Monday, June 29, 2009
Saturday, June 27, 2009
Patients and their families always ask me will lowering my cholesterol end up shrinking or reducing the extent of blockages in my heart, leg, or neck arteries. My answer is maybe. There is evidence that using Crestor, researchers were able to document a small amount of plaque regression with very low LDLs. I tell my patients that more important than plaque regression is plaque stabilization. Unstable plaques crack and lead to acute events (heart attacks and strokes).
A new study recently presented at the Society for Vascular Surgery 2009 Vascular Annual Meeting reported that after twelve months of Lipitor therapy, patients with LDL levels < 70 had significantly more carotid plaque stabilization that patients with LDLs 70-100.\
This is important for a few reasons:
- It seems that ability of statins to stabilize a plaque is not compound dependent but class dependent. (ie: its not which statin you use, but is the statin you are using lowering your LDL below 70)
- Plaque stabilization does occur and probably explains why patients with very low LDLs have the lowest event rates
Friday, June 26, 2009
Tuesday, June 23, 2009
Here is info taken for the Go Red for Women site -- I could not have stated it better
Some heart attacks are sudden and intense, causing someone to gasp dramatically, clutch her heart and drop to the ground. No one has any doubts about what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often the people affected aren't sure what's wrong and wait too long before getting help.
Here are some signs a heart attack may be happening:
- Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath. This feeling may occur with or without chest discomfort.
- Other signs of discomfort. These may include breaking out in a cold sweat, nausea or lightheadedness.
- As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.
If you or someone you are with has chest discomfort, especially with one or more of the other signs, don't wait longer than five minutes before calling 9-1-1 for help."
Monday, June 22, 2009
The evidence shows that patients with low aerobic fitness levels in their 20's were 2-3 times more likely to develop diabetes than those that maintained their physical fitness.
Physical fitness may protect against diabetes via weight loss, improved muscle insulin sensitivity, improved endothelial function and autonomic function, or reduced inflammation and oxidative stress, the researchers said.
Thursday, June 18, 2009
Wednesday, June 17, 2009
Abdominal Visceral Fat (aka Belly Fat) has been strongly [...]
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Wednesday, June 3, 2009
A consensus paper is being published online by the American Academy of Periodontology and the American Journal of Cardiology. In the paper the two societies make the following recommendations:
- Patients with periodontitis who have 1 known major atherosclerotic CVD risk factor such as smoking, immediate family history for CVD, or history of dyslipidemia should consider a medical evaluation if they have not done so within the past 12 months.
- A periodontal evaluation should be considered in patients with atherosclerotic CVD who have: signs or symptoms of gingival disease; significant tooth loss, and unexplained elevation of hs-CRP or other inflammatory biomarkers.
- A periodontal evaluation of patients with atherosclerotic CVD should include a comprehensive examination of periodontal tissues, as assessed by visual signs of inflammation and bleeding on probing; loss of connective tissue attachment detected by periodontal probing measurements; and bone loss assessed radiographically. If patients have untreated or uncontrolled periodontitis, they should be treated with a focus on reducing and controlling the bacterial accumulations and eliminating inflammation.
- When periodontitis is newly diagnosed in patients with atherosclerotic CVD, periodontists and physicians managing patients' CVD should closely collaborate in order to optimize CVD risk reduction and periodontal care.
I am very interested in following the science behind this association. Is the relationship between heart disease and periodontal disease a causal one (does one disease truly cause the other disease) or a casual one ( is it just that patients with one disease are more likely to have the other disease too).
I will keep you updated as more research is reported.