Mayo Clinic Women's HealthSource - January 30, 2002

Tuesday, January 29, 2002

New Indicators for Heart Disease

SCOTTSDALE, Ariz. - You know that high cholesterol puts you at risk for coronary artery disease (CAD), but did you know that an estimated 50 percent of people who have heart attacks have normal cholesterol levels? According to the January issue of Mayo Clinic Women's HealthSource, medical researchers have been looking for other indicators - beyond high blood pressure, smoking and diabetes - that might put people at risk for CAD. Chief among them are C-reactive protein (CRP), homocysteine, fibrinogen and lipoprotein(a), also known as Lp(a).

CRP is manufactured when body tissue is injured or inflamed. Researchers believe that elevated CRP can be the result of atherosclerosis - an inflammatory-like process in the arteries. Atherosclerosis is the most common form of CAD.

Homocysteine is an amino acid that, in large amounts, can damage blood vessels in the heart and brain. High levels of homocysteine can run in families, and regular folic acid intake can help keep levels normal.

Fibrinogen is a blood-clotting protein manufactured by the body. It can indicate inflammation and an increased likelihood of blood clots. Increased levels of fibrinogen are associated with an increased risk of CAD, but the exact reason why is unknown. Fibrinogen also is higher in smokers. Quitting smoking and exercising may reduce fibrinogen levels.

Lp(a) is a cholesterol-carrying molecule that also carries a protein that might inhibit the body's ability to dissolve blood clots. This, in turn, may increase risk of heart attacks.

Currently, there isn't enough information about these emerging risk factors to make regular screening useful. However, if you have a family history of heart disease, these factors may play a more important role in your health.

Food Safety Is in Your Hands

SCOTTSDALE, Ariz. - The Centers for Disease Control and Prevention say that there are an estimated 76 million cases of food-borne infection - commonly called food poisoning - each year. Of those, more than 300,000 people are admitted to the hospital and more than 5,000 die. The January issue of Mayo Clinic Women's HealthSource says that you can help prevent food-borne infections at home by following these recommendations from the American Dietetic Association and ConAgra Foundation.

• Wash your hands. Scrub for at least 20 seconds before and after handling food. Be sure to wash hands when switching from raw meat, poultry or seafood to other foods such as raw vegetables.
• Wash surfaces, countertops, appliances, utensils and cutting boards with hot, soapy water.
• Use two cutting boards, one for raw meats and the other for ready-to-eat foods such as vegetables and bread. Discard cutting boards with cracks.
• Wash dishcloths and towels often. Use the hot cycle on your washing machine.
• Wash produce with tap water and a clean produce brush before eating. Trim away damaged or bruised areas.
• Don't place washed produce back in its original container. Refrigerate produce within two hours of peeling or cutting.
• Thaw meat in the refrigerator or microwave - not on the countertop.
• Cook foods to proper temperatures. Use a meat thermometer to be sure. Ground meat should register at least 160 F; other beef 160 to 170 F; poultry 170 to 180 F; pork 160 to 170 F and fish until it flakes easily.
• Avoid eating raw meats, seafood or eggs.
• Store food in leak-proof bags or containers at proper temperatures. The refrigerator should be set below 40 F.

Beyond Mammograms

SCOTTSDALE, Ariz. - Recently, a small study in the Journal of the National Cancer Institute suggested that magnetic resonance imaging (MRI) might be beneficial in diagnosing breast cancer. This news leaves many women wondering if they should push for this test over the standard mammogram. The good news, according to the Mayo Clinic Women's HealthSource, is that most women will be well served by mammography and don't need an MRI - the costly test isn't always covered by health insurance. The other good news is that women at high risk of breast cancer - either due to family history or the presence of genetic mutations - may truly benefit from this high-tech test.

The study compared mammograms and MRIs in 179 women at high risk for early onset breast cancer. Most of the women were under age 50. Thirteen cases of breast cancer were found. MRI detected all of them. Mammogram detected only six. Researchers point out that younger women in particular have dense breast tissue that is more difficult to evaluate with a mammogram than with MRI. Also, MRIs are valuable to help clarify inconclusive mammograms or breast ultrasounds.

More testing is needed to confirm the value of MRI in breast cancer screenings. In the meantime, it will continue to be an important complementary tool in the detection of breast cancer. ###

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