European Stars And Stripes (Newspaper) - November 3, 1987, Darmstadt, Hesse                                To your health the silent heart problem by Daniel q. Haney associated Pressw Hen the heart gels in trouble it grabs its owner s attention with a Dull heavy pain called angina or so the experts once thought Bui recently doctors have discovered that More often than not. The heart keeps quiet about its misery. And that s not Good. The consequence is a surprisingly common condition doctors Call silent ischaemia something Ordinary people might think of As painless angina millions of folks have it and Don t know it even though the heart pumps blood throughout the body it needs a Good Supply of blood itself. For this it depends on a network of blood vessels called the coronary arteries. These vessels however often get clogged with fatty buildups Over the years. As a result they May barely Supply enough blood to keep the heart working. If because of exertion or some other stress he heart needs a Little More blood from Lime to Lime the plumbing May not be Able to handle he increased demand when this happens the heart fails to get enough oxygen. It begins to suffocate and this is what s known As ischaemia. If the ischaemia lasts for More than 20 or 30 minutes the oxygen starved Section of the heart Dies and that s a heart attack usually however the crisis passes in a few minutes. Once doctors thought that ischaemia always announced itself with the pain of angina. But recent studies have convinced the experts that ischaemia is More often painless and people May have repeated and prolonged ischaemia without feeling any of the warning symptoms. The silent variety is the most common form of ischaemia we have and it s present in patients with All clinical forms of coronary artery disease says or. Carl j. Repine of the University of Florida. A decade ago. He and colleagues showed that people endure three or four bouts of silent ischaemia for every angina attack that and Many studies thai followed have begun to change the Way that doctors think about head disease and treat it. We Are shifting the focus away from symptoms to ischaemia Pepine says. Most of us believe that the major goal of therapy in patients with coronary disease if we Are to do anything about increasing survival and preventing heart attacks has to focus on reducing or eliminating ischaemia most of which is  doctors Are also learning that painless ischaemia is just As is 1 As angina. Both kinds can damage the near muscle and both Are warnings that people Are at High risk of suffering heart attacks or deadly heart rhythm disturbances in a Way though Siren ischaemia is even More insidious than noisy ischaemia or angina because it s hidden. Says or. Sidney Gottlieb of Johns Hopkins some people think it s worse because you Don t know it s there so you Don t treat patients As aggressively As you might if they said they were having  no one knows precisely How Many people have silent ischaemia. However or. Peter f. Cohn of the state University of new York at Stony Brook estimates that Between 1 million and 2 million Middle aged american men have silent ischaemia with no outward signs of heart disease. An additional 3 million to 4 million Are Likely to suffer several episodes of silent ischaemia for each bout of angina. This is a very very prevalent phenomenon Cohn says. We Are now starting to see the emergence of studies that link the episodes of silent ischaemia to Adverse prognostic outcomes such As heart attack and  for instance one study followed a group of men with totally painless ischaemia for five years and found that their death rate from coronary artery disease was five times higher than usual. Silent ischaemia can be treated the same Way angina is. Doctors commonly prescribe the drugs nitroglycerine Beta blockers and Calcium Channel blockers. Coronary bypass surgery or angioplasty a procedure that uses a balloon to Force open clogged arteries May also be performed. The trouble though is knowing when someone has silent ischaemia if he feels no symptoms. One Way to find out is the exercise test. People walk briskly on a Treadmill while hooked to an electrocardiograph machine. This May trigger silent ischaemia just As it does angina. The equipment picks up the Peculiar heart Waves that signal ischaemia. Another method is to fit people out with Small portable electrocardiograph devices that keep a 24-hour record of their heart. This can be useful because silent ischaemia often occurs during mental not physical stress such As while speaking publicly or trying to solve a math problem. In general doctors agree that men in Middle age and beyond should be tested for silent ischaemia if they already have the classic risk factors for heart trouble such As a bad family history of the disease cigarette smoking High blood pressure or elevated cholesterol Levels. The experts said that Over the past year or two the internists and family practitioners who usually treat heart disease have begun to appreciate the importance of painless angina. Gottlieb frequently gives talks about silent ischaemia at medical meetings. About two years ago he says people were saying what is it?1 or i Don t believe in it now All they want to know is what machine they should buy to measure  chimps in the family tree Chimp an Man i Elmott it Fetrow. Byjah Ziegler United press International he most extensive genetic analysis Ever conducted reaffirms that humans closest cousins on the evolutionary family tree Are chimpanzees whose genes Are about 96.4 percent similar to Peoples researchers reported recently. Who is our closest Irving relative that turns out to be the Chimp. In our family tree they re the ones right next to us said Michael m. Miyamoto an assistant zoology professor at the University of Florida. Chimps and humans Are about 98.4 percent similar in their dam the material that makes up genes while humans and gorillas Are 98.3 percent similar. Orangutans and humans Are 96 5 percent similar Miyamoto said. Scientists have been analysing these three primates for years because of their apparent closeness to humans. Although researchers earlier had concluded that chimps were people s closest relatives in the animal kingdom the new study reported in the journal science was More extensive. Past genetic analyses were based on up to a few thousand of what Are known As base pairs. These pairs of amino acids Are linked together in distinctive patterns to form dam. Miyamoto who conducted the study with colleagues while at Wayne state University Analysed 7,000 base pairs from a Region of a family of genes that produces haemoglobin the oxygen carrying substance in blood. The reason that this is exciting is because it represents the first time such a Large body of Dan sequences has been compiled he said in a Telephone interview. Miyamoto said the percentage of similarities would probably hold True for All genes in animals and in humans not just the haemoglobin family. The research also shows humans Are evolving at a slower Pace than chimps or gorillas. Researchers in general have concluded that humans evolved from a Chip Gorilla ancestor Long ago but used to think humans split from the ape Branch of the family tree 18 million to 20 million years ago. Miyamoto said his group s Dan analysis supports the theory developed Over the last two decades that the sport occurred much sooner probably about 5 million years ago. Early humans might have had ape like characteristics such As knuckle walking. However genetic analysis of remains of Early humans would not provide Many dues because the crucial molecules have deteriorated Miyamoto said. Page 16 the stars and stripes tuesday november 3,1987