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.
See Family Practice News, January, 2014, p. 6-7

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,