See Family Practice News, January, 2014, p. 6-7
Thursday, June 26, 2014
Women Are at Risk of Heart Attacks and Strokes
A New York
survey reported at the American Heart Association meeting in Dallas revealed
that only 28% of 1013 women correctly identified heart disease as the number one
killer of women. Many of them considered
an OB/GYN doctor to be their primary care physician. All women, but especially those with any
family history of heart disease or strokes or ones who smoke, should have a
cholesterol panel. Other good screening
tests include a Calcium score CT scan, a carotid artery screen, and a Max Pulse
test. The former is available at many
hospitals and the later two at our office.
If risk is identified, much can be done to prevent a cardiovascular
event, which can be devastating.
Tuesday, June 24, 2014
Beta Blockers Losing Their Luster
The CAFÉ
study showed that beta blockers have more side effects than benefits to the
heart when used to control blood pressure.
They result in less protection of the kidneys, less avoidance of left
ventricular hypertrophy, more insulin resistance, reduced exercise tolerance,
weight gain, and more problems with withdrawal than other BP meds. There was some benefit for these drugs to
prevent strokes. Many patients come to
me for natural alternatives to BP meds.
My first choices are an herbal preparation with Rauwolfia in it and
magnesium. They are usually quite
effective without side effects.
See Family Practice News, March 1, 2014, p. 26-27.
Thursday, June 19, 2014
Nuts to the Diet
The 2013
American Heart Association diet recommendations advocate eating more fruits and
veggies, whole grains, legumes, fish, poultry, and especially nuts because they
contain good fats and protein. Foods to
avoid include sugar, sodium and red meat.
My impression of the evidence is that lean red meat is not bad to eat in
moderation. Otherwise, I can live with
the recommendations, except for the fact that many people have low-grade food
allergies that they are not aware of.
You can be allergic to healthy foods, including nuts. Gluten is a common problem. Generally speaking, the diet should be
individualized. An Elisa blood test for
food allergies is a good place to start.
See J. Am. Coll. Cardiol., Jan 28, 2014.
Tuesday, June 17, 2014
The Best Blood Pressure Predictor for Cardiovascular Disease is the Mid-BP
Investigators
showed that even minor elevations of blood pressure in patients age 18-30 years
was strongly associated with coronary artery calcification 25 years later. Interestingly, the best predictor of future
problems was the mid-BP, which is defined as the mean of the systolic and
diastolic blood pressures. This
calculation is new, and might change the way we evaluate the risk of elevated
blood pressure.
See Coronary Artery Risk Development in Young Adults
(CARDIA) study, reported in Family Practice News, Feb. 15, 2014, p. 18-19.
Thursday, June 12, 2014
Too Much Sugar Caused a 40% Higher Risk of Cardiovascular Death
The
National Health and Nutrition Examination
Survey (NHANES) showed that those who consumed 17-21% of their diet in
sugar had a 40% higher risk of CV death than those who consumed less than 10%
of their calories from sugar. One-tenth
of the population consumes greater than 25% of their diet in sugar, and they
tripled their risk of CV death. The
numbers speak for themselves. Healthy
nutrition makes a big difference in your longevity, health, and quality of
life.
See JAMA. Internal Medicine, 2014 online.
Tuesday, June 10, 2014
What is the Best Treatment for Osteoarthritis of the Knee?
Several
physician organizations have issued guidelines recently about the best
non-surgical treatment for arthritis of the knee. They all agree on weight loss, exercise, and
education. However, they disagree on the
relative effectiveness of steroid shots, hyaluronic acid injections (Synvisc),
non-steroidal anti-inflammatory drugs, topical capsaicin, glucosamine, and
acupuncture. Unfortunately, they did not
even mention the treatment that I have found to be the most effective,
prolotherapy. Prolo injections rebuild
and strengthen the ligaments that support the joint, and can give long-lasting,
if not permanent, relief of pain.
Go to the web site, www.getprolo.com.
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