Month: July 2011

Smoking Cessation Aid Varenicline Associated with Increased Risk for Cardiovascular Events
On June 16th, 2011 the U.S. Food and Drug Administration (FDA) announced that the smoking cessation aid varenicline (Chantix in USA and Champix in Canada) may be associated with increased risk for adverse cardiovascular events, such as heart attack, in patients with pre-existing cardiovascular disease. In a clinical trial with 700 male and female smokers with cardiovascular disease, researchers found that those taking Champix had about double the risk of a cardiovascular event than those taking a placebo drug. However, the risk associated with Champix was still very low (1.4 – 2.3% increased risk for cardiovascular event). Therefore, the FDA announced these findings not to scare away patients but to inform them of the risks, which will now be added to the “Warnings and Precautions” section on the drug label.

Champix is the brand name for varenicline — a drug that helps people quit smoking by blocking the effects of nicotine from the brain. This drug was approved by the FDA in 2006 and has been widely used to aid patients in their struggle to quit smoking. Varenicline is typically taken for 12 weeks and can more than double likelihood of quitting smoking and abstaining from smoking long-term.

Based on the recent FDA announcement regarding varenicline, it is important that patients considering using or currently taking this drug consider the pros and cons of its use. Smoking is the number one most preventable cause of death in the United States and the most preventable risk factor for heart disease. Smoking increases risk for heart attack up to six times and greatly increases risk of death. Once smokers quit, however, they experience health benefits within just a few hours and greatly reduce risk for heart disease and other conditions over time. Therefore, the increased cardiovascular risk associated with varenicline (up to 2.3%) in patients with heart disease will often outweigh the many significant risks associated with continuing smoking. However, be sure to discuss all concerns with your doctor before using a smoking cessation aid to determine which is best for you.

Questions for You to Consider
Q: What should I do if I have heart disease and am currently taking varenicline (Chantix)?

A: If you are currently taking Chantix and have heart disease, contact your healthcare provider if you experience any new or worsening symptoms of heart disease, such as chest pain or shortness of breath. You should also discuss any concerns you may have regarding Chantix with your doctor.

Q: Are there alternative smoking cessation aids other than varenicline (Chantix)?

A: There are many smoking cessation aids other than Chantix that can help smokers fight nicotine withdrawal and tobacco cravings. Bupropion (Zyban) is another type of prescription drug, normally used to treat depression that helps people stop smoking. There are also various types of nicotine replacement therapy, including patches, inhalers, lozenges, gums and nasal sprays that can help wean smokers off of cigarettes.

Not getting enough sleep can affect us in many ways — worsening our mood, decreasing productivity and affecting our ability to concentrate. And stress? We all know how that can affect our daily lives. But what about the effects of sleep deprivation and stress that are less noticeable? Not only can stress and getting little sleep have negative effects on our body, they can also have more serious long-term effects on our health.

Studies have long suggested that sleep deprivation can increase risk for heart disease and even death. The exact cause of this relationship has remained a bit of a mystery, but recent findings may help explain why getting enough sleep is essential for our heart health. Researchers from the University of Pittsburgh’s Sleep Medicine Institute found that not getting enough sleep in addition to stress can have a serious impact on our blood pressure, and ultimately our cardiovascular health. In a study involving 20 healthy young adults, they found that stress in combination with sleep deprivation increases systolic blood pressure by 10 points in comparison with being stressed but well-rested.

These findings are very interesting, as they help clarify the relationship between stress, sleep, blood pressure and heart disease. Doctors know that chronic stress is a risk factor for heart disease, as it can raise blood pressure, putting a strain on the heart. They also know that getting enough sleep each night can help us live longer and improve our heart health. But knowing how these two factors in combination can affect blood pressure will prove helpful in the fight against heart disease.

Sleep deprivation and stress often come hand in hand as partners in a vicious cycle that, if not addressed, can become chronic conditions that can affect our health. However, these study findings may help people break this cycle. By getting enough sleep, we can help reduce the effect that stress may have on our blood pressure. In turn, this can reduce stress levels, lowering blood pressure and improving heart health.

Questions for You to Consider
Q: How much sleep is recommended each night for adults?

A: When the body encounters stress, heart rate increases and blood vessels narrow, causing a temporary rise in blood pressure. When stress becomes a chronic condition, it can lead to hypertension (high blood pressure) — a risk factor for stroke, heart attack and heart disease.

Bupropion for Smoking Cessation in Patients With Acute Coronary Syndrome
First, what is Bupropion? Bupropion (marketed as Wellbutrin) is an atypical antidepressant and smoking cessation aid. Initially marketed as an antidepressant, bupropion was subsequently found to be an effective smoking cessation aid.
In a double-blind, randomized, controlled trial, the investigators compared the safety and efficacy of 8 weeks of treatment with bupropion SR or placebo for smokers hospitalized with acute coronary syndrome (ACS) as an adjunct to nurse-led hospital- and telephone-based support. Primary efficacy outcome was smoking abstinence at 1 year. Primary safety outcome was clinical events at 1 year.
A total of 151 patients were enrolled; all but two completed follow-up. Abstinence rates at 3 months were 45% versus 44% in the bupropion SR and placebo groups, respectively; 37% versus 42% at 6 months; and 31% versus 33% at 1 year.
Treatment with bupropion SR was not associated with an increase in clinical events or change in blood pressure or body mass index, but dizziness was more common compared with placebo
The authors concluded that in hospitalized patients with ACS who received continuous, intensive nurse counseling about smoking cessation, bupropion did not increase the rates of smoking abstinence.
The study results suggest that although bupropion SR is safe in patients hospitalized with ACS, it had no added value over placebo in this population when combined with intensive smoking cessation counseling. Based on this, adding bupropion to intensive counseling may be considered only in selected patients such as patients with post–myocardial infarction depression. Overall, the study emphasizes the unique opportunity to approach heavy smokers during hospitalization with ACS, in a forced nonsmoking environment, utilizing the effect of a life-threatening condition in order to achieve long-term high abstinence rates.