Air pollution impacts blood-vessel health. (Embargoed until 2 p.m. EST, Monday, Nov. 16.)Results from the Multi-Ethnic Study of Atherosclerosis (MESA) and Air Pollution Study confirm that air pollution appears to have short- and long-term ill effects on the health and resiliency of blood vessels. The researchers used ultrasound-guided measurements of blood-vessel diameter and responsiveness in 3,501 people participating in the ongoing MESA study, a long-term population-based study of ethnically diverse Americans in six urban U.S. regions. The researchers recorded air pollution levels in these locales the day before the blood vessel measurements were taken and estimated annual exposure to fine particulate air pollution. The results link long-term exposure to air pollution with both forearm-artery narrowing and a reduced ability of these arteries to adjust to normal changes in blood flow. In contrast, short-term exposure to air pollution only appeared to affect artery-narrowing. The study suggests that both types of changes may be early cardiovascular disease risk factors affected by the environment. NHLBI spokesperson: Diane Bild, M.D. Study investigator: Joel D. Kaufman, M.D., University of Washington, Seattle. Contact Dr. Kaufman at 206-669-7014 or joelku.washington

Fat deposits near the heart linked to clogged arteries. (Embargoed until 4 p.m. EST, Monday, Nov 16.) Along with abdominal fat, fat deposits near the heart itself (pericardial fat), have been associated with cardiovascular disease, diabetes and metabolic syndrome. Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity that increase the risk of heart disease, diabetes, and stroke. Researchers discovered that pericardial fat alone was associated with clogged arteries (detected by magnetic resonance imaging), independent of other known risk factors such as high blood pressure and smoking. The results suggest that pericardial fat may be involved in the development of atherosclerosis, or hardening of the arteries. The study involved 94 male participants in the ongoing Multi-Ethnic Study of Atherosclerosis (MESA) study, a long-term population-based study of ethnically diverse Americans in six urban U.S. regions. NHLBI spokesperson: Diane Bild, M.D. Study investigator: Cuilian Miao, M.D., Johns Hopkins University Medical Center. Dr. Miao can be reached at 443-248-1014 or cmiao2jhmi.

Combination of physician and patient intervention best lowers blood pressure. (Embargoed until 10 a.m. EST, Tuesday, November 17.) Despite widely publicized hypertension treatment guidelines for physicians and lifestyle recommendations for patients, blood pressure control rates remain low. Researchers from Duke University who conducted the Hypertension Improvement Project (HIP) tested physician and patient intervention methods in community-based primary care clinics. A total of 32 physicians and 574 patients participated in the study. Physician intervention techniques included Internet-based training (before patient intervention began), followed by self-monitoring and quarterly feedback reports for 18 months. Patient intervention practices included 20 weekly group counseling sessions focused on weight loss, a hypertension-controlling diet, exercise, and reduced sodium intake, followed by 12 brief monthly phone contacts. After six months, those who received both physician and patient intervention methods experienced the largest impact with a decrease in systolic blood pressure of 9.7 mmHg. The systolic blood pressure of those patients who received only physician intervention decreased 5.3 mmHg; the systolic blood pressure of those who had only patient intervention decreased 7.1 mmHg. However, the added benefit of the combined intervention did not persist 12 months after the period of intense patient intervention. Notably, at 18 months more than 70 percent of patients were at goal blood pressure in all study groups (compared with approximately 60 percent at baseline). Future research should focus on increasing the magnitude of the effect in each individual component and sustainability of the interaction between an informed patient and a proactive practice team. NHLBI spokesperson: Paula T. Einhorn, M.D., M.S. HIP Investigator: Laura P. Svetkey, M.D., Duke University. Contact Dr. Svetkey at svetk001mc.duke.

Source: NIH/National Heart, Lung and Blood Institute