, average age 61, all of whom were recovering from mild to moderate ischemic (caused by vessel blockage) or hemorrhagic (bleeding) strokes.

The stroke survivors were randomly divided into two groups: one group assigned to standard recreational therapy for impaired arms, involving the playing of card games or the block-stacking game Jenga, and a second group assigned to Wii-based therapy, either playing virtual tennis or cooking virtually (through “Wii tennis” or “Wii Cooking Mama”).

The Wii-based therapy involved movements that mimic the arm strokes required in a tennis match or those needed for cutting potatoes, peeling onions, slicing meat and shredding cheese.

Both the recreational and Wii-based therapies were administered in eight 60-minute sessions spread over two weeks. Both regimens were launched within two months following stroke occurrence, and both were described by the researchers as “intensive.”

After two weeks, the Wii group showed greater improvements than the recreational group in the patients’ affected arms, as measured in terms of the speed and grip strength necessary for normal motor function. No evidence of safety risk was found among the Wii group.

“Basically, we found that Wii therapy produced a 30 percent better improvement than recreational therapy in the time it took for the Wii patients to execute a task, and in how well they were able to execute a task,” said Saposnik.

Saposnik said that if the apparent benefits of Wii therapy hold up to further scrutiny, the high-tech physical therapy approach could help address two paramount challenges patients face when embarking on a recovery program: time and access.

“Rehabilitation is time-consuming, which can translate into poor compliance,” he noted. “And it’s not always available to all patients, based on cost and insurance constraints. But the high-intensity, repetitive nature of Wii therapy seems to offer quick benefits, and it’s widely available. So this could prove to be very helpful.”

“However, this is just an initial step towards expanding our understanding of the potential benefit this kind of innovative, interactive approach in neuro-rehabilitation might have following a stroke,” Saposnik cautioned.

“A larger study should be completed before making recommendations,” he said. “And that is already under way.”

Dr. William Meehan, director of the Sports Concussion Clinic at Children’s Hospital Boston, said Saposnik’s early observation makes “a lot of sense.”

“In general terms, the use of computer programs with some sort of motor movement component has certainly already been shown to be of benefit in terms of helping patients regain balance control when dealing with a sports-related concussion,” he said. “So I think this whole rehabilitation approach has great promise.”

“And it is much more convenient than normal therapy, in that patients could perhaps do this kind of thing at home,” Meehan added. “But, I would say it will probably end up best being used to augment standard therapies, because you do always want an actual therapist to monitor patient progress.”

SOURCES: Gustavo Saposnik, M.D., M.Sc., director, Stroke Outcomes Research Unit, Li Ka Shing Knowledge Institute, St. Michael’s Hospital of the University of Toronto, Toronto, Canada; William Meehan, M.D., director, Sports Concussion Clinic, Division of Sports Medicine, Children’s Hospital Boston; American Stroke Association Conference, San Antonio, Texas.

Black women are much more likely than whites to develop a potentially deadly weakening of the heart muscle around the time they give birth, a new study suggests.

Symptoms of peripartum cardiomyopathy, which typically occurs in the last month of pregnancy or the first few months after delivery, include shortness of breath, particularly when lying down. The death rate is between 15 percent and 56 percent.

“When it hits, it’s totally unexpected because these are young, otherwise healthy women with young children. [They aren't patients] you’d expect to have any sort of health problem, much less heart failure,” study corresponding author Dr. Mindy B. Gentry, a cardiologist at the Medical College of Georgia, said in a news release from the school.

In this study, Gentry and colleagues looked at cases of peripartum cardiomyopathy among women who gave birth at an MCG teaching hospital between July 2003 and July 2008. While 55 percent of the women who gave birth were white, 93 percent of the 28 women who developed peripartum cardiomyopathy were black. Of those 28 women, one died and another required a heart transplant.

Being black was the most important predictor of peripartum cardiomyopathy. Other risk factors include high blood pressure, being unmarried, smoking during pregnancy and having more than two previous pregnancies, Gentry said.

The study was published in the current issue of the Journal of the American College of Cardiology.

Gentry and colleagues said further research is needed to identify genetic and/or environmental factors associated with African descent that may explain the increased risk of peripartum cardiomyopathy in black women.

SOURCE: Medical College of Georgia, news release.