ISLAMABAD (APP) Home based rehabilitation is no worse than hospital- based programmes for helping patients get better after a heart attack or surgery to clear blocked heart arteries. It has been known for long that the risk of death is lower among heart patients who participate in exercise-based rehabilitation programmes, but most patients do not complete these programmes. Women, older people, and minorities are even less likely to enter these programmes and complete them, Health News reported. To investigate whether offering patients the chance to do a rehabilitation programme at home might improve adherence, researchers from the UK randomly assigned 525 patients living in Englands West Midlandss region to a home or traditional hospital-based rehab programme. The hospital programmes, offered at four different centres were 8 to 12 weeks long, and began 4 to 8 weeks after a patients heart attack or revascularization surgery. The home programmes included visits from rehab nurses at 10 days, 6 weeks and 12 weeks after discharge from the hospital and a telephone contact 3 weeks after discharge, as well as additional visits if the nurse thought them necessary. Both programmes were based on the Heart Manual developed that recommends patients to gradually increase their activity until they are doing at least 15 minutes of moderate intensity exercise daily. It was previously believed that HDL production occurred throughout the body. Some HDL production does occur in the walls of blood vessels. These results profoundly alter our concept of how HDL is manufactured in the body and establish the liver as the single most important source of HDL in a mouse model, Parks said. Obese children face heart attacks at 40 THE obese teenagers of today are heading for heart attacks in their forties, experts have warned. Cardiac specialists said that while the number of people dying from heart disease was falling, it meant more were living with the often-devastating consequences of the condition. Leading cardiologist Peter Weissberg warned that the current decline could be the lull before the storm as rates of childhood obesity continued to rise. Dieticians last night said that people could even start having problems in their twenties and thirties as obesity in toddlers increased. Prof Weissberg, medical director of the British Heart Foundation (BHF) said: The current cohort of obese teenagers is heading for heart attacks in their forties if they get Type 2 diabetes, and many of them will. He said a large section of the public did not realise what impact living with heart disease could have. We can be pretty powerless to do anything for them in hospital so we just send them home to slowly die, he said. Prof Weissberg said of all those patients with heart disease, between 20-30 per cent would be housebound and in many cases confined to one room because their condition made them breathless and exhausted. He said the current provision of community heart nurses funded by the NHS was patchy and more were urgently needed to improve patients quality of life in their final months and years. A survey of more than 1,000 people carried out by the BHF found that people under- estimated how difficult it could be to live with heart disease. Prof Weissberg added: This survey suggests people do not fear heart disease as much as cancer or Alzheimers because they think that while they may have to live with heart disease for many years, it would be a relatively easy disease to live with. Sadly, this is rarely the case. While some heart patients are lucky to carry on with only minor lifestyle changes, thousands of people each year have to deal with the fact their hearts are permanently damaged. Dympna Pearson, committee member and former chairwoman of the charity Dieticians Working In Obesity Management UK, said: The younger the child becomes obese, the sooner they are going to have problems. I am seeing more and more toddlers who are obese, which will give them problems in their twenties and thirties. Tracking Kidney Patients Cardiac Risks New blood tests designed to assess a kidney patients cardiac death risk still arent as effective as traditional risk factors such hypertension or smoking in evaluating an older patients survival odds, a new study finds. The message from this study is clear: To reduce heart disease and stroke deaths in older people with chronic kidney disease, we need to target and control traditional risk factors, study co-author Dr. Teri Manolio, director of the U.S. National Heart, Lung, and Blood Institute (NHLBI) epidemiology and biometry program, said in a prepared statement. The findings come from the NHLBI-funded longitudinal Cardiovascular Health Study. That effort focused on traditional and emerging risk factors for heart disease death in more than 5,800 men and women over age 65 in four U.S. communities. It found that study participants with chronic kidney disease who also had other cardiovascular risk factors diabetes, systolic high blood pressure, left ventricular hypertrophy (enlarged heart), history of smoking and a sedentary lifestyle were at an increased risk of cardiovascular-related death compared to kidney disease patients. without these characteristics. Among these same patients, newly discovered risk factors such as elevated levels of C-reactive protein (linked to inflammation), and clotting agents such as fibrinogen or blood clotting factor VIIIc, werent as strongly associated with increased risk of death from cardiovascular causes. Fortunately for patients, there are many effective interventions for reducing traditional risk factors, Manolio said. These include lowering blood sugar and reducing high blood pressure, increasing physical activity and quitting smoking.Home care good for heart patients: Study