LONDON (Reuters) – People who are usually happy and enthusiastic are less likely to develop heart disease than those who tend to be glum, scientists said on Thursday, and boosting positive emotions could help cut heart health risks.

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U.S. researchers said their observational study was the first to show an independent relationship between positive emotions and coronary heart disease, but stressed that more work was needed before any treatment recommendations could be made.

“We desperately need rigorous clinical trials in this area. If the trials support our findings, then these results will be incredibly important in describing specifically what clinicians and/or patients could do to improve health,” Karina Davidson of Columbia University Medical Center wrote in the study in the European Heart Journal.

Heart disease is the leading killer of men and women in Europe, the United States and most industrialized countries. Together with diabetes, cardiovascular diseases accounted for 32 percent of all deaths around the world in 2005, according to the World Health Organization.

Over 10 years, Davidson and her team followed 1,739 men and women who were taking part in a large health survey in Canada.

Trained nurses assessed the participants’ heart disease risk and measured negative emotions like depression, hostility and anxiety, as well as positive emotions like joy, happiness, excitement, enthusiasm and contentment — collectively known as a “positive affect.”

The researchers ranked the “positive affect” across five levels ranging from “none” to “extreme” and found that for each rank the risk of heart disease fell by 22 percent.

Davidson, who led the research, said her findings suggested it might be possible to help prevent heart disease by enhancing people’s positive emotions.

“Participants with no positive affect were at a 22 percent higher risk of … heart attack or angina … than those with a little positive affect, who were themselves at 22 percent higher risk than those with moderate positive affect,” she wrote.

“We also found that if someone who was usually positive had some depressive symptoms at the time of the survey, this did not affect their overall lower risk of heart disease.”

Smoking, being overweight, a history of heart problems in the family and high blood pressure are traditionally seen as major risk factors for heart disease, but studies have also linked such things as intelligence and income levels to heart risks. Research published last week found intelligence is second only to smoking as a predictor of heart disease.

Davidson’s team said one possible reason for the link between happiness and heart risk could be that people who are happier tend to have longer periods of rest or relaxation, and may recover more quickly from stressful events and not spend as much time “re-living” them.

(Editing by Robin Pomeroy)

LONDON (Reuters) – People on cholesterol-lowering statins are 9 percent more likely to develop diabetes, but this small absolute risk is outweighed by the drugs’ heart-protecting properties, researchers said on Wednesday.

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The finding is unlikely to dent the use of best-selling pills like Pfizer Inc’s Lipitor and AstraZeneca Plc’s Crestor by the majority of patients.

It could, however, prompt a rethink among those with low cardiovascular risk factors who are tempted to take statins to prevent future heart disease.

Statins are among the most successful drugs of all time and have been credited with preventing millions of heart attacks and strokes. They generally have few adverse side effects.

Experts said the latest finding, published in the Lancet medical journal, should not stop patients at moderate or high heart risk from taking statins. But it could deter a headlong rush to use them even more widely.

“It will stop us putting statins in the water, as it were, and mean we give them when appropriate for the right reasons,” lead researcher Naveed Sattar of the Glasgow Cardiovascular Research Center at the University of Glasgow told Reuters.

Past trials of statins have produced conflicting results, with some — including an influential study of Crestor in 2008 — suggesting they may cause type 2 diabetes, but others pointing to an actual reduction in risk.

LIVE-SAVING DRUGS

To resolve the issue, Sattar and colleagues carried out what is known as a meta-analysis, reviewing data from 13 large randomised controlled trials of statins between 1994 and 2009, involving more than 91,000 patients.

The result showed a clear statin-diabetes link, which researchers said was unlikely to be a chance finding. But the effect was slight and treating 255 patients with statins for four years would result in only one extra case of diabetes.

For comparison, the researchers estimated that giving statins to the same group would avoid 5.4 deaths or heart attacks over four years, and nearly the same number of strokes or artery-opening procedures would also be avoided.

“Whilst a new risk of statins has been identified, the risk seems small and far outweighed by the benefits of this life-saving class of drugs,” Christopher Cannon of Boston’s Brigham and Women’s Hospital and Harvard Medical School said in an accompanying commentary.

Sattar said the effect appeared to be common to all drugs in the statin class, although whether some may be more detrimental than others required further research.

The diabetes finding contrasts with that of cancer, where another meta-analysis two years ago concluded statins neither caused nor prevented the disease.

Just why statins should be linked to diabetes risk is unclear and cannot be explained by the fact that people on the drugs live slightly longer.

Sattar said the fact that statins cut bad cholesterol, improved blood vessel function and dampened inflammation made the link surprising. But he noted they also affected the liver and muscles, which seemed to tip the balance.

(Editing by Rupert Winchester)

WASHINGTON (Reuters) – Condoms that do not fit right could break and may reduce sexual pleasure for both partners, suggesting reasons why men and women often fail to use them, researchers reported on Monday.

Health  |  Lifestyle

The study has implications for countries trying to encourage people to use condoms to reduce the risk of AIDS, other sexually transmitted infections and unwanted pregnancy, the researchers reported in the journal Sexually Transmitted Infections.

“Men and their female sex partners may benefit from public health efforts designed to promote the improved fit of condoms,” Dr. Richard Crosby of the University of Kentucky and Dr. Bill Yarber of the Kinsey Institute for Research in Sex, Gender and Reproduction in Indiana wrote.

They surveyed 436 men aged 18 to 67 for their study.

Nearly half — 45 percent — said they had used a badly fitting condom during the previous three months.

These men were more than 2 1/2 times as likely to say the condom broke or slipped when they used it. They also often reported it was irritating to wear.

The men who wore poorly fitting condoms were twice as likely to say that using one reduced sexual pleasure for themselves and their partners.

The findings may make some people giggle, but the researchers said the implications were serious. Men will often not buy condoms sized “small” or even “medium,” they said.

“Moreover, the increased likelihood that men using ill-fitting condoms will remove condoms before sex ends constitutes another form of condom failure. Fortunately, it seems likely that these problems could be rectified through education programs,” the researchers wrote.

NEW YORK (Reuters Health) – Taking charge of your toddler’s vaccination record may be the best way to ensure he or she doesn’t miss any shots, a new study suggests.

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“In our country, we think the doctor should have all the medical records,” said Dr. James McElligott, a pediatrician at the Medical University of South Carolina who worked on the study. “I like the idea of putting the ownership back in Mom’s hands and empowering her a little bit.”

When parents kept a so-called shot card, their child’s odds of being up-to-date on vaccinations rose by more than half.

Experts agree that kids aren’t getting the vaccines they need, from those for measles, mumps, and rubella to those for polio and the flu. Tapping into national vaccination data, McElligott and his colleague Dr. Paul Darden found that about 81 percent of 2-year-olds were considered up-to-date according to national guidelines.

But no one has figured out the best way to meet national goals. One potential solution is using shot cards.

In their study, McElligott and Darden, who is now at the University of Oklahoma, found that about 40 percent of the toddlers had a shot card, and 84 percent of these had up-to-date vaccinations. By contrast, only 79 percent of the children without a card had all their shots.

The timing of vaccinations is important because toddlers’ immune systems have not yet matured enough to fight off many diseases, said Dr. Robert M. Jacobson, a professor of pediatrics at the Mayo Medical School in Rochester, Minnesota, who was not involved in the study.

In principle, experts would like for at least 95 percent of children to have up-to-date-vaccinations, Jacobson added. But in the real world, numbers fall well short of that. In some poor communities, it’s about 50 percent.

The new study found that shot cards were particularly effective when mothers had little education or had many children, and when a child had multiple health-care providers.

McElligott said the findings strengthened the case for holding on to your child’s vaccination records.

“It turns out that not only does it make a big difference, but it seems to work in the people who need it the most,” he said.

Pediatric societies already recommend using the shot card as a way to ensure that children get vaccinated. But some states have been more hesitant to adopt the card than others. In Indiana, for example, the researchers found that less than one in five kids had it, while in Kansas, more than half did.

With an ever-expanding list of shots, it may be difficult for parents to keep track of which vaccines their kids already have and which ones they still need.

“You need a vaccination record in part to remind yourself and in part to share with providers when you move,” said Jacobson.

From the study, however, it is impossible to determine whether the card itself led to more vaccinations. It could be that the kinds of parents who are organized enough to keep their own records are the kinds of parents who remember to take their kids to the doctor regularly-or vice versa.

Nonetheless, Jacobson urges parents and providers to use the card. “The fact is that it doesn’t have a downside and it’s cheap,” he said.

SOURCE: Pediatrics 2010; online February 15.

LONDON (Reuters) – Expensive extra scans using MRI on breast cancer patients make no difference to the number of patients who have a repeat operation, scientists said on Friday, raising questions about whether the scans are worth it.

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A study of 1,623 women with breast cancer found that those who have a conventional triple assessment of their cancer are no more likely to be told they need a repeat operation than those assessed using magnetic resonance imaging (MRI) as well.

“Our results have important implications in routine clinical practice for the appropriate use of health-service resources and patient burden on health services,” said Lindsay Turnbull of Britain’s Hull University and Hull Royal Infirmary, who led the study. “MRI is an expensive procedure.”

Turnbull said that since the use of MRI scans in breast cancer patients is similar in many countries worldwide, her findings should be taken into account by all health authorities.

“We believe that our findings are generalisable to all healthcare providers, and show that MRI might not be necessary in this population of patients in terms of reduction of reoperation rates,” she wrote in the Lancet medical journal.

Siemens, General Electric and Philips Electronics are among the major makers scanning technology like magnetic resonance imaging, computed tomography (CT) and positron emission tomography (PET).

The industry has drawn some criticism in the United States where use of expensive scans has risen sharply in recent years.

Critics say many scans are unnecessary and often don’t improve results.

Turnbull’s study took place in 45 centers across Britain where the 1,623 women were all given a standard triple assessment — a clinical examination, an x-ray or ultrasound image of the breast, and lab tests to assess the tumor’s pathology — and then received either MRI or no further scans.

The researchers found 19 percent in the MRI group needed reoperation versus 19 percent of those who had no MRI.

Yet while the outcomes for patients were virtually the same, the costs — both in terms of hospital resources and patient time — were higher for those who had MRI scans, they said.

Breast cancer is the most common cancer in women worldwide, accounted for around 16 percent of all female cancers.

It kills around 519,000 people globally each year, but the World Health Organization says survival rates vary widely from more than 80 percent in the United States, Sweden and Japan to under 40 percent in low-income countries.

The researchers said their findings should benefit Britain taxpayer-funded National Health Service (NHS) since they show MRI might be unnecessary in some scenarios and “could assist in improved use of NHS services.”

(Editing by Dominic Evans)