Category Archives: Heart Disease

Do You Really Need That Heart Stent or Bypass Surgery?

Heart attacks and chest pains are linked to blocked arteries in the heart

Doctors are often criticised for over-using coronary artery angioplasty/stenting and coronary artery bypass grafting.

From Stanford Medicine:

Patients with severe but stable heart disease who are treated with medications and lifestyle advice alone are no more at risk of a heart attack or death than those who undergo invasive surgical procedures, according to a large, federally-funded clinical trial led by researchers at the Stanford School of Medicine and New York University’s medical school.

The trial did show, however, that among patients with coronary artery disease who also had symptoms of angina — chest pain caused by restricted blood flow to the heart — treatment with invasive procedures, such as stents or bypass surgery, was more effective at relieving symptoms and improving quality of life.“For patients with severe but stable heart disease who don’t want to undergo these invasive procedures, these results are very reassuring,” said David Maron, MD, clinical professor of medicine and director of preventive cardiology at the Stanford School of Medicine, and co-chair of the trial, called ISCHEMIA, for International Study of Comparative Health Effectiveness with Medical and Invasive Approaches.

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“Based on our results, we recommend that all patients take medications proven to reduce risk of heart attack, be physically active, eat a healthy diet and quit smoking,” Maron said. “Patients without angina will not see an improvement, but those with angina of any severity will tend to have a greater, lasting improvement in quality of life if they have an invasive heart procedure. They should talk with their physicians to decide whether to undergo revascularization.”

Source: Stents, bypass surgery show no benefit in heart disease mortality rates among stable patients | News Center | Stanford Medicine

Steve Parker, M.D.

PS: The Mediterranean diet is a healthy diet, and you can even lose weight with it!

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.

Taking Hypertension Meds at Bedtime Prevents Cardiovascular Events

High blood pressure is linked to heart attacks

Very recently I’ve noticed hypertension patients taking their medications at bedtime. Now I know why.

From Medscape:

Taking antihypertensive medication at bedtime led to an almost halving of cardiovascular events in a new study.

The Hygia Chronotherapy Trial is the largest ever study to investigate the effect of the time of day when people take their antihypertensive medication on the risk of cardiovascular events.

The trial randomly assigned 19,084 patients to take their medication on waking or at bedtime and followed them for an average of 6 years.Results showed that patients who took their pills at bedtime had a 45% reduction in overall cardiovascular events. This included a 56% reduction in cardiovascular death, a 34% reduction in myocardial infarction (MI), a 40% reduction in coronary revascularization [bypass surgery and angioplasty/stenting], a 42% reduction in heart failure, and a 49% reduction in stroke, all of which were statistically significant.

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“We showed that if blood pressure is elevated during sleep then patients have increased cardiovascular risk regardless of daytime pressure, and if blood pressure during sleep is normal then cardiovascular risk is low even if the [doctor’s] office pressure is elevated,” Hermida said.

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Results showed that during the 6.3-year median patient follow-up, 1752 participants experienced the primary cardiovascular disease (CVD) outcome (a composite of CVD death, MI, coronary revascularization, heart failure, or stroke).

Drug classes at physicians’ disposal were ARBs (angiotensin receptor blockers, calcium channel blockers, ACE inhibitors, and diuretics. Preventative effects were most pronounced for ARBs and ACE inhibitors.

Don’t change your BP medication dosing until you check with your personal physician.

Source: Bedtime Dosing of Hypertension Meds Reduces CV Events

Did you know most heart attacks occur in the morning, and those tend to be the most serious?

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.

 

 

Dog Ownership Lowers Risk of Death From Heart Attack and Stroke

Young Hank

From UPI:

A pair of new reports found that dog owners have a lower risk of early death than people without canine companionship, particularly when it comes to dying from a heart attack or stroke.

Dog ownership decreases a person’s overall risk of premature death by 24 percent, according to researchers who conducted a review of the available medical evidence.

The benefit is most pronounced in people with existing heart problems. Dog owners had a 65 percent reduced risk of death following a heart attack and a 31 percent reduced risk of death from heart disease, the researchers said.

Source: Having a dog can lower risk of death from heart attack, stroke – UPI.com

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.

Red and Processed Meats May Not Be the Killers We Imagined

From New York Times:

Public health officials for years have urged Americans to limit consumption of red meat and processed meats because of concerns that these foods are linked to heart disease, cancer and other ills.

But on Monday, in a remarkable turnabout, an international collaboration of researchers produced a series of analyses concluding that the advice, a bedrock of almost all dietary guidelines, is not backed by good scientific evidence.

Whew…What a relief! Dodged that bullet.

Click for Gina Kolata’s article.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com

Animal Versus Plant Protein: Which Is Healthier?

Filet mignon and sautéed asparagus

“In this large prospective study, higher plant protein intake was associated with lower total and CVD-related mortality. Although animal protein intake was not associated with mortality outcomes, replacement of red meat protein or processed meat protein with plant protein was associated with lower total, cancer-related, and CVD-related mortality.”

Source: Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality | Cardiology | JAMA Internal Medicine | JAMA Network

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com

Reduced Heart Failure Incidence Linked to Higher Blood levels of Omega-3 Fatty Acids

Salmon, a cold-water fatty fish, is a rich source of omega-3 fatty acids

 

 

 

 

 

 

 

 

 

Higher blood levels of omega-3 fatty acid are associated with reduce risk of heart failure. How do you get higher levels os blood omega-3 fatty acids? One way is to eat cold-water fatty fish.

Here’s an abstract from JACC: Heart Failure:

Objectives

The aim of this study was to determine if plasma eicosapentaenoic acid (EPA) abundance (%EPA) is associated with reduced hazard for primary heart failure (HF) events in the MESA (Multi-Ethnic Study of Atherosclerosis) trial.

Background

Clinical trials suggest that omega-3 polyunsaturated fatty acids (ω3 PUFAs) prevent sudden death in coronary heart disease and HF, but this is controversial. In mice, the authors demonstrated that the ω3 PUFA EPA prevents contractile dysfunction and fibrosis in an HF model, but whether this extends to humans is unclear.

Methods

In the MESA cohort, the authors tested if plasma phospholipid EPA predicts primary HF incidence, including HF with reduced ejection fraction (EF) (EF <45%) and HF with preserved EF (EF ≥45%) using Cox proportional hazards modeling.

Results

A total of 6,562 participants 45 to 84 years of age had EPA measured at baseline (1,794 black, 794 Chinese, 1,442 Hispanic, and 2,532 white; 52% women). Over a median follow-up period of 13.0 years, 292 HF events occurred: 128 HF with reduced EF, 110 HF with preserved EF, and 54 with unknown EF status. %EPA in HF-free participants was 0.76% (0.75% to 0.77%) but was lower in participants with HF at 0.69% (0.64% to 0.74%) (p = 0.005). Log %EPA was associated with lower HF incidence (hazard ratio: 0.73 [95% confidence interval: 0.60 to 0.91] per log-unit difference in %EPA; p = 0.001). Adjusting for age, sex, race, body mass index, smoking, diabetes mellitus, blood pressure, lipids and lipid-lowering drugs, albuminuria, and the lead fatty acid for each cluster did not change this relationship. Sensitivity analyses showed no dependence on HF type.

Conclusions

Higher plasma EPA was significantly associated with reduced risk for HF, with both reduced and preserved EF. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487)

Source: Predicting Risk for Incident Heart Failure With Omega-3 Fatty Acids | JACC: Heart Failure

Most of my recommended diets include twice weekly servings of cold-water fatty fish.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com

Gum Disease May Cause or Promote Alzheimer’s Disease

From Medical Xpress:

“Researchers have determined that gum disease (gingivitis) plays a decisive role in whether a person develops Alzheimer´s or not.

“We discovered DNA-based proof that the bacteria causing gingivitis can move from the mouth to the brain,” says researcher Piotr Mydel at Broegelmanns Research Laboratory, Department of Clinical Science, University of Bergen (UiB).

The bacteria produces a protein that destroys nerve cells in the brain, which in turn leads to loss of memory and ultimately, Alzheimer’s.”

Source: Brush your teeth—postpone Alzheimer’s

I take this with a large grain of salt. Click for detailed info on the theory and the Porphyromonas gingivalis bacterium. This organism is the most common bacterium found in the arteries of patients with cardiovascular disease.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com in the U.S.