Heart and Vascular Health
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Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
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Scooped by Seth Bilazarian, MD
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Air Versus Oxygen in ST-Segment Elevation Myocardial Infarction

Air Versus Oxygen in ST-Segment Elevation Myocardial Infarction | Heart and Vascular Health | Scoop.it

Supplemental oxygen therapy in patients with STEMI but without hypoxia may increase early myocardial injury and was associated with larger myocardial infarct size assessed at six months.

Seth Bilazarian, MD's insight:

The teaching and conventional wisdom for many years has been that oxygen is a critical treatment for patients having myocardial infarction (heart attack). Like many things in medicine this makes a lot of theoretical sense, but  there has not been very good data to support it.

In myocardial infarction or heart attack, part of the heart muscle is suffering from lack of oxygen. What has been thought now for decades is that giving the patient more oxygen must be beneficial.

Doctors & nurses are taught the pneumonic MONA for (morphine, oxygen, nitrates, aspirin)

Fortunately, with better clinical trial data these recommendations and conventional wisdoms are falling. The MONA recommendations have almost been completed discredited, except for aspirin. Use of morphine may actually increase harm because its use delays absorption of medications that are given early in the patient's course and can cause nausea and vomiting.

Unfortunately, changing the habit of placing all patients with chest pain on oxygen will be a challenge.  MONA should be retired.

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My Vlog: Hypertension Guidelines: Clear as Mud!

My Vlog: Hypertension Guidelines: Clear as Mud! | Heart and Vascular Health | Scoop.it

I've been trying to make sense of guidelines now for a couple of months. We had lipid guidelines that came out in November at the American Heart Association (AHA) meeting, and then in December we had the publication of the new Joint National Committee (JNC 8) guidelines, [1] also called the "2014 hypertension guidelines," and I'm trying to make sense of it.

Seth Bilazarian, MD's insight:

After more than a decade the hypertension (high blood pressure) guidelines were updated.  The delay and changes have been criticized.  Clinicians and patients need regular updates for all risk factor categories: hypertension, cholesterol & lipids and diabetes.  The guideline writers needs some practical guidelines to write better guidelines.  My fast take on the subject at theheart.org on Medscape.com 

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New Cholesterol Guidelines => Statin Nation

New Cholesterol Guidelines => Statin Nation | Heart and Vascular Health | Scoop.it

12.8 Million more adults are eligible for statin therapy based on a new study
attempting to determine the effect of new ACC/AHA guidelines
for the management of cholesterol, with the increase seen mostly
among older adults without cardiovascular disease. Among adults
60 and 75 years without cardiovascular disease, the percentage
eligible for such therapy would increase from 30.4% to 87.4%
among men and from 21.2% to 53.6% among women.

Statin Nation - graphic is from Cardiosource  World News at http://www.joomag.com/magazine/cardiosource-worldnews-april-2014/0842627001398192120

Seth Bilazarian, MD's insight:

Are you among the 12.8 million Americans for whom statin is now recommended?

The new atherosclerotic cardiovascular risk calculator (ASCVD) is available as a smartphone app at 

https://itunes.apple.com/us/app/ascvd-risk-estimator/id808875968?mt=8

or

online at:

 http://tools.cardiosource.org/ASCVD-Risk-Estimator/


Use the risk calculator and the current guidelines recommend treatment with statin cholesterol lowering medication  if the 10 year risk of stroke MI or other vascular disease is greater than 7.5% based on this calculator.

 

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askdrmaxwell's curator insight, May 26, 2014 5:17 PM

Cholesterol guidelines have gotten so low, few people can meet them, thus they are prescribed statin drugs. 

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New Cholesterol guidelines from ACC/AHA.

New Cholesterol guidelines from ACC/AHA. | Heart and Vascular Health | Scoop.it

This downloadable spreadsheet is a companion tool to the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. The spreadsheet enables health care providers and patients to estimate 10-year and lifetime risks for atherosclerotic cardiovascular disease (ASCVD), defined as coronary death or nonfatal myocardial infarction, or fatal or nonfatal stroke, based on the Pooled Cohort Equations and the work of Lloyd-Jones, et al., respectively. The information required to estimate ASCVD risk includes age, sex, race, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure lowering medication use, diabetes status, and smoking status,  Its here =>

http://goo.gl/d9NldB

Seth Bilazarian, MD's insight:

Many changes for management of patients with statin medications, based on 2013 ACC/AHA guidelines.  My Vlog review of these changes for community based physicians and patients at theheart.org and Medscape reviews the changes. 

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John Mills's curator insight, March 1, 8:58 AM

Quality Chia Seeds Online Store

 

The Cholesterol Guidelines:

 

Many changes for management of patients with statin medications, based on 2013 ACC/AHA guidelines.  My Vlog review of these changes for community based physicians and patients at theheart.org and Medscape reviews the changes.