It's a startling statistic. Cardiovascular diseases afflict almost a quarter of the U.S. adult population and account for 38.5 percent of all deaths, making these afflictions of the heart by far the nation's largest killer.
That's why the American Heart Association's annual Scientific Sessions, held Nov. 7-10 in New Orleans, was one of the most important medical meetings of the year, drawing some 30,000 attendees. This year's presentations highlighted some important new advances against obesity and heart failure. Among them: a "jacket" that fits over enlarged hearts to prevent further swelling.
Most of the research focused on new uses for older drugs, which indicates that researchers are having a tough time coming up with new biological targets for heart disease. Yet, the value of a new target was demonstrated by Acomplia, the seeming miracle obesity drug from Sanofi-Synthelabo that blocks a cellular receptor found in the brain and fat cells involved with experiencing pleasurable sensations.
By blocking this receptor, Acomplia dampens appetite. It's now the first drug to prove that it can help obese people take weight off and keep it off for more than one year. Beyond this consideration, it also fights nicotine addiction, and can improve cholesterol levels and various other heart disease risk factors. Sanofi expects to file with the Food and Drug Administration for approval of Acomplia in 2005.
A breakthrough like Acomplia is rare, however. As in other fields of medicine, often it's new uses for older drugs that make for interesting discoveries. Hence, researchers try to figure out how to make existing drugs work better.
Scientists from Walter Reed Army Medical Center in Washington, for example, reported that so-called "good" cholesterol (HDL-C) levels could be raised even higher when the niacin-based drug Niaspan, made by Kos Pharmaceuticals, is taken along with a statin, which lowers the "bad" cholesterol (LDL-C). This study raised the likelihood that doctors increasingly will focus on raising "good" cholesterol along with lowering bad.
Such combinations are becoming more the norm in treating heart disease. In fact, a key report at the meeting focused on a combo of two older drugs that significantly improved the outlook for patients with chronic heart failure -- but only if they are African American.
Change for the better
In a controversial move, Lexington, Mass.-based NitroMed decided to test its drug BiDil, a combination of two 30-year-old heart drugs, in African Americans only, after the drugs failed to show little effect in earlier trials involving patients of all races. The gamble worked, but it also raised questions about why one racial group would respond more than others to a drug. Moreover, it raises new questions about race-based medical research.
Ultimately, members of all groups would do better if heart disease can be prevented in the first place. At the meeting, one researcher after another presented studies showing the benefits of a healthy diet and exercise -- reminding all that a few lifestyle changes would do more good than all the drugs in the world.