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The next frontier in heart care: Research aims to personalize treatment with genetics

The next frontier in heart care: Research aims to personalize treatment with genetics | Healthy Recipes and Tips for Healthy Living | Scoop.it

Cardiologists have struggled in recent years to score major advances against heart disease and stroke. Although death rates have been dropping steadily since the 1960s, progress combating the twin diseases has plateaued by other measures.

Genetics has had a profound impact on cancer treatment in recent years. Now, heart-disease specialists hope genetics will reveal fresh insight into the interaction between a person's biology, living habits and medications that can better predict who is at risk of a heart attack or stroke.

Heart disease is linked to about 800,000 deaths a year in the U.S. In 2010, some 200,000 of those deaths could have been avoided, including more than 112,300 deaths among people younger than 65. Now, widespread prevalence of obesity and diabetes threatens to undermine such gains. And a large gap remains between how white patients and minorities—especially African-Americans—benefit from effective strategies.


Via Seth Bilazarian, MD
Steve Kingsley's insight:

About 800,000 deaths a year in the U.S. due to heart disease... while better treatments are always welcome, the best -- an least costly -- treatment is prevention = healthy lifestyle!

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Seth Bilazarian, MD's curator insight, November 30, 2013 10:33 AM

There's great hope that personalized genetic testing can help with both risk assessment and helping to streamline treatment decisions for patients.  Being able to tell a patient that based on your genetic profile you have a 60% chance of response to treatment A and a 30% chance of response to treatment B would be a fantastic advance in treatment efficiency and cost. Unfortunately, the closest thing we currently have , to this in current application is genetic testing for the drug Plavix (clopidogrel) and the adoption has been fraught with difficulty.  Clinicians and patients wait with eager anticipation of this research.

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Researchers Compare Exercise, Drugs as Cardiovascular Treatments | News | The Harvard Crimson

Researchers Compare Exercise, Drugs as Cardiovascular Treatments | News | The Harvard Crimson | Healthy Recipes and Tips for Healthy Living | Scoop.it

Structured exercise programs may be as effective, or even more useful, than medication to treat cardiovascular conditions. The authors evaluated and synthesized the results of 305 previous studies to compare the benefits of drug and exercise regimens on disease outcomes.  

After identifying four conditions for which exercise has been studied as a preventive technique—coronary heart disease, stroke, heart failure, and type-2 diabetes—Naci and Ioannidis compared the efficacy of drugs used to treat these conditions to previously-reported effects of exercise.

 They found that structured physical activity was more effective than drug use in the treatment and prevention of strokes, and equally effective in the secondary prevention of coronary heart disease and diabetes.  Diuretic drugs were more successful than exercise, however, in treating heart failure.

“[Our study] will trigger debate, which is really important,” said Naci. “In cases where we have evidence of exercise, exercise seems to do really well in comparison to drugs, but there are still a lot of instances where we don’t know how exercise fares against drugs.”


Via Seth Bilazarian, MD, Steve Kingsley, Robin Thomas
Steve Kingsley's insight:

Structured exercise programs may be as effective, or even more useful, than medication?  Say it ain't so... your friendly pharmamedical complex team 

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Dr. KGM BIYABANI's comment, November 3, 2013 12:00 AM
TREATMENT REGIMENS ARE TO BE INDIVIDUALIZED ACCORDING TO THE PATIENT'S DISEASE AND THE TREATMENT REGIMEN OUTCOMES. ACCORDING TO THE ABOVE STUDY THERE SHOULDN'T BE AN "OR".; TREATMENT REGIMENS MAY INCLUDE MANY PREVENTIVE AS WELL AS CURATIVE THERAPIES, BOTH PHARMACOLOGICAL AND NON-PHARMACOLOGICAL. AT THE END PATIENT/PERSON MATTERS. THERE SHOULD BE "AND" instead of "OR". OF COURSE THERE IS NEVER A MAGIC BULLET IN HEALTHCARE;THAT'S WHY THERE SHOULDN'T BE AN "OR" AS DR. BILAZARIAN HAS SAID. AND I AGREE WITH ROBIN THOMAS ABOUT "THE MAGIC BULLET" PART ONLY.
Dr. KGM BIYABANI's curator insight, November 3, 2013 12:04 AM

TREATMENT REGIMENS ARE TO BE INDIVIDUALIZED ACCORDING TO THE PATIENT'S DISEASE AND THE TREATMENT REGIMEN OUTCOMES. ACCORDING TO THE ABOVE STUDY THERE SHOULDN'T BE AN "OR".; TREATMENT REGIMENS MAY INCLUDE MANY PREVENTIVE AS WELL AS CURATIVE THERAPIES, BOTH PHARMACOLOGICAL AND NON-PHARMACOLOGICAL. AT THE END PATIENT/PERSON MATTERS. THERE SHOULD BE "AND" instead of "OR". OF COURSE THERE IS NEVER A MAGIC BULLET IN HEALTHCARE;THAT'S WHY THERE SHOULDN'T BE AN "OR" AS DR. BILAZARIAN HAS SAID. AND I AGREE WITH ROBIN THOMAS ABOUT "THE MAGIC BULLET" PART ONLY.

Randy Randhawa, DC's curator insight, November 5, 2013 10:45 AM

Daily motivation, "structured exercise programs may be as effective, or even more useful, than medication to treat cardiovascular conditions."

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Fat Chance or Fat Choice? | Review of Fat Chance: The bitter truth about sugar

Fat Chance or Fat Choice? | Review of Fat Chance: The bitter truth about sugar | Healthy Recipes and Tips for Healthy Living | Scoop.it

We see many examples of people who have never really engaged with behaviour change and many who have tried hard but failed to achieve any meaningful outcome. So, how do we encourage real, life-changing and long-lasting behaviour change in our patients? When faced with many disappointments, can it even work?

Lustig spends most of the first half of the book explaining why behaviour change alone is so difficult. Our bodies have multiple adaptations to protect our body weight and we do not relinquish it without a fight. This battle is waged day by day in our guts (gut hormones) and our brains (leptin) making sustained weight loss incredibly difficult. Lustig clearly believes that individual behaviour change, while important, is inadequate to fully tackle the global obesity epidemic. Orchestrating this disaster, according to Lustig, is a food environment which has changed dramatically over the last 50 years in the Western World, in parallel to the rise in obesity, and Lustig argues that tackling this aspect of our culture should be a greater concern.


Via Seth Bilazarian, MD
Steve Kingsley's insight:

Yes, it's much more than changing one's diet - it really is about changing one's life style.

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Seth Bilazarian, MD's curator insight, October 1, 2013 4:36 PM

My patients' food environments are the biggest impediment to successful lifestyle modification adn weitght loss.

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My Life Check - Life's Simple 7™

My Life Check - Life's Simple 7™ | Healthy Recipes and Tips for Healthy Living | Scoop.it

Learn about the state of your heart and what you can do to live better. Take the My Life Check Assessment. I recommend reviewing the American Heart Association’s Life’s Simple 7 to learn about your cardiovascular health in a patient-friendly format. You can go through the Life’s Simple 7 assessments and bring those numbers, as well as your questions, to your doctor.

Just recently a patient with a family history of heart disease asked, “Am I doing everything I can to avoid developing coronary heart disease as I get older?” We looked at the computer in my office together for an introduction to Life’s Simple 7.

I also explained how to sign up on the AHA’s Heart360 website, where you can enter and track personal cardiovascular health information (such as blood pressure, weight, glucose and cholesterol measurements, and medications). It was easy. And within less than 15 minutes we were linked up on Heart360, which patients and doctors can use to communicate online — quickly and securely — about a patient’s health."


Via Seth Bilazarian, MD
Steve Kingsley's insight:

Simple to prescribe... hard to follow for most.

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Seth Bilazarian, MD's curator insight, November 17, 2013 4:25 PM

The AHA's Simple 7 is a great place for people to start to begin to know aboiut strategies that can reduce lifetime risk of heart attack and stroke.

The SEVEN are listed but the website does a great job explaining each in detail:

1.  Get Active 

2. Control Cholesterol

3. Eat Better

4. Manage Blood Pressure

5.  Lose Weight

6. Reduce Blood Sugar

7.  Stop Smoking

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Researchers Compare Exercise, Drugs as Cardiovascular Treatments | News | The Harvard Crimson

Researchers Compare Exercise, Drugs as Cardiovascular Treatments | News | The Harvard Crimson | Healthy Recipes and Tips for Healthy Living | Scoop.it

Structured exercise programs may be as effective, or even more useful, than medication to treat cardiovascular conditions. The authors evaluated and synthesized the results of 305 previous studies to compare the benefits of drug and exercise regimens on disease outcomes.  

After identifying four conditions for which exercise has been studied as a preventive technique—coronary heart disease, stroke, heart failure, and type-2 diabetes—Naci and Ioannidis compared the efficacy of drugs used to treat these conditions to previously-reported effects of exercise.

 They found that structured physical activity was more effective than drug use in the treatment and prevention of strokes, and equally effective in the secondary prevention of coronary heart disease and diabetes.  Diuretic drugs were more successful than exercise, however, in treating heart failure.

“[Our study] will trigger debate, which is really important,” said Naci. “In cases where we have evidence of exercise, exercise seems to do really well in comparison to drugs, but there are still a lot of instances where we don’t know how exercise fares against drugs.”


Via Seth Bilazarian, MD
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Dr. KGM BIYABANI's comment, November 3, 2013 12:00 AM
TREATMENT REGIMENS ARE TO BE INDIVIDUALIZED ACCORDING TO THE PATIENT'S DISEASE AND THE TREATMENT REGIMEN OUTCOMES. ACCORDING TO THE ABOVE STUDY THERE SHOULDN'T BE AN "OR".; TREATMENT REGIMENS MAY INCLUDE MANY PREVENTIVE AS WELL AS CURATIVE THERAPIES, BOTH PHARMACOLOGICAL AND NON-PHARMACOLOGICAL. AT THE END PATIENT/PERSON MATTERS. THERE SHOULD BE "AND" instead of "OR". OF COURSE THERE IS NEVER A MAGIC BULLET IN HEALTHCARE;THAT'S WHY THERE SHOULDN'T BE AN "OR" AS DR. BILAZARIAN HAS SAID. AND I AGREE WITH ROBIN THOMAS ABOUT "THE MAGIC BULLET" PART ONLY.
Dr. KGM BIYABANI's curator insight, November 3, 2013 12:04 AM

TREATMENT REGIMENS ARE TO BE INDIVIDUALIZED ACCORDING TO THE PATIENT'S DISEASE AND THE TREATMENT REGIMEN OUTCOMES. ACCORDING TO THE ABOVE STUDY THERE SHOULDN'T BE AN "OR".; TREATMENT REGIMENS MAY INCLUDE MANY PREVENTIVE AS WELL AS CURATIVE THERAPIES, BOTH PHARMACOLOGICAL AND NON-PHARMACOLOGICAL. AT THE END PATIENT/PERSON MATTERS. THERE SHOULD BE "AND" instead of "OR". OF COURSE THERE IS NEVER A MAGIC BULLET IN HEALTHCARE;THAT'S WHY THERE SHOULDN'T BE AN "OR" AS DR. BILAZARIAN HAS SAID. AND I AGREE WITH ROBIN THOMAS ABOUT "THE MAGIC BULLET" PART ONLY.

Randy Randhawa, DC's curator insight, November 5, 2013 10:45 AM

Daily motivation, "structured exercise programs may be as effective, or even more useful, than medication to treat cardiovascular conditions."