Simply measuring a woman's resting pulse rate can predict how likely she is to suffer a heart attack, says a study in the British Medical Journal.

 US researchers looked at the records of around 129,000 postmenopausal women who had no history of heart problems.

 They found that those with the highest heart rates were significantly more likely to suffer a heart attack than the women with the lowest rates.

 However, the association was weaker than that with cigarettes and diabetes.

 Previous studies have shown that resting heart rate predicts coronary events in men.

 'Clinically meaningful'

 The researchers from the pharmaceutical company, AstraZeneca, said the strength of this association "might be large enough to be clinically meaningful."

 They assessed women over the age of 50 and enrolled in the Women's Health Initiative who were involved in four randomised trials and an observational study from 1993 to 1998.

 They followed them up for about seven years and found that the women suffered 2,281 fatal or non-fatal heart attacks and 1,877 strokes.

 Women with the fastest resting heart rates of more than 76 beats per minute were 1.6 times as likely to suffer a coronary event compared with those with the lowest resting heart rates below 62 beats per minute.

 And the relationship was stronger in the younger postmenopausal women.

 Weight, high blood pressure, high cholesterol and consumption of saturated fats were all higher in the women with the highest heart rates as were the incidence of diabetes, smoking, and depression.

 The women with the lowest resting heart rates were more active but also drank more alcohol than the others.

 Other risk factors

 Professor Peter Weissberg, medical director of the British Heart Foundation, said: "It adds heart rate to the numerous other risk factors known to influence the chances of having a heart attack.

 "One's heart rate changes minute by minute in response to things like activity and emotion, so people shouldn't automatically assume that if their heart rate happens to be high at a particular time it is putting them at risk of a heart attack."

 Dr Tim Chico, consultant cardiologist at the University of Sheffield, said: "We already have methods to predict someone's risk of heart disease based upon things they can change, for example whether they smoke, eat a healthy diet, maintain a healthy weight, or things they can't change, such as their age and sex.

 "We all need to pay more attention to things we can do in our lifestyle to lower our risk of heart disease."

 Pharmacists across the UK have been told they can continue to refuse to prescribe items that might clash with their personal religious beliefs.

 A revised code of conduct from the new industry regulator will allow staff to opt out of providing items such as the morning-after pill and contraception.

 But they may in future have to give customers details of alternative shops.

 The National Secular Society wanted the General Pharmaceutical Council to scrap the so-called conscience clause.

 The General Pharmaceutical Council (GPhC) is to take over the regulation of pharmacists, pharmacy technicians and the registration of pharmacy premises from the Royal Pharmaceutical Society later this year.

 Under its new code, pharmacists with strong religious principles will still be able to continue to refuse to sell or prescribe products if they feel that doing so would contradict their beliefs.

 But the GPhC says pharmacists who refuse services could be obliged to tell patients where they can access them and it plans to consult more widely on the issue.

 Terry Sanderson, president of the National Secular Society, said he was disappointed by the code.

 "This was a perfect opportunity to severely restrict the exercise of this supposed conscience clause which has caused a great deal of embarrassment and inconvenience to people recently.

 "It seems incredible that pharmacists can arbitrarily tell people that they won't serve them with medication that has been prescribed by a doctor."

 The issue was highlighted recently by a woman denied the pill by a Sheffield chemist. She was told to return to the shop the following day when another staff member would be on duty.

 People with occasionally high blood pressure are more at risk of stroke than those with consistently high readings, research suggests.

 Current guidelines focus on measuring average blood pressure levels to spot and prevent the chance of a stroke.

 But research suggests doctors should no longer ignore variation in test results and give drugs that produce the most steady blood pressure levels.

 The Stroke Association called for national guidelines to be overhauled.

 In the first of the series of studies published in The Lancet, UK and Swedish researchers looked at the variability in blood pressure readings at doctors' checks.

 They found those with fluctuating readings at different GP visits had the greatest risk of future stroke regardless of what their average blood pressure reading was.

 A review of previous trials also found that the differences in effectiveness of several blood pressure drugs could be explained by how well they kept blood pressure on an even keel.

 Some drugs, in particular beta blockers, were shown in a separate study in The Lancet Neurology, to increase variation in a patient's blood pressure.

 'Major implications'

 Professor Peter Rothwell of the Department of Clinical Neurology at the University of Oxford, who led the research, said the findings have major implications for how GPs spot and treat people at high risk of stroke.

 "At the moment, the guidelines for GPs say not to believe a one-off unusual reading, to bring the patient back and measure again, and as long as it's not consistently high, there is no need to treat.

 "What we're saying is don't discount that one-off high blood pressure reading."

 He added that GPs would also need to make sure they prescribe the most effective drug combinations - ideally one that lowers blood pressure but also stabilises it.

 It is not know exactly why occasional spikes would increase a person's risk of stroke but it is thought it puts undue stress on the system.

 "If you get rapid fluctuations that can cause turbulent flow of blood which can cause damage and stiffening in the arteries," said Professor Rothwell.

 He said anyone with high blood pressure who tests themselves at home might want to mention to their GP if they spot variations in their results.

 The National Institute for Health and Clinical Excellence's guidelines on high blood pressure is in the process of being rewritten and these latest studies will be taken into account.

 Joe Korner, director of communications at The Stroke Association said people who have occasional high blood pressure readings - known as episodic hypertension - are often not treated.

 "With this new research it is now important that the clinical guidelines about treating high blood pressure are reviewed.

 "In the meantime we urge GPs to read this research to help them prescribe the best treatment for people at risk of stroke."

 Experts stressed that those already prescribed medication for high blood pressure should not worry or stop taking their pills.

 Professor Peter Weissberg, medical director at the British Heart Foundation said: "Current practice is not wrong, but this might add a new measure to help doctors make decisions on who to treat for hypertension and which drug to use."

 At-home screening tests for the virus responsible for most cervical cancers could detect many more cases of the disease, say Dutch researchers.

 Although cervical screening programmes have cut deaths, not all women take up the invite from the GP.

 But self-test kits for human papillomavirus (HPV) could double the number of women diagnosed, the British Medical Journal reported.

 Trials of self-testing for HPV are currently being done in the UK.

 There are more than 100 types of HPV, which is sexually transmitted, but only 13 of them are known to cause cancer.

 Although most HPV infections clear up by themselves, in some women it persists and cause damage to cells which may eventually develop into cervical cancer.

 A vaccine against the two main types of HPV was introduced in the UK in 2008 for schoolgirls.

 But the NHS has also been piloting HPV testing as an "add-on" to traditional screening - to pick out those most at risk.

 Test kit

 In the latest study almost 28,000 Dutch women who had not responded to two invites to attend the regular screening programme were sent an at-home screening kit for HPV.

 A smaller group were sent a third invitation for routine screening.

 More than a quarter of those sent kits returned a completed test kit, compared with only one in seven who responded in the recall group.

 Those who self-tested and had a positive result were then referred for further tests.

 Importantly, those women who had also not taken up the offer of the previous round of screening had a higher risk of abnormal changes in their cervix.

 The researchers said more than half of cervical cancers in countries with screening programmes are diagnosed in women who have not attended routine testing.

 Stephen Duffy, Cancer Research UK's professor of cancer screening, said: "While it's important for women to attend cervical screening appointments, some find it difficult to do so for cultural or other reasons.

 "For these women, self-sampling for HPV may be an option.

 "Its acceptability and effectiveness are currently being researched here in the UK."

 Aggressive childhood brain tumours could be treatable with a novel combination of two existing cancer drugs, a study suggests.

 Researchers led by the Institute of Cancer Research (ICR) examined 90 tumours from children and found two new genetic abnormalities in nine of them.

 They were then able to kill these abnormal tumours, in laboratory tests, by combining the two existing drugs.

 But one expert says the findings remain "far off being applicable to patients".

 In the UK, about 400 children are diagnosed with brain tumours every year.

 The research, published in the journal Clinical Cancer Research, brought together scientists from the UK, France, Portugal, Brazil and America.

 The abnormal tumours - known as glioblastomas, aggressive and often fatal cancers of the brain's glial cells - contained too many copies of the EGFR gene and mutations of the gene the scientists say have never before been found in children.

 They tried to block the EGFR gene with a drug, erlotinib (Tarceva), used in clinical trials to treat adult glioblastomas, but identified a molecule specific to the children's cells - platelet-derived growth factor receptor (PGFR) - that was making it ineffective.

 But when they combined erlotinib with a drug, imatinib (Glivec), they hoped would block the PGFR molecules, they killed a significant number of the cancer cells.

 Dr Chris Jones, who led the research, said it proved "that cancers may look the same, but it is only when you get down to the genetic level that you can truly understand them and devise treatments".

 Professor Geoff Pilkington, of the Brainstrust charity, said the research, though fascinating, was at too early a stage to turn into a treatment for patients.

 "This sort of twin therapy is a good thing to consider for the future," he said.

 Bur he added: "The cells of the brain seem to be unusually resistant to anything thrown at them."

 UK scientists say they can find no proof that a particular virus is the cause of chronic fatigue syndrome (CFS) or ME, contrary to recent claims.

 The Imperial College London team say they want to share the findings as some patients are pinning their hopes on drugs to fight the virus called XMRV.

 They analysed blood samples from 186 patients with CFS and found none had the virus, PLoS One journal reports.

 Experts said the latest findings would be a bitter disappointment to many.

 They said more trials were under way and when these report in coming months, scientists will be able to draw more firm conclusions.

 Work in the US, published in Science, had found the retrovirus in 68 of 101 CFS patients.

 The UK team say the conflict between the two studies might be down to differences between the patients enrolled or the way the research was conducted.

 Or there might be different geographical types or strains of XMRV.

 Regardless, they say potent antiretroviral drugs should not be used to treat CFS because there is not enough evidence that this is necessary or helpful.

 The drugs may do more harm than good, they say.

 Professor Myra McClure, one of the Imperial College London investigators, said: "We are confident that our results show there is no link between XMRV and chronic fatigue syndrome, at least in the UK."

 She said they had used extremely sensitive DNA testing methods, called polymerase chain reaction, to look for the virus.

 "If it had been there, we would have found it."

 'Disappointing'

 Co-author Professor Simon Wessely said the findings did not invalidate all previous research, some of which has shown that CFS can be triggered by other infectious agents, such as Epstein Barr Virus.

 The number of swine flu deaths reported worldwide has jumped by more than 700 in a week, latest World Health Organization figures reveal.

 More than 5,700 swine flu deaths were reported by 25 October, compared to nearly 5,000 the week before.

 The biggest rise was in the Americas where 4,175 deaths have been reported, up 636 from the week before.

 Meanwhile, Ukraine has shut all schools and banned public meetings for three weeks after its first swine flu death.

 Prime Minister Yulia Tymoshenko said the measures were to prevent the spread of the H1N1 virus.

 Mrs Tymoshenko said there would also be restrictions on what she called non-urgent travel between different parts of Ukraine.

 Cases 'unreported'

 The latest WHO figures showed there had been 440,000 confirmed cases of the H1N1 virus worldwide.

 But the organisation said that as many countries have stopped counting individual cases, the actual number is likely to be significantly higher.

 The BBC's Imogen Foulkes says the WHO has warned for months that as winter sets in, the northern hemisphere can expect swine flu cases to rise. Now that appears to be happening.

 The virus emerged in Mexico in April and was declared a global flu pandemic on 11 June.

 "In the temperate zone of the northern hemisphere, influenza transmission continues to intensify, marking an unusually early start to winter influenza season in some countries," said the WHO's latest update.

 Statistics showed fatal cases in Europe climbed to at least 281, while those in Asia-Pacific rose to 1,070.

 In a separate statement, the WHO said that experts meeting this week had concluded that a single dose of swine flu vaccine was sufficient to immunise adults and children over 10.

 The Strategic Advisory Group of Experts (Sage) said that countries that had made vaccinating children a priority could administer them a single dose to ensure that as many as possible are immunised quickly.

 It said that while more data on children between six months and 10 years was needed "the priority should be to give them at least one dose of vaccine now, and to cover as many of them as possible".

 Women who have had a fracture are not getting treatment to prevent them having future bone breaks, a Cambridge University study suggests.

 An audit covering 1,600 women presenting to a specialist clinic with a fracture showed that 31% had suffered a previous break.

 Yet only 28% had been put on recommended bone-protective drugs.

 A GPs' leader said more could be done to find women at risk, but side-effects stopped some patients taking the drugs.

 Normal ageing can lead to osteoporosis, a condition in which bones become fragile and break easily. The fractures are most common in bones of the spine, wrists and hips.

 Women are more at risk after the menopause because they lose oestrogen which protects bones from damage.

 Current guidelines from the National Institute of Health and Clinical Excellence say that women over the age of 75 who have had a fracture should automatically be offered preventive treatment with drugs such as bisphosphonates.

 Because of the high risk of future fracture after a break, postmenopausal women under the age of 75 are supposed to have a bone density scan before being offered treatment if necessary.

 Some experts argue that the guidelines do not go far enough, and more women with signs of bone-weakening should be offered protective therapy.

 Poor uptake

 In the latest analysis, 526 of 1641 postmenopausal women attending a fracture clinic had previously had a bone break, the QJM journal reported.

 Overall, 27% of those were taking a bisphosphonate or other treatment such as calcium or vitamin D supplements.

 Among the over-75s, only 45% were receiving bone protective therapy.

 The study leader, Professor Julia Compston, said some areas of England may be better than others but the low levels of treatment found in the study were "broadly applicable" to the rest of the country.

 She said reasons for lack of treatment included poor recording of fractures in patient notes; absence of incentives for GPs to treat osteoporosis, unlike many other chronic conditions; and the fact that patients "get lost" between hospitals and GPs because of poor communication.

 "Someone needs to take responsibility for deciding whether a patient should be treated and there are a lot of processes that can fall down.

 "Patients also need to be better informed that they might need treatment."

 In some areas of the country access to scans to measure bone density is problematic, she added.

 Professor Steve Field, chairman of the Royal College of GPs, said the study highlighted the fact that more could be done to make sure treatment was available.

 "But these drugs can have very unpleasant side-effects - so some patients are offered them but stop taking them," he said.

 "Exercise and diet are also important."

 It is a myth that women have different heart attack symptoms from men, according to Canadian researchers.

 A study presented at the Canadian Cardiovascular Congress found no gender differences in symptoms after studying 305 patients undergoing angioplasty.

 They say it is a commonly held belief that men and women feel the effects of a heart attack differently.

 Dr Beth Abramson, of Canada's Heart and Stroke Foundation, said: "Heart disease is an equal-opportunities killer."

 'The Myth'

 In 2003 a study by the US National Institutes of Health did suggest that many women never had chest pains and that their symptoms were not as predictable.

 Martha Mackay, who led the Canadian research, said these latest findings suggested that this simply was not the case.

 In the study, researchers found was that the women had all the classic symptoms like chest pain and also tended to have pain in the throat, jaw and neck.

 She said: "Clear educational messages need to be crafted to ensure that both women and healthcare professionals realise the classic symptoms are equally common in men and women."

 The average age of the people undergoing angioplasty was 63 and nearly 40% of them were women.

 'No gender differences'

 As part of the angioplasty procedure a balloon is inflated inside the blocked blood vessel to stretch it out.

 This can briefly cause pain and discomfort which is the same as the patient would feel if they are having a heart attack.

 During inflation, the patients were questioned about their current sensations and an electrocardiogram measurement was taken before inflation and when the balloon was deflated.

 A total of 245 (83%) had ischemia or a decreased blood supply in their blood vessel.

 No gender differences were found in rates of chest pain or typical acute coronary syndrome (ACS) symptoms regardless of their ischemic status.

 Women were significantly more likely to report throat, jaw and neck discomfort, as well as only non-chest discomfort.

 The gender effect was increased after controlling for age, urgency, a prior heart attack or a prior angioplasty.

 Dr Beth Abramson, of the Canadian Heart and Stroke Foundation, said that while women may describe their pain differently from men, the most common symptom in women was still chest pain.

 She said: "Heart disease is an equal opportunities killer - the differences between women and men are negligible.

 "Women do tend to present about seven to 10 years later than men when they are older and sicker.

 "The first thing most people feel is a heaviness in the chest and we all need to be aware of that."