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ACO part of Obamacare not popular

ACO part of Obamacare not popular | Heart and Vascular Health | Scoop.it

My comment: ACO's (accountability care organizations) are programs only bureaucrats love.  It may not matter if patients, doctors and hospitals hate them; there may not be an option in the near future.

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Those who would be expected to carry out Obamacare are beginning to revolt.

Although it has been championed as a potential model by the Obama administration, the Cleveland Clinic (pictured)  has declined to participate in the administration's "pioneer" ACO progrm. Hospitals & doctors are revolting because ACOs saddle them with significant financial risks and substantial new administrative burdens. Patients won’t like them because they’ll put government bureaucrats — not their doctors — in charge of their care. Ultimately, ACOs will reduce competition throughout the healthcare market place — and raise costs.

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Dental Surgery and Antiplatelet Agents: Bleed or Die

Dental Surgery and Antiplatelet Agents: Bleed or Die | Heart and Vascular Health | Scoop.it

In patients taking antiplatelet medications who are undergoing dental surgery, physicians and dentists must weigh the bleeding risks in continuing antiplatelet medications versus the thrombotic risks in interrupting antiplatelet medications. Bleeding complications requiring more than local measures for hemostasis are rare after dental surgery in patients taking antiplatelet medications. Conversely, the risk for thrombotic complications after interruption of antiplatelet therapy for dental procedures apparently is significant, although small. When a clinician is faced with a decision to continue or interrupt antiplatelet therapy for a dental surgical patient, the decision comes down to “bleed or die.” That is, there is a remote chance that continuing antiplatelet therapy will result in a (nonfatal) bleeding problem requiring more than local measures for hemostasis versus a small but significant chance that interrupting antiplatelet therapy will result in a (possibly fatal) thromboembolic complication. The decision is simple: It is time to stop interrupting antiplatelet therapy for dental surgery.

Seth Bilazarian, MD's insight:

From the paper's conclusion:

When a clinician is faced with a decision to continue or interrupt antiplatelet therapy for a dental surgical patient, the decision comes down to “bleed or die.” That is, there is a remote (∼0.2%) chance that continuing antiplatelet therapy will result in a (nonfatal) bleeding problem requiring more than local measures for hemostasis versus an unknown but significant chance that interrupting antiplatelet therapy will result in a (possibly fatal) thromboembolic complication. The decision is fairly simple: It is time to stop interrupting antiplatelet therapy for dental surger

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Lower Your Triglycerides with Lifestyle

Triglycerides (TGs) are a type of fat in the bloodstream. They are used for energy. When TGs become too high, this biomarker
suggests risk for cardiovascular disease, especially when accompanied by low HDL-cholesterol and high LDL-cholesterol. High
triglycerides are a common problem in the United States. One third of adults have levels above the normal range (< 150 mg/dl).
The good news about TGs is that they are highly responsive to lifestyle modifications. Optimal lifestyle interventions can lower
TGs by 20-50%. We suggest that you look at the following chart and select a change or changes you feel ready to make!
Note: When evaluating TG levels over time, be aware that there is considerable variability in the measurement of TG. Look at
the trend in TG over time (not just one reading) to evaluate the success of your lifestyle changes. Remember, the same positive
lifestyle changes that lower TG, also improve your overall health!

Seth Bilazarian, MD's insight:

Nice resource from National Lipid Association on therapeutic lifestyle changes that reduce triglycerides.  PDF tear sheet.

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Ellen Diane's curator insight, March 25, 7:19 AM

excellent article

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Pernio (Chilblains) in 104 Patients at Mayo

Pernio (Chilblains) in 104 Patients at Mayo | Heart and Vascular Health | Scoop.it
Objective -To further characterize the clinical features, etiologic associations, laboratory findings, and treatment of pernio.Patients and Methods This is a retrospective review of patients with pernio seen at our institution between January 1, 2000, and December 31, 2011.Results Of 104 patients with pernio (mean age at diagnosis, 38.3 years), 82 (79%) were women. Pernio affected the toes in 85 patients (82%) and the fingers in 31 (30%). Thirty-eight patients (37%) had at least 1 abnormal laboratory test result, and test results were positive for cold agglutinins in 11 (55%) of 20 tested patients. Results were negative for cryoglobulins in all tested patients (n=53). Four patients (4%) had connective tissue disease (nonlupus) associated with pernio; 3 patients (3%) had an associated hematologic malignant disease. Conservative treatments (eg, warming, drying, and smoking cessation) provided complete response in 23 (82%) of 28 patients with follow-up data.Conclusion To our knowledge, this study represents one of the largest single-center case series of pernio to date. Most of the patients did not have an underlying systemic association with pernio, although a few patients had pernio in association with connective tissue disease or hematologic malignant disease.
Seth Bilazarian, MD's insight:

Pernio or Chilblains are a common concern for patients (especially in colder climes) but this largest ever study confirms that they are benign and best treated conservatively.

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Tackling men's reluctance to join weight loss programmes

Tackling men's reluctance to join weight loss programmes | Heart and Vascular Health | Scoop.it

Male obesity is increasing but few men take part in weight loss programs.  We assessed the effect of a weight loss and healthy living program on weight loss in football (soccer) fans.

 747 male football fans aged 35—65 years with a body-mass index (BMI) > 28 kg/m2 from 13 Scottish professional football clubs. Participants were randomly assigned, stratified by club, to a weight loss program delivered by community coaching staff in 12 sessions held every week. The intervention group started a weight loss program within 3 weeks, and the comparison group were put on a 12 month waiting list. All participants received a weight management booklet.

At 12 months the mean difference in weight loss between groups, adjusted for baseline weight and club, was 4·94 kg (10.9 lbs)  and percentage weight loss, was 4·36% (3·64—5·08), both in favor of the intervention. 

The FFIT programme can help a large proportion of men to lose a clinically important amount of weight; it offers one effective strategy to challenge male obesity.

 

Here's the link to the article on Lancet

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62420-4/abstract

 

Seth Bilazarian, MD's insight:

Weight loss achieved in this weekly education and accountability program was impressive and lasted 12 months.  Weight loss might be one of the educational opportunities best undertaken in a single sex environement

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Angioplasty Performed Without Pre-Procedural Aspirin

Angioplasty Performed Without Pre-Procedural Aspirin | Heart and Vascular Health | Scoop.it

Aspirin is an essential medicine before and after angioplasty or percutaneous coronary intervention (PCI). Previous studies suggest that pre-procedural aspirin is not administered to a clinically significant number of patients undergoing PCI. 

The study population comprised 65,175 patients, of whom 4,640 (7.1%) did not receive aspirin within 24 h before undergoing PCI. Aspirin nonreceivers were more likely to have had previous gastrointestinal bleeding or to present with cardiogenic shock or after cardiac arrest. Absence of aspirin before PCI was associated with a higher rate of death (3.9% vs. 2.8%; p < 0.001) and stroke (0.5% vs. 0.1%;  with no difference in need for transfusions. This association was consistent across multiple pre-specified subgroups.

Conclusions  Lack of aspirin before PCI was associated with significantly increased in-hospital mortality and stroke. Our study results support the need for quality efforts focused on optimizing aspirin use before PCI.

Seth Bilazarian, MD's insight:

The inexpensive, readily available medicine, aspirin before PCI reduces death and stroke significantly.  The 1.1% absolute risk reduction means that for every 91 people who are taking aspirin before angioplasty or PCI, one life will be saved.  This quality metric has become part of the pre-procedure assessment for patients it's so important

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National Trends in Patient Safety for Heart Attack, CHF, pneumonia or surgery 2005–2011

National Trends in Patient Safety for Heart Attack, CHF, pneumonia or surgery 2005–2011 | Heart and Vascular Health | Scoop.it

Patient safety poses serious challenges to the health care system in the United States. Since 2001, nationwide efforts have focused on reducing in-hospital adverse events over the past decade.  Extensive nationwide efforts have focused on improving care processes and outcomes, starting with Medicare patients with acute myocardial infarction (AMI), in 1992, . The cardiovascular care community, in particular, has embraced quality improvements for patients hospitalized with acute myocardial infarction or congestive heart failure by launching national registries, developing performance measures and appropriate-use criteria, and initiating national quality-improvement campaigns.

The study included 61,523 patients hospitalized for heart attack (AMI)  (19%), congestive heart failure (25%), pneumonia (30%), and conditions requiring surgery (27%). From 2005 through 2011, among patients with acute myocardial infarction (AMI), the rate of occurrence of adverse events declined from 5.0% to 3.7%..  Among patients with congestive heart failure (CHF) the rate of occurrence of adverse events declined from 3.7% to 2.7%. . Patients with pneumonia and those with conditions requiring surgery had no significant declines in adverse-event rates.

 From 2005 through 2011, adverse-event rates declined substantially among patients hospitalized for acute myocardial infarction or congestive heart failure but not among those hospitalized for pneumonia or conditions requiring surgery.
Seth Bilazarian, MD's insight:

Good news from CMS on improvement in patient safety for two of the most common reasons for hospitalization in the cardiology realm.  Adverse events in patients admitted with heart attack and congestive heart failure are declining.  Why this has occurred might be due to the attention being given to this important issue by cardiology societies.

One area of heart attack care that increased during the interval studied is injury to the kidney after cardiac catheterization (contrast-induced nephropathy), This problem increased significantly among patients with acute myocardial infarction, but has been an area of significant attention and increased efforts to identify patients at risk and reduce this problem.

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F as in Fat: How Obesity Threatens America’s Future 2013

F as in Fat: How Obesity Threatens America’s Future 2013 | Heart and Vascular Health | Scoop.it

After three decades of increases, adult obesity rates remained level in every state except for one, Arkansas, in the past year, according to F as in Fat: How Obesity Threatens America's Future 2013, a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). The full report is available here. Visit http://www.FasinFat.org/ for interactives, graphs, charts and obesity rates for the states and nation going back decades.

Thirteen states now have adult obesity rates above 30 percent, 41 states have rates of at least 25 percent, and every state is above 20 percent, according to the report. In 1980, no state was above 15 percent; in 1991, no state was above 20 percent; in 2000, no state was above 25 percent; in 2007, only Mississippi was above 30 percent.*

Since 2005, there has been some evidence that the rate of increase has been slowing. In 2005, every state but one experienced an increase in obesity rates; in 2008, rates increased in 37 states; in 2010, rates increased in 28 states; and in 2011, rates increased in 16 states.*

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Adverse Cardiovascular Events After Ingestion of Energy Drinks

Adverse Cardiovascular Events After Ingestion of Energy Drinks | Heart and Vascular Health | Scoop.it

Energy drink (ED) consumption has been linked to several adverse event reports, but there is limited data on related cardiovascular (CV) complications.. We searched case reports in peer-reviewed journals from 1980, to 2013, in which an acute CV event was associated temporally with ED consumption.

We identified 14 eligible articles involving 15 cases (5 atrial arrhythmias, 5 ventricular arrhythmias, 1 QT prolongation, 4 ST-segment elevations). Two additional cases of cardiac arrest from our institution are included. Of these 17 cases of ED-related acute CV events (13 male cases; 15 cases aged <30 years, age range 13 to 58 years), only 1 had minor previous cardiac disease. Cardiac investigations did not reveal any predisposing cardiac abnormality in the majority of cases. Of the 11 cases related to a serious event (i.e., cardiac arrest, ventricular arrhythmia, or ST-segment elevations), 5 reported acute heavy ED consumption, 4 reported co-ingestions with alcohol or other drugs, and 2 were found to have a channelopathy. Potential mechanisms of ED-related cardiac events are reviewed. In conclusion, several adverse CV events after consuming ED have been reported in the literature. Although causality cannot be inferred from our series, physicians should routinely inquire about ED consumption in relevant cases, and vulnerable consumers such as youth should be advised that caution is warranted with heavy consumption and/or with concomitant alcohol or drug ingestion.

Seth Bilazarian, MD's insight:

The ingredients in energy drinks present theoretical risk for arrhythmia's.  The risk, however is not born out by this report based on the few cases (17 cases) presented in the literature.  This may be related to poor reporting by clinicians, of events which have a possible or probable linkage to energy drink use, 

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askdrmaxwell's curator insight, January 27, 4:50 PM

Energy drinks are not good for your health. They contain excessive amounts of caffeine and potentially-harmful additives and preservatives. 

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Study finds Americans are beginning to consume fewer calories and eat at home more often.

Study finds Americans are beginning to consume fewer calories and eat at home more often. | Heart and Vascular Health | Scoop.it

Americans are beginning to consume fewer calories and eat at home more often, according to a government study that suggests the nation's diet is taking a slightly healthier turn.

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JAMA => The War Against Tobacco: 50 Years and Counting

JAMA => The War Against Tobacco: 50 Years and Counting | Heart and Vascular Health | Scoop.it

JAMA theme issue on tobacco control.  Epidemiology, original reserach and the status of e-cigarettes and strategies for quitting cigarettes is reviewed.  It's been 50 years since the Surgeon General's report. 

Seth Bilazarian, MD's insight:

The cover collage is great.  How far we've come, but not all the way there.  The advertisement of a physician recommending smoking at the top left with highlights of the Surgeon general's report and other news highlights over the last 50 years.

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Adherence Toolkit | National Lipid Association Online

Adherence Toolkit | National Lipid Association Online | Heart and Vascular Health | Scoop.it

The consequence of not recognizing and addressing these barriers is too great to ignore. The breakdown of medication adherence begins in the prescriber’s office and the likelihood of adherence diminishes as the patient proceeds to the pharmacy to fill the prescription and once the patient takes the medication home.

Reference: Adapted from Oyekan E. The B-SMART Medication Adherence Checklist. A Tool to make it easier for Physicians and Providers to do the right thing when addressing America’s other drug problem – Medication Non Adherence. Website: Department of Managed Health Care.  http://dmhc.ca.gov/library/reports/news/rci/oyekan.pdf

 

Seth Bilazarian, MD's insight:

A helpful monograph from National Lipid Association on the problem of medication and lifestyle adherence by patients.

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Frequently Asked Questions About "Better" Fats from AHA

Frequently Asked Questions About "Better" Fats from AHA | Heart and Vascular Health | Scoop.it
What are the "better" fats and which foods contain them?

The unsaturated fats (monounsaturated and polyunsaturated) are also found in many foods.  Vegetable oils, nuts, and seafood are recommended sources of these fats.

Seth Bilazarian, MD's insight:

Great resource on FAQs about, un-, mono-, poyun- and saturated fat Dscussion about omega -3 and 6 fatty acids and fish oil is very clear and understandable..  The words "eat fish" appear often. 

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Here's Why Eating McDonalds Every Day Is A Bad Idea (Even If You Do Lose Weight)

Here's Why Eating McDonalds Every Day Is A Bad Idea (Even If You Do Lose Weight) | Heart and Vascular Health | Scoop.it

Can you lose weight eating nothing but McDonald's for three months? Yes — as evidenced by the now-famous science teacher who reportedly did just that.

But — while we don't recommend it — you could also lose weight eating nothing but jellybeans. The real story is about portion size and exercise: Cisna went from not exercising or watching his food intake to walking for 45 minutes each day and carefully restricting himself to 2,000 calories and recommended dietary allowances for carbohydrates, cholesterol, etc. (Compare that to Spurlock's 5,000 daily calories and many sodas during Super Size Me.)

Are there nutrients in McDonald's apple slices and side salads? Of course. But navigating a fast food menu so that you get the nutrients you need without completely overloading on calories, sugar, carbohydrates, and saturated fat would be a difficult and perhaps futile endeavor. If your end goal is to improve your health, it would also be ill-advised.

Seth Bilazarian, MD's insight:

Little to add here.  We live in a calorie dense environment.  Avoiding circumstances and places where the calories are dense and nutritional options limited is sensible and wise.  The more people that avoid fast food purveyors the more they will be responsive with better nutritional options. The fast food makers are capitalists.

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Stroke, an Animation & Telehealth ER evaluation

Stroke, an Animation & Telehealth ER evaluation | Heart and Vascular Health | Scoop.it
A description of what happens when a stroke occurs.
Seth Bilazarian, MD's insight:

Very good animation of the carotid artery and development of atherosclerosis and then thrombosis.  The feature following the animation is a real telehealth visit for a patient with a stroke in the setting of atrial fibrillation making a decision about whether to use thrombolytic treatment (tPA) for clot busting of the stroke causing clot.

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Diminishing Returns of Modern Medicine - fight to shave minutes in heart attack care

Diminishing Returns of Modern Medicine - fight to shave minutes in heart attack care | Heart and Vascular Health | Scoop.it
In-hospital mortality after an acute heart attack has dropped 10-fold, from 30 percent to 3 percent, since the invention of the modern cardiac care unit in the 1960s. Can shaving a few more minutes off the time it takes to get hospital treatment possibly yield any additional benefit?
Seth Bilazarian, MD's insight:

This is a good account of the problem with advancing medicine.  As we reduce bad outcomes closer to zero OF COURSE there is going to be much greater difficulty (this is the high hanging fruit)..  The author is right that because of the pressure of public reporting on door to balloon time (D2BT) sometimes decisions are rushed and this is an area of concern.

The example he provides of the cardiologist driving 90 mph is not appropriate because that is an example of a system problem that SHOULD be fixed.  Taking 60 minutes to figure out a patient has a heat attack is much to long and not good care.

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Heart Attack Incidence With Shifts to Daylight Savings Time

Heart Attack Incidence With Shifts to Daylight Savings Time | Heart and Vascular Health | Scoop.it

Modulators of normal bodily functions such as the duration and quality of sleep might transiently influence cardiovascular risk. The transition to daylight savings time (DST) has been associated with a short-term increased incidence of heart attack or acute myocardial infarction (AMI). The present retrospective study examined the incidence of AMIs that presented to Beaumont Hospitals in Michigan the week after DST and after the autumn switch to standard time, October 2006 to April 2012, with specific reference to the AMI type.

The study population (n = 935; 59% men) was obtained from the electronic medical records. Overall, the frequency of AMI was similar in the spring and autumn, 463 (49.5%) and 472 (50.5%), respectively.

The incidence ratio for the first week after the spring shift was 1.17. After the transition from DST in the autumn, the IR for the same period was lower, but not significantly different, 0.99.  Nevertheless, the greatest increase in AMI occurred on the first day (Sunday) after the spring shift to DST (1.71, 95% confidence interval 1.09 to 2.02; p <0.05). Also, a significantly greater incidence was found of non–ST-segment myocardial infarction after the transition to DST in the study group compared with that in the control group (p = 0.022). In conclusion, these data suggest that shifts to and from DST might transiently affect the incidence and type of acute cardiac events, albeit modestly.

Seth Bilazarian, MD's insight:

These investigators have shown the Spring switch to Day Light Savings is of greater hazard to for the incidence of heart attack especially on the first day (Sunday ) after the switch.  The effect is modest but sheds some insights on the impact of sleep and daily body rhythms and their importance in heart and vascular disease..

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William Payne's curator insight, March 15, 9:22 AM

Sleep is critical important to repairing body functions

 

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ASCVD Risk Calculator Pooled Cohort Equations - Cardiac Risk Assist

ASCVD Risk Calculator Pooled Cohort Equations - Cardiac Risk Assist | Heart and Vascular Health | Scoop.it
Get ASCVD Risk Calculator Pooled Cohort Equations - Cardiac Risk Assist on the App Store. See screenshots and ratings, and read customer reviews.

Cardiac Risk Assist is an application that aids in calculating the 10-year and lifetime risks for atherosclerotic cardiovascular disease (ASCVD) based on the information provided by the user: age, gender, race, total cholesterol, HDL cholesterol, systolic pressure, and additional parameters.

Seth Bilazarian, MD's insight:

Very nice risk calculator - quick and easy to use.  A big advance ovr the cumbersome spreadsheet released by ACC/AHA.

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Dental Prophylaxis Protective to Ischemic Stroke

Dental Prophylaxis Protective to Ischemic Stroke | Heart and Vascular Health | Scoop.it

 Correlation has been found between periodontal disease (PD) and stroke. This study was conducted to investigate whether dental prophylaxis and periodontal treatment reduce the incidence of ischemic stroke.

Stroke rate of non-PD subjects was 0.32%/year. In the PD group, subjects who received dental prophylaxis had the lowest stroke IR (0.14%/year); subjects with intensive treatment or tooth extraction had a higher stroke IR (0.39%/year); and subjects without PD treatment had the highest stroke IR (0.48%/year; P<0.001).

Maintaining periodontal health by receiving dental prophylaxis and PD treatment can help reduce the incidence of ischemic stroke.

Seth Bilazarian, MD's insight:

The results of this study show that periodontal disease increases the incidence of ischemic stroke, especially among the younger population. Because it can be prevented and treated with improved oral hygiene, those who already have periodontal should seek treatment to alleviate tissue inflammation and thereby reduce the incidence of ischemic stroke.

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CARDIORESPIRATORY FITNESS AND SHORT TERM OUTCOMES WITH CORONARY ARTERY BYPASS GRAFT SURGERY

CARDIORESPIRATORY FITNESS AND SHORT TERM OUTCOMES WITH CORONARY ARTERY BYPASS GRAFT SURGERY | Heart and Vascular Health | Scoop.it

Pre-operative risk assessment for coronary artery bypass surgery (CABG) has been evaluated with multiple predictive models; yet none incorporate low cardiorespiratory fitness as a risk factor. The present study evaluates pre-operative metabolic equivalents (METs) and short term morbidity and mortality after CABG.

Patients undergoing CABG from January 2002 to December 2010 at Beaumont Health Systems were reviewed for peak or symptom-limited stress testing < 90 days prior to surgery. METs were estimated from the achieved treadmill speed, grade, and duration, or the cycle ergometer workload corrected for body weight.

596 patients were categorized into 2 groups: those with low aerobic capacity (<5 METs); and those achieving = 5 METs. Fisher's exact tests compared pre-operative aerobic capacity and post-operative morbidity and mortality between the two groups (Table 1). After adjusting for potential confounding variables, we found an inverse relationship between cardiorespiratory fitness and complications after CABG.

Low pre-operative cardiorespiratory fitness was associated with higher operative mortality, 30 day mortality, sternal wound infections, and prolonged ventilation after CABG. These data suggest that pre-operative cardiorespiratory fitness provides an independent and additive marker of prognosis after CABG that has not been previously reported.

Seth Bilazarian, MD's insight:

Using this simple metric there was a dramatic difference in death rates in patients having coronary bypass.  If a patient could walk just 5 minutes on the treadmill then there death rate was 1% after bypass surgery in this study.  Those patients who could not get to the fifth minute had a death rate of 5%.  This absolute difference is significant and another reason to recommend efforts at fitness.

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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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Do Statins cause dementia?

Do Statins cause dementia? | Heart and Vascular Health | Scoop.it

Adults with no history of cognitive dysfunction treated with statins were included from high-quality randomized controlled trials and prospective cohort studies after formal bias assessment. Sixteen studies were included in qualitative & 11 in quantitative synthesis.

Short-term trials did not show a consistent effect of statin therapy on cognitive end points. Long-term cognition studies included 23,443 patients with a mean exposure duration of 3 to 24.9 years. Three studies found no association between statin use and incident dementia, and 5 found a favorable effect. Pooled results revealed a 29% reduction in incident dementia in statin-treated patients.

Conclusion In patients without baseline cognitive dysfunction, short-term data are most compatible with no adverse effect of statins on cognition, and long-term data may support a beneficial role for statins in the prevention of dementia.
Seth Bilazarian, MD's insight:

Patients are understandably concerned that a medicine might cause problems with their ability to think and function as they age.  For proponents  (like me) of statin type cholesterol lowering medicines the long-term benefit of improved vascular health provided by statins is compelling.  The theoretical benefit on long term brain health from improved vascular health is also interesting but conflicts with some reports taht memory might be effected by statin use.  The authors from Johns Hopkins have provided a useful review of the literature and concluded that statins are neutral to positive for long term brain health and function, and may "support a beneficial role for statins in the prevention of dementia".

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Smoking and Health (1964)

Smoking and Health (1964) | Heart and Vascular Health | Scoop.it

January 11, 2014 marks the 50th anniversary of the first Surgeon General's report on Smoking and Health. The 1964 report was the first comprehensive compilation of research linking cigarette smoking to severe adverse health effects. Victories have occurred since the release of this landmark report, but there are ongoing challenges and gaps in protections and the course that we will chart to ensure that everyone lives and works in a smokefree environment, that no one picks up the smoking habit and subsequent nicotine addiction, and that no one has to needlessly suffer from a smoking- or secondhand smoke-related disease is an ongoing effort.

Seth Bilazarian, MD's insight:

I still see patients in there 70 and 80's who say that the day the Surgeon general's report came out they put down their cigarettes and never smoked again.  Its a testament to the power of information.  It's estimated that 50% of smokers quit on there own.  We live in a new era and information is more disseminated via the web, and often less authoritative than in 1964, but information still has a potent effect on prevention for many.

The patients that did quit smoking in the early 60's would not be alive today had they not responded  to the surgeon general's call.

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What Patients Say Works for Hypertension

What Patients Say Works for Hypertension | Heart and Vascular Health | Scoop.it
CureTogether, a free resource owned by 23andMe, reports out on what patients say works for them in treating hypertension.

Via 27BloodPressure
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Life Expectancy Calculator

Life Expectancy Calculator | Heart and Vascular Health | Scoop.it
Answer this quiz to calculate your life expectancy - see the effects that genetics and lifestyle choices have on your life expectancy.
Seth Bilazarian, MD's insight:

Useful calculator that predicts life expectancy from cardiovascular disease and other risks such as hazardous driving, alcohol and drug use and seat belt use.

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Color-coded labels, healthier food

Color-coded labels, healthier food | Heart and Vascular Health | Scoop.it
Marking such items and displaying them better prompts cafeteria diners to make more wholesome long-term choices

Using color-coded labels to mark healthier foods and then displaying them more prominently appears to have prompted customers to make more healthful long-term dining choices in their large hospital cafeteria, according to a report from Harvard-affiliated Massachusetts General Hospital (MGH).  Previously reported changes have continued up to two years after the labeling intervention was introduced.

“Our current results show that the significant changes in the purchase patterns of both hospital employees and all customers resulting from the labels and the choice architecture program did not fade away as cafeteria patrons became used to them,”

”This is good evidence that these changes in healthy choices persist over time.”

The first phase involved the application of “traffic light” labels — green for the healthiest items, such as fruits, vegetables, and lean sources of protein; yellow for less healthy items; and red for those with little or no nutritional value — to all items in the main hospital cafeteria. Several weeks before the labels were introduced, cafeteria cash registers began to identify and record each purchased item as red, yellow, or green.

The current study analyzed purchase patterns for the 24 months following the program’s implementation and found that the changes present at the end of the first year were virtually unchanged at the end of the second. Overall, purchases of “green” items had increased 12% , compared with the pre-intervention period, and “red” item purchases dropped 20%. Purchases of “red” beverages — primarily sugar-sweetened beverages — dropped 39%, while “green” beverage purchases increased 10%. The changes remained similar for all types of employees, and overall cafeteria sales during the two-year period were stable.

Seth Bilazarian, MD's insight:

Like many nutrition issues helping end users get educated is of paramount importance.  People can't make wise choices if they don't know what the best nutritional options are, but this study took it a step further by adding the information at the point of selection and purchase.  It worked well, but as a user of the cafeteria it's still a challenge to avoid the Papa Gino's pizza station after a long day. 

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