New virus 'not yet global threat'

4 July 2013 Last updated at 20:40 ET By James Gallagher Health and science reporter, BBC News

The deadly coronavirus that emerged last year does not currently appear to be infectious enough to pose a global threat, researchers say.

Their analysis of 55 cases of Middle East respiratory-syndrome coronavirus, published in the Lancet, indicated the virus struggled to spread in people.

But the virus may be mutating, which means it could become a much greater threat.

It is similar to viruses that cause Sars and the common cold.

So far there have been 77 confirmed cases and 41 deaths. Most infections come from an unidentified animal source, but there have been cases in which the virus has spread between people.

On Friday it was revealed that the World Health Organization has convened a telephone conference of its International Health Relations Emergency Committee next week.

The committee has only met once before ,during the 2009 H1N1 flu outbreak.

It said the meeting was a proactive approach, rather than a sign the situation was escalating.

Going global?

The team at the Pasteur Institute in Paris tried to calculate the average number of people each infected person passed the virus on to - what is known as a "basic reproduction value".

Continue reading the main story

My concern is that people read this and not worry about it, but the opposite is true. This is the perfect time to identify the animal host and stop it"

End Quote Prof Arnaud Fontanet Pasteur Institute

A high value means the number of cases can increase rapidly and potentially spread around the world, but a number less than one would mean the virus was destined to fade away.

The study indicated each patient would, on average, infect 0.69 others. So three infected patients would pass the virus on to just two people.

Prof Arnaud Fontanet told the BBC: "The virus as it currently stands is not able to start an epidemic.

"My concern is that people read this and not worry about it, but the opposite is true. This is the perfect time to identify the animal host and stop it."

In the early stages of Sars in late 2002 it had a basic reproduction value of 0.8, but eventually the virus mutated and could spread more easily.

"Sars' adaption to humans took just several months, whereas Middle East respiratory syndrome coronavirus has already been circulating more than a year in human populations without mutating into a pandemic form," Prof Arnaud Fontanet added.

There have been cases in Jordan, Qatar, Saudi Arabia and the United Arab Emirates. Additional cases in France, Germany, Italy, Tunisia and the UK were linked to travel to the Middle East.

On Thursday, the death of a patient in the UK was announced. He had been treated for kidney failure and severe breathing difficulties since being flown in from Qatar in September.

Dr Benjamin Neuman, from the University of Reading, said: "The authors have done their best to predict how Middle East respiratory syndrome will spread based on the few cases that we know about, and found that the virus appears to be slowly dying out.

"But other work has shown that the virus is changing, and that change makes it difficult to predict the future of Middle East respiratory syndrome.

"What most concerns me is that people are still becoming infected from an unknown source."

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Surgeon death data 'not robust'

4 July 2013 Last updated at 20:40 ET

Publishing death rates for individual surgeons will not spot poor performers in certain fields because too few operations take place, a study finds,

In June, the NHS in England published the first data, including death rates, for vascular surgeons, with nine more specialist areas to follow.

But the paper says it would be better if some data was shown per hospital.

NHS England said the reason for the initiative was transparency - not to try to spot poorly performing doctors.

'Statistically reliable?'

The team from the London School of Hygiene and Tropical Medicine used hospital data from England to look at death rates in four specialist areas,

These were adult heart surgery, bowel cancer resection (removing part of the colon or rectum), oesophagectomy (removing the oesophagus) and gastrectomy (taking out all or part of the stomach), and hip fracture surgery.

Continue reading the main story

"Start Quote

Results for individual surgeons should be based on outcomes that are fairly frequent, and fortunately, mortality is not one of them "

End Quote Dr Jenny Neuburger, Study author

They then assessed how many procedures would be necessary for reliable detection of poor performance, and how many surgeons in English NHS hospitals actually do that number of operations.

The researchers concluded enough heart and hip operations were carried out to make death rate data statistically reliable.

But they suggest the same is not true for the other categories they studied.

For example, the median number of bowel cancer resections carried out by an individual surgeon was nine - meaning the number was too small and too easily affected by a range of other factors, such as one surgeon doing more complex operations than their peers on sicker patients.

In addition, death rates after hip surgery are extremely low and so would not give a fair reflection of the procedure's success.

The researchers suggest post-operative quality of life might be a better measure for this specialty.

Other factors

They conclude that in many areas, individual performance data would not be robust - and may give a false sense of complacency because "an absence of evidence could be falsely interpreted as evidence of acceptable performance".

Continue reading the main story

"Start Quote

I have discovered that the few surgeons with the worst apparent records are to be flagged as an 'alert' and their work will be reviewed"

End Quote

Dr Jenny Neuburger, who led the research, said: "The reporting of results for individual surgeons should be based on outcomes that are fairly frequent, and fortunately, from the point of view of patients, mortality is not one of them.

"For specialties in which most surgeons do not perform sufficient numbers of operations to reliably assess their outcomes, reporting should be at the level of the surgical team or hospital, and not the surgeon."

Prof Jan van der Meulen, who also worked on the paper, said there should be as much transparency as possible.

But he said: "It's not just the surgeon who has an impact - it's the whole care package, the whole team, the pre and post-operative care."

Prof Norman Williams, president of the Royal College of Surgeons, said: "The driving force behind the publication of surgeon-level outcomes data is to improve surgical performance and allow patients to find out more about the quality of care provided by hospitals and individual surgeons."

He said it was "an extremely challenging project" and particularly complex for cancer operations where there were "low volumes of surgery".

But Prof Williams said: "This is the beginning of a new approach to transparency in healthcare.

Continue reading the main story

"Start Quote

Auditing some areas of surgery is undeniably easier than others"

End Quote Prof Norman Williams Royal College of Surgeons

"Auditing some areas of surgery is undeniably easier than others.

"This is by no means a reason not to measure outcome as long as the complexities are understood and interpreted correctly - and the profession is committed to doing so, no matter how difficult it may be."

And Prof Sir Bruce Keogh, medical director at NHS England, said: "The authors have misunderstood the purpose of public disclosure of information.

"It is not a statistical exercise to identify poor performers. Rather it is an exercise to provide information on activity and outcomes, to focus minds on improving results and to assure the public that the NHS offers high quality surgery.

"But it does raise the question as to whether it is better to have your complex operation performed by a surgeon doing a lot of that operation or only a few."

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'Named clinician' for older patients

4 July 2013 Last updated at 23:05 ET

Please turn on JavaScript. Media requires JavaScript to play.

Jeremy Hunt: We're asking NHS England to ensure there is a named clinician responsible for every vulnerable older person

Elderly people in England are to have a named clinician responsible for their care when they leave hospital, the health secretary has said.

The initiative was unveiled at an event to celebrate the 65th anniversary of the National Health Service.

Mr Hunt says it will to help create a "more personal service".

But Labour have said the NHS' anniversary is overshadowed by a "real sense of worry about where the NHS is heading".

'Wrong path'

At an event at Guy's Hospital in London, Mr Hunt proposed that a named doctor or nurse would be responsible for vulnerable patients "at all times".

He said: "As we celebrate, we also reflect. The world today is very different to 1948. The old model was curable illnesses where you went into hospital unwell and came out better.

"Yet most people now leave hospital with long-term conditions which need to be supported and managed at home.

"So the challenge today is to provide integrated, co-ordinated, out of hospital care. Something where the NHS, with our tradition of family doctors and primary care, could lead the world.

"But to do that we need to know that there is a clinician accountable for vulnerable older people in the community, just as there is a consultant responsible for them in hospital...

"They should be named so that patients, families and carers all know where the buck stops."

Mr Hunt said the eight million people with diabetes, chronic obstructive pulmonary disease and heart disease "need radically different models of care to what the NHS has been accustomed to" and could benefit from the plan.

The "named clinician" proposal is part of a consultation being launched on an updated "NHS Mandate".

Continue reading the main story

Patients and staff have precious little faith that the NHS is safe in this government's hands"

End Quote Andy Burnham Shadow health secretary

Dr Peter Carter, general secretary of the Royal College of Nursing said: "Dealing with rising numbers of older people in need of care is a challenge across the NHS, and the infrastructure of the service must reflect that need.

"It is vital that the named clinicians in this role have the capacity and the organisational support to join up services so that patients experience a seamless journey from home to hospital and back again."

And Jeremy Hughes, chief executive of the Alzheimer's Society, said: "Having a named clinician responsible for the care of vulnerable individuals has the potential to transform the experience people with dementia have of health and social care.

"However, it's crucial that the doctors and nurses who are assigned are accessible, understand dementia and how to provide the best care for people with the condition."

Digital records

The health secretary also launched a new organisation, Genomics England, to map the DNA of 100,000 patients with cancer and rare diseases.

Mr Hunt said: "If we really want this to be the century of personalised care, then we must radically improve our understanding of disease and how to design treatments better tailored to individual patients.

"Combine the information from genomes with the information in digital medical records - all done with proper consent - and you have the most remarkable treasure trove about the make-up of diseases with huge clues as to how to treat them."

Shadow health secretary Andy Burnham said the NHS anniversary was being overshadowed by "a real sense of worry about where the NHS is heading under David Cameron".

"Patients and staff have precious little faith that the NHS is safe in this government's hands," he said.

"Cameron's reorganisation has put the NHS on the wrong path - a fast-track to fragmentation and privatisation."

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Surgeon death data 'not robust'

4 July 2013 Last updated at 20:40 ET

Publishing death rates for individual surgeons will not spot poor performers in certain fields because too few operations take place, a study finds,

In June, the NHS in England published the first data, including death rates, for vascular surgeons, with nine more specialist areas to follow.

But the paper says it would be better if some data was shown per hospital.

NHS England said the reason for the initiative was transparency - not to try to spot poorly performing doctors.

'Statistically reliable?'

The team from the London School of Hygiene and Tropical Medicine used hospital data from England to look at death rates in four specialist areas,

These were adult heart surgery, bowel cancer resection (removing part of the colon or rectum), oesophagectomy (removing the oesophagus) and gastrectomy (taking out all or part of the stomach), and hip fracture surgery.

Continue reading the main story

"Start Quote

Results for individual surgeons should be based on outcomes that are fairly frequent, and fortunately, mortality is not one of them "

End Quote Dr Jenny Neuburger, Study author

They then assessed how many procedures would be necessary for reliable detection of poor performance, and how many surgeons in English NHS hospitals actually do that number of operations.

The researchers concluded enough heart and hip operations were carried out to make death rate data statistically reliable.

But they suggest the same is not true for the other categories they studied.

For example, the median number of bowel cancer resections carried out by an individual surgeon was nine - meaning the number was too small and too easily affected by a range of other factors, such as one surgeon doing more complex operations than their peers on sicker patients.

In addition, death rates after hip surgery are extremely low and so would not give a fair reflection of the procedure's success.

The researchers suggest post-operative quality of life might be a better measure for this specialty.

Other factors

They conclude that in many areas, individual performance data would not be robust - and may give a false sense of complacency because "an absence of evidence could be falsely interpreted as evidence of acceptable performance".

Continue reading the main story

"Start Quote

I have discovered that the few surgeons with the worst apparent records are to be flagged as an 'alert' and their work will be reviewed"

End Quote

Dr Jenny Neuburger, who led the research, said: "The reporting of results for individual surgeons should be based on outcomes that are fairly frequent, and fortunately, from the point of view of patients, mortality is not one of them.

"For specialties in which most surgeons do not perform sufficient numbers of operations to reliably assess their outcomes, reporting should be at the level of the surgical team or hospital, and not the surgeon."

Prof Jan van der Meulen, who also worked on the paper, said there should be as much transparency as possible.

But he said: "It's not just the surgeon who has an impact - it's the whole care package, the whole team, the pre and post-operative care."

Prof Norman Williams, president of the Royal College of Surgeons, said: "The driving force behind the publication of surgeon-level outcomes data is to improve surgical performance and allow patients to find out more about the quality of care provided by hospitals and individual surgeons."

He said it was "an extremely challenging project" and particularly complex for cancer operations where there were "low volumes of surgery".

But Prof Williams said: "This is the beginning of a new approach to transparency in healthcare.

Continue reading the main story

"Start Quote

Auditing some areas of surgery is undeniably easier than others"

End Quote Prof Norman Williams Royal College of Surgeons

"Auditing some areas of surgery is undeniably easier than others.

"This is by no means a reason not to measure outcome as long as the complexities are understood and interpreted correctly - and the profession is committed to doing so, no matter how difficult it may be."

And Prof Sir Bruce Keogh, medical director at NHS England, said: "The authors have misunderstood the purpose of public disclosure of information.

"It is not a statistical exercise to identify poor performers. Rather it is an exercise to provide information on activity and outcomes, to focus minds on improving results and to assure the public that the NHS offers high quality surgery.

"But it does raise the question as to whether it is better to have your complex operation performed by a surgeon doing a lot of that operation or only a few."

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New virus 'not yet global threat'

4 July 2013 Last updated at 20:40 ET By James Gallagher Health and science reporter, BBC News

The deadly coronavirus that emerged last year does not currently appear to be infectious enough to pose a global threat, researchers say.

Their analysis of 55 cases of Middle East respiratory-syndrome coronavirus, published in the Lancet, indicated the virus struggled to spread in people.

But the virus may be mutating, which means it could become a much greater threat.

It is similar to viruses that cause Sars and the common cold.

So far there have been 77 confirmed cases and 41 deaths. Most infections come from an unidentified animal source, but there have been cases in which the virus has spread between people.

Going global?

The team at the Pasteur Institute in Paris tried to calculate the average number of people each infected person passed the virus on to - what is known as a "basic reproduction value".

Continue reading the main story

My concern is that people read this and not worry about it, but the opposite is true. This is the perfect time to identify the animal host and stop it"

End Quote Prof Arnaud Fontanet Pasteur Institute

A high value means the number of cases can increase rapidly and potentially spread around the world, but a number less than one would mean the virus was destined to fade away.

The study indicated each patient would, on average, infect 0.69 others. So three infected patients would pass the virus on to just two people.

Prof Arnaud Fontanet told the BBC: "The virus as it currently stands is not able to start an epidemic.

"My concern is that people read this and not worry about it, but the opposite is true. This is the perfect time to identify the animal host and stop it."

In the early stages of Sars in late 2002 it had a basic reproduction value of 0.8, but eventually the virus mutated and could spread more easily.

"Sars' adaption to humans took just several months, whereas Middle East respiratory syndrome coronavirus has already been circulating more than a year in human populations without mutating into a pandemic form," Prof Arnaud Fontanet added.

There have been cases in Jordan, Qatar, Saudi Arabia and the United Arab Emirates. Additional cases in France, Germany, Italy, Tunisia and the UK were linked to travel to the Middle East.

On Thursday, the death of a patient in the UK was announced. He had been treated for kidney failure and severe breathing difficulties since being flown in from Qatar in September.

Dr Benjamin Neuman, from the University of Reading, said: "The authors have done their best to predict how Middle East respiratory syndrome will spread based on the few cases that we know about, and found that the virus appears to be slowly dying out.

"But other work has shown that the virus is changing, and that change makes it difficult to predict the future of Middle East respiratory syndrome.

"What most concerns me is that people are still becoming infected from an unknown source."

21.24 | 0 komentar | Read More

'Named clinician' for older patients

4 July 2013 Last updated at 23:05 ET

Elderly people in England are to have a named clinician responsible for their care when they leave hospital, the health secretary has said.

The initiative was unveiled at an event to celebrate the 65th anniversary of the National Health Service.

Mr Hunt says it will to help create a "more personal service".

But Labour have said the NHS' anniversary is overshadowed by a "real sense of worry about where the NHS is heading".

'Wrong path'

At an event at Guy's Hospital in London, Mr Hunt proposed that a named doctor or nurse would be responsible for vulnerable patients "at all times".

He said: "As we celebrate, we also reflect. The world today is very different to 1948. The old model was curable illnesses where you went into hospital unwell and came out better.

"Yet most people now leave hospital with long-term conditions which need to be supported and managed at home.

"So the challenge today is to provide integrated, co-ordinated, out of hospital care. Something where the NHS, with our tradition of family doctors and primary care, could lead the world.

"But to do that we need to know that there is a clinician accountable for vulnerable older people in the community, just as there is a consultant responsible for them in hospital...

"They should be named so that patients, families and carers all know where the buck stops."

Mr Hunt said the eight million people with diabetes, chronic obstructive pulmonary disease and heart disease "need radically different models of care to what the NHS has been accustomed to" and could benefit from the plan.

The "named clinician" proposal is part of a consultation being launched on an updated "NHS Mandate".

Continue reading the main story

Patients and staff have precious little faith that the NHS is safe in this government's hands"

End Quote Andy Burnham Shadow health secretary

Dr Peter Carter, general secretary of the Royal College of Nursing said: "Dealing with rising numbers of older people in need of care is a challenge across the NHS, and the infrastructure of the service must reflect that need.

"It is vital that the named clinicians in this role have the capacity and the organisational support to join up services so that patients experience a seamless journey from home to hospital and back again."

And Jeremy Hughes, chief executive of the Alzheimer's Society, said: "Having a named clinician responsible for the care of vulnerable individuals has the potential to transform the experience people with dementia have of health and social care.

"However, it's crucial that the doctors and nurses who are assigned are accessible, understand dementia and how to provide the best care for people with the condition."

Digital records

The health secretary also launched a new organisation, Genomics England, to map the DNA of 100,000 patients with cancer and rare diseases.

Mr Hunt said: "If we really want this to be the century of personalised care, then we must radically improve our understanding of disease and how to design treatments better tailored to individual patients.

"Combine the information from genomes with the information in digital medical records - all done with proper consent - and you have the most remarkable treasure trove about the make-up of diseases with huge clues as to how to treat them."

Shadow health secretary Andy Burnham said the NHS anniversary was being overshadowed by "a real sense of worry about where the NHS is heading under David Cameron".

"Patients and staff have precious little faith that the NHS is safe in this government's hands," he said.

"Cameron's reorganisation has put the NHS on the wrong path - a fast-track to fragmentation and privatisation."

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Active brain 'keeps dementia at bay'

3 July 2013 Last updated at 19:54 ET By Helen Briggs BBC News

Keeping mentally active by reading books or writing letters helps protect the brain in old age, a study suggests.

A lifetime of mental challenges leads to slower cognitive decline after factoring out dementia's impact on the brain, US researchers say.

The study, published in Neurology, adds weight to the idea that dementia onset can be delayed by lifestyle factors.

An Alzheimer's charity said the best way to lower dementia risk was to eat a balanced diet, exercise and stay slim.

In a US study, 294 people over the age of 55 were given tests that measured memory and thinking, every year for about six years until their deaths.

Continue reading the main story

The brain that we have in old age depends in part on what we habitually ask it to do in life"

End Quote Dr Robert Wilson Rush University Medical Center

They also answered a questionnaire about whether they read books, wrote letters and took part in other activities linked to mental stimulation during childhood, adolescence, middle age, and in later life.

After death, their brains were examined for evidence of the physical signs of dementia, such as brain lesions and plaques.

The study found that after factoring out the impact of those signs, those who had a record of keeping the brain busy had a rate of cognitive decline estimated at 15% slower than those who did not.

Dr Robert Wilson, of Rush University Medical Center in Chicago, who led the study, said the research suggested exercising the brain across a lifetime was important for brain health in old age.

He told BBC News: "The brain that we have in old age depends in part on what we habitually ask it to do in life.

"What you do during your lifetime has a great impact on the likelihood these age-related diseases are going to be expressed."

Cognitive reserve

Dementia exacts a heavy toll on society, with more than 820,000 people in the UK alone currently living with the condition.

Commenting on the study, Dr Simon Ridley, head of research at Alzheimer's Research UK, said there was increasing evidence mental activity may help protect against cognitive decline. But the underlying reasons for this remained unclear.

"By examining donated brain tissue, this study has shed more light on this complex question, and the results lend weight to the theory that mental activity may provide a level of 'cognitive reserve', helping the brain resist some of the damage from diseases such as Alzheimer's," he said.

Dr James Pickett, head of research at the Alzheimer's Society, added: "More research and bigger studies are needed, but in the meantime reading more and doing crosswords can be enjoyable and certainly won't do you any harm.

"The best way to reduce your risk of developing dementia is to eat a balanced diet, exercise regularly and maintain a healthy weight."

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Man dies from new coronavirus in UK

4 July 2013 Last updated at 05:31 ET

A man infected with the novel Middle East respiratory syndrome coronavirus (MERS-nCV) has died in a UK hospital.

The patient, who was 49, was being treated for kidney failure and acute respiratory syndrome.

He was flown to St Thomas' Hospital in London from Qatar in September last year.

There have now been 41 deaths from the virus, which emerged last year and is similar to those that cause Sars and the common cold.

A hospital statement said: "Guy's and St Thomas' can confirm that the patient with severe respiratory illness due to novel coronavirus (MERS-nCV) sadly died on Friday 28 June, after his condition deteriorated despite every effort and full supportive treatment."

Around the world, 77 people are known to have been infected with the virus. It causes fever, a cough and breathing difficulties. Most patients have developed pneumonia.

Cases have been confirmed in Jordan, Qatar, Saudi Arabia, the United Arab Emirates, France, Germany, Italy, Tunisia and the UK.

In a statement in May the World Health Organization (WHO) said: "The greatest global concern is about the potential for this new virus to spread.

"This is partly because the virus has already caused severe disease in multiple countries, although in small numbers, and has persisted in the [Middle East] region since 2012.

"Of most concern, however, is the fact that the different clusters seen in multiple countries increasingly support the hypothesis that when there is close contact this novel coronavirus can transmit from person to person."

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'Urgent steps' needed at hospital

4 July 2013 Last updated at 05:50 ET

The government must take urgent action to improve care at a Greater Manchester hospital being probed for high death rates, said a patients' association.

Two senior bosses at Tameside Hospital resigned on Wednesday after it emerged two independent reviews criticised the hospital for poor patient care.

The Patients Association's Dr Mike Smith said "urgent steps to up the ante" at the hospital were needed.

Tameside is one of 14 hospitals under scrutiny for its high death rates.

'Up the ante'

Dr Smith claimed the association received a number of complaints in recent weeks about the hospital including one from a consultant who works there. He wrote to Health Secretary Jeremy Hunt and the Care Quality Commission with concerns on 14 June but is yet to receive replies.

He said: "Jeremy Hunt now needs to take pretty urgent steps to up the ante and see a proper quality of care is provided for the people of Manchester covered by this particular hospital.

"It would be good from our point of view - as the voice of the patients of the nation - to know that that is something that can happen."

He said concerns included the standards of nursing care for the elderly in particular "being way, way below what it should be", "increasing waits" and "services just not fit for purpose".

Dr Smith added: "It is now time severe action was taken."

Two reviews, seen by the Guardian newspaper, found problems in the hospital's A&E and medical assessment units.

One report, commissioned by Tameside Hospital, found up to eight A&E patients at a time were waiting in a corridor, with one left for seven hours. It said weak leadership had affected "patient outcomes".

The hospital said the reviews were commissioned because of staff concerns and it had responded with an action plan.

A Department of Health spokesman said it took any concerns about care failings seriously and always took action, including passing them to regulators for examination.

He said: "The government ordered a review into standards at Tameside in February and we expect the report will be published shortly.

"In addition, standards at Tameside are also being examined by CQC."

The news of the reports was followed by the announcement of the resignation of Christine Green, chief executive of Tameside Hospital Trust, and Medical Director Tariq Mahmood.

Take failings seriously

A trust spokesman said Mr Mahmood had offered his resignation three months ago, for family reasons, but the trust delayed its announcement until a replacement was found.

Ms Green, who has been chief executive since 1988, said she decided to resign last week after finalising plans for a "listening exercise" to hear what local people and groups such as GPs thought of the hospital.

She said it had become clear her position "was no longer helpful to the organisation".

A Department of Health spokesman said it took any concerns about care failings seriously and always took action, including passing them to regulators for examination.

He said: "The government ordered a review into standards at Tameside in February and we expect the report will be published shortly.

"In addition, standards at Tameside are also being examined by CQC."

In February, NHS medical director Prof Bruce Keogh announced Tameside was one of 14 hospitals that he would be investigating over its high death rates.

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Good night's sleep 'protects heart'

2 July 2013 Last updated at 20:34 ET By Helen Briggs BBC News

Seven or more hours' sleep a night boosts the benefits to the heart of a healthy lifestyle, research suggests.

According to a large study, traditional advice on exercise, diet, drinking and smoking reduced deaths from heart disease or stroke, but even more lives were saved by also having enough sleep.

Advice on getting enough sleep could have a substantial impact on public health, say European researchers.

In theory, many heart and stroke deaths could be prevented or postponed.

A team in the Netherlands tracked heart disease and strokes in more than 14,000 men and women for more than a decade.

By the end of the study, about 600 individuals had suffered heart disease or stroke, and 129 died.

The study found that deaths were less likely in people who followed all four positive lifestyle recommendations - taking exercise, eating a healthy diet, drinking alcohol in moderation, and not smoking.

Continue reading the main story

This research shows that combining a good night's sleep with other healthy lifestyle choices can reduce your risk of heart disease"

End Quote Doireann Maddock British Heart Foundation

Observing all four behaviours was associated with a 57% lower risk of cardiovascular disease and a 67% lower risk of dying from stroke or heart disease, they say.

But when sufficient sleep - seven or more hours a night - was added to the other four lifestyle factors, the beneficial effect was amplified - resulting in a 65% lower risk of cardiovascular disease and an 83% lower risk of death from cardiovascular disease.

The researchers say other studies have shown a link between poor sleep and cardiovascular disease, but this is the first to look at whether sleep - added to the other four healthy lifestyle recommendations - can further reduce risk.

"If all participants adhered to all five healthy lifestyle factors, 36% of composite cardiovascular disease [heart disease or stroke] and 57% of fatal cardiovascular disease could theoretically be prevented or postponed," say the researchers, from the National Institute for Public Health and the Environment, Bilthoven, and Wageningen University.

"The public health impact of sufficient sleep duration, in addition to the traditional healthy lifestyle factors, could be substantial."

Commenting on the work, published in the European Journal of Preventive Cardiology, Prof Grethe S Tell, of the University of Bergen, Norway, said the benefits of sleep should be considered by public health experts and parents alike.

"The main message of the study is that we need to consider sleep as an important factor for health," she told BBC News.

"From a public health point of view we should encourage people to get enough sleep and like all other healthy lifestyle factors this needs to be taught at home."

Sleepless nights

Doireann Maddock, senior cardiac nurse at the British Heart Foundation, said people suffering sleepless nights should not be alarmed.

"This research shows that combining a good night's sleep with other healthy lifestyle choices can reduce your risk of heart disease," she said.

"But troubled sleepers should not be alarmed - this study doesn't mean sleepless nights cause heart disease."

She added that further research was needed to fully understand the link between sleeping habits and the heart.

"If you find it difficult to drift off, avoiding caffeine and heavy meals too close to the end of the day may help.

"But if lack of sleep is becoming a problem, make sure you have a chat to your doctor."

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