Heart and Vascula...
Follow
Find
27.5K views | +3 today
Heart and Vascular Health
Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
Your new post is loading...
Your new post is loading...
Scooped by Seth Bilazarian, MD
Scoop.it!

Stress has less effect on high-ranking baboons—and British civil servants

Stress has less effect on high-ranking baboons—and British civil servants | Heart and Vascular Health | Scoop.it

Take Home message:  Patients ask me every day about stress and health.  The amount of stress is not correlated to health outcomes; the response to stress is what matters.  From a very practical standpoint stress can lead to unhealthy behaviors: smoking, alcohol, eating, disrupted sleep. Controlling stress may be the key.  The alpha male in the baboon troop can control stress by choosing when to fight. Humans can control this by intentionally taking a break: day off, vacation, meditation, recreational diversions like walking or hobbies.  It matters.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Social Media for Cardiologists

Social Media for Cardiologists | Heart and Vascular Health | Scoop.it
Should cardiologists be interested in social media? Do they follow their colleagues on Twitter? Is it better for physicians not to join Facebook?

Drs Seth Bilazarian & Westby Fisher sit down with heartwire's Shelley Wood to talk about how they got their start in social media and why they think their colleagues should join this worldwide conversation.

> Two experts (Shelly and Wes) & a Social Media Novice (me) encourage cardiologists to engage these new information platforms.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Controlling Hypertension (High Blood Pressure) Via Kidney = Renal Denervation

Controlling Hypertension (High Blood Pressure)  Via Kidney = Renal Denervation | Heart and Vascular Health | Scoop.it

New experimental treatment for stubborn hypertension: Singeing the walls of nerve-lined arteries leading to the kidneys, blocking the organs' ability to raise blood pressure.

 

Medtronic is investigating a renal denervation strategy in a trial called Symplicity.  Procedure takes about 30 - 40 minutes. The study will target 530 patients with systolic blood pressure over 160 despite taking at least three medicines.  "Until now, there were no other options for such patients, other than adding more drugs".

 

For patients with resistant hypertension interested in clinical trial participation in Symplicity contact the clincial research office at (978) 469-5494 or visit the website http://www.pmaonline.com/clinical-trials.htm ;

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

What Is High Blood Pressure? - NHLBI, NIH

What Is High Blood Pressure? - NHLBI, NIH | Heart and Vascular Health | Scoop.it
Information in an easy to read and understand format for patients to uderstand the imprtance of high blood pressure treatment. What Is High Blood Pressure?
High blood pressure (HBP) is a serious condition that can lead to coronary heart disease (also called coronary artery disease), heart failure, stroke,
kidney failure, and other health problems.

"Blood pressure" is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.

 

more...
No comment yet.
Rescooped by Seth Bilazarian, MD from Medical Apps
Scoop.it!

Apps for the Traveler With Medical Issues

Apps for the Traveler With Medical Issues | Heart and Vascular Health | Scoop.it

Apps can now deliver information like blood glucose levels, the location of a stent or the name of the nearest specialty hospital.


Via Alex Butler, Guus van den Brekel
more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

How to Get the Best Price on Generic Plavix from Angioplasty.Org

How to Get the Best Price on Generic Plavix from Angioplasty.Org | Heart and Vascular Health | Scoop.it

Key Takeaway:  When generic drugs first become available the market is dynamic.  With Plavix there are 7 manufacturers and pharmacies have not all priced in the expected discount.  This excellent service by angioplasty.org evaluated and found a range from 35 cents to 17 times greater.  For those paying cash the critical message is SHOP!

 

At the Mass Drug look up http://www.madrugcard.com/ ; on 5/31/2012 CVS lists 30 day supply $154.05 and Walgreens $179.32.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Anyone Can Save A Life

Anyone Can Save A Life | Heart and Vascular Health | Scoop.it

Anyone Can Save A Life is a first-of-its-kind emergency response program for after-school practices and events.

 

Key Take Away: My community has done a great job acquiring Automatic External Defibrillators (AED) for schools, churches and public places.  HOWEVER, these devices will not be life saving unless people know where the nearest AED is and how to use it.  This is a great program to get schools to create confident and rapid use in the setting of Sudden Cardiac Arrest (SCA).  By implementing Anyone Can Save A Life, the school community is ‘heart safe’–equipped and prepared to respond to life-threatening emergencies that may take place during after-school athletic and activity practices and events.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Taking Calcium Supplements May Pose Heart Risks

Taking Calcium Supplements May Pose Heart Risks | Heart and Vascular Health | Scoop.it
In a large European study, people who were taking calcium supplements had nearly a 30 percent greater risk of heart attack over four years than those who were not.
more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Systems of Care for Heart Attack => ST-Segment–Elevation MI from AHA

Systems of Care for Heart Attack => ST-Segment–Elevation MI from AHA | Heart and Vascular Health | Scoop.it

Key take away for patients:

This paper was a survey of over 300 hospitals that take care of the sickest type of heart attack called the STEMI.  Best practices to improve care by reducing the time to open up the artery (called door to balloon time (D2B)) were identified. 

 

These practices are:

1.  accepting patients at a PCI hospital regardless of bed availability

2.  single phone call activation of cath lab

3.  emergency department physician activation
of lab without cardiology consultation

4.  national data registry participation

5.  Prehospital activation of the catheterization laboratory by paramedics & transferring physicians.

 

The most commonly reported barriers to system
implementation were hospital and cardiology group
competition and EMS transport and finances.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Living Off the Land May Protect the Heart

Living Off the Land May Protect the Heart | Heart and Vascular Health | Scoop.it

Key Take Away for patients:  Exercise and plant based diets reduce or eliminate cardiovascular disease. 

---------------------

Populations that gather or grow what they need to survive from nature and have little contact with the outside world appear to have lower cardiovascular risk than more modern societies, two studies showed.

 

Both studies, which were published online in Hypertension: Journal of the American Heart Association, suggest that lifestyle factors present in these traditional populations -- high levels of physical activity, low stress levels, and diets rich in fruits and vegetables -- may protect against the effects of aging.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Catheter based Renal Nerve Ablation Safely Lowers BP in kidney disease patients

Catheter based Renal Nerve Ablation Safely Lowers BP in kidney disease patients | Heart and Vascular Health | Scoop.it

My comment for patients:  More good news for renal nerve denervation.  This catheter based treatment done like a heart catheterization from the artery in the groin has been show to have significant BP improvement for those patients who can't be controlled with 3 or more drugs, called resistnt hypertension.  This study shows that this treatment also works in patients with chronic kidney disease.  We won't have this available in the US for two or more years but the future for this technolopgy looks bright.

 

From the article:

Catheter-based renal nerve ablation helps lower resistant hypertension, but now researchers have found that it works as well in those with chronic kidney disease (CKD), a pilot study showed.  n 15 patients with resistant hypertension and stage 3 and 4 CKD, bilateral renal denervation lowered blood pressure by a mean of 34/14 mmHg at 1 month and 32/15 mmHg at 6 months.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

FDA Approves Generic Versions of Plavix

FDA Approves Generic Versions of Plavix | Heart and Vascular Health | Scoop.it

My comment for patients:  this will move Plavix in the form of clopidogrel to the generic tier for patients with substantial savings on copayments.  For cash paying patients the cost should descend quickly from nearly 200/;month to less than 50 / month in the next 6 months because of the number of competitors.  To check the price at a pharmacy near you see my scoop it below.  Massachusetts Drug Card or go to link

https://reportal.restat.com/xpertrx/drugPrices

 

The price at my local pharmacy tfor 1 month on 5/19/2012 via this look up was $160.76 

 

Generic Plavix (Clopidogrel) approved by the FDA: Nine pharmaceutical companies will produce 2 different generic versions of the ubiquitous blood thinner. 

On the FDA website: Generic drugs approved by FDA are of the same high quality and strength as brand-name drugs. The generic manufacturing and packaging sites must pass the same quality standards as those for brand-name drugs. http://goo.gl/3oAWQ  ;

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Healthy Food Is a Better Deal Than Junk, USDA Says

Healthy Food Is a Better Deal Than Junk, USDA Says | Heart and Vascular Health | Scoop.it
Healthy food isn't necessarily more expensive than junk food, according to a new government report.

 

The finding contradicts long-held conventional wisdom that it’s cheaper to snack on potato chips than carrots, and bolsters the Obama administration’s fight against rising obesity levels in the U.S.

Food economists traditionally measure the amount of calories you get for your money. By that measure, you still get more when you buy pizza, French fries or other foods high in sodium, salt and saturated fat.

But the USDA study looked at a food’s worth from new perspective and concluded there’s better value in fruits, vegetables, lean meat and low-fat milk. You may get fewer calories per dollar, researchers say, but you get more food when you’re measuring based on price per weight, or price per portion.  By the food-portion metric, romaine lettuce is much cheaper than ice cream sandwiches and 1% milk is cheaper than soda.

 

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Leapfrog grades hospitals on patient safety

Leapfrog grades hospitals on patient safety | Heart and Vascular Health | Scoop.it

To judge hospital safety, Leapfrog Group graded hospitals across the US on how well they do preventing medical errors.  One-third of major teaching hospitals & 28%  of non-teaching hospitals received an A grade, nationally.

Sixty-two Massachusetts hospitals (76%) got an A.  15 received a B or C. No Massachusetts hospital received a grade lower than a C. All Boston teaching hospitals received A’s.

 

My take: In our community we have 2 A hospitals, 1 B and 1 C. Grading system is an oversimplification, but will become a standard & hosptials will invariably change their efforts to make good marks. Studies have shown that this reporting can improve what is measured, but may cause problems in areas that are not measured. Continued vigilence.

 

Check out you hospital at  http://hospitalsafetyscore.org/ ;

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Association of Aspirin With Major Bleeding

Association of Aspirin  With Major Bleeding | Heart and Vascular Health | Scoop.it

KEY TAKE AWAY: This trial looked at PRIMARY prevention.  The use of a drug to prevent a first event such as heart attack.  This study has no bearing on SECONDARY prevention.  Drug use to prevent a second event (after a heart attack).  The net benefit of aspirin for secondary prevention would substantially exceed the bleeding risk. =>  DON'T STOP if you are in this group.

There is a debate about aspirin in primary prevention.  Is the bleeding too high compared with reduced heart attack benefit?  Because risk factors for bleeding overlap with cardiovascular risk  factors, "guidelines advocating the routine use of aspirin for primary prevention for individuals above moderate risk of coronary heart disease should be carefully considered as this approach may not be advisable for all patients."

In this study18.5% of patients were younger than 50 - a low risk group.  The annual aspirin bleeding rate is about 0.6%.

I will continue to recommend aspirin for high risk men with multiple coronary risk factors including diabetes after age 50, who do not have a history of GI bleeding, consistent with guidelines from AHA and ADA.

 

The editorial by Jolanta M. Siller-Matula, MD, PhD accompanying the paper does a great job reviewing these issues.

http://goo.gl/82iPr ;

 

From the JAMA article:

The benefit of aspirin for primary prevention of cardiovascular events is relatively small for individuals with and without diabetes. This benefit could easily be offset by the risk of hemorrhage.

In 186,425 individuals treated with low-dose aspirin and matched controls without aspirin.  During 5.7 years follow-up, the bleeding rate was 5.58 for aspirin users and 3.60 (per 1000 person-years) for those without aspirin.  Aspirin was associated with a greater risk of major bleeding.  In a population-based cohort, aspirin use was significantly associated with an increased risk of major gastrointestinal or cerebral bleeding episodes. Patients with diabetes had a high rate of bleeding that was not independently associated with aspirin use.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Cardiologist loses $3 Million Lawsuit In Patient's Death From Sexual Threesome

Cardiologist  loses $3 Million Lawsuit In Patient's Death From Sexual Threesome | Heart and Vascular Health | Scoop.it

Take home message:  Tort reform is needed in American medicine.  Lawsuit stories like this fuel defensive medicine by US physicans. 

 

A $3 million judgment was awarded to the family of a Georgia man after he suffered a heart attack during a strenuous 3-way sexcapade.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Health Groups to FTC: Claritin Ain't Candy

Health Groups to FTC: Claritin Ain't Candy | Heart and Vascular Health | Scoop.it

Take Home Message:  Bad Idea by Merck. This is bad health policy but also makes no marketing sense. Were they hoping a child will say "Mommy I prefer Claritin over all other antihistamines"

 

Public health advocates are charging that Merck's entertainment product tie-in campaign for children’s Claritin with the movie Madagascar 3 is deceptive and dangerous because it could cause children to confuse medicine with candy.  

Coinciding with the release of the Dreamworks movie in June, the tie-in features the movie cartoon characters on packaging, in games, on stickers and in other giveaways for grape-flavored chewable children's Claritin tablets and grape-flavored over-the-counter allergy syrup. There were also free movie tickets offered with Claritin purchases at many stores. Merck, manufacturer of the Claritin products, also used its "Children's Claritin Mom Crew" to hold Madagascar 3 viewing parties, providing free product sample

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Why do Congestive Heart Failure (CHF) patient's not take their medications?

Why do Congestive Heart Failure (CHF) patient's not take their medications? | Heart and Vascular Health | Scoop.it

Key Takeaways:

Medications in CHF have been shown to reduce death and hospitalization rates.

Not reliably taking medications (nonadherence) rates are high. The factors predicting nonadherence remain unclear.  These authors identified 3 factors that more than doubled the likelihood of patients not "staying with the program"

1.  lapses in attention OR = 2.65

2.  excessive daytime sleepiness OR = 2.51

3.  Two or more medication dosings daily OR= 2.59

 

Adherence averaged about 84%, dosing adherence averaged 77%, and timing adherence averaged 63%.

Several factors anticipated to predict adherence were not significant predictors. Practical support for self-care, income, cost of medications, minor depression were all not predictors of adherence. The most likely reason for the difference between these results and past reports might be that most prior studies measured adherence using self-reportong.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Emergency Departments Can Identify Low-Risk Cardiac Patients Quickly

Emergency Departments Can Identify Low-Risk Cardiac Patients Quickly | Heart and Vascular Health | Scoop.it

Key Take Away for Patients:

When patients come to the Emergency Room with chest pain the main goal is to assess whether the patient is having a heart attack or at high risk for a heart attack.  In either circumstance the patient will be admitted overnight for treatment and testing.  Identifying low risk patients is a need, but has always been a concern because of the fear of missing someone who MIGHT be at risk and would be at risk for a heart attack or death if discharged.  Strategies to identify lower risk patients who can be discharged home and then seen for out-patient testing is an elusive goal, because there is no certainty.  This study discussed use of TIMI Risk score, EKG and 2 blood tests done 2 hours apart to identify lower risk patients. The negative predictive value of the diagnostic protocol was 99.7%: that means that for every 1000 considered low risk only 3 patients would be miscategorized.

TIMI Risk Score is online at http://goo.gl/vCJgh ;

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Heart Patients May Face a Dilemma with generic Plavix

Heart Patients May Face a Dilemma with generic Plavix | Heart and Vascular Health | Scoop.it
The newly low cost of Plavix, one of the biggest-selling drugs, is intensifying debate among cardiologists over how to make sure patients get optimal benefit from any blood-thinning medication.

 

Key Take away for Patients: After a heart attack or stent taking BOTH aspirin and another blood thinner like Plavix is critical. This is called Dual Antiplatelet (DAP) therapy.  Some patients may not have adequate blood thinning effect from Plavix and the newer drugs might be better even though they are more expensive.  Figuring out which patients will benefit by these more expensive drugs is controversial.

 

For those interested in this topic see my blog Mind the DAP at http://goo.gl/6uDNp for what we know and waht we wish we knew about these medicines.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Michael Evans: General practitioner & developer of 23 1/2 hours video

Dr. Michael Evans describes the emerging strategy of helping patients with care at home by investing through development of teams that combine clinicans and patients with "creatives" (filmmakers & designers) that can create a buffet of self service information available on the web.  

When engaging patients with health information, developers need to remember:

1. Stories trump data

2. Relationships trump stories

3.  Individual's trump organizations

 

The viral aspects of sharing good media and information by "engaing your tribe" via Facebook or direct email will be the way forward.  Helping patients by curating good information is a step in the right direction

 

Thanks to Carolyn Thomas of @heartsisters who blogged about this:  http://goo.gl/y0nnT ;

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Choosing wisely for interventionalists: top 5

Choosing wisely for interventionalists:  top 5 | Heart and Vascular Health | Scoop.it

FFR, BMS, complete angiography, complete revascularization, radial approach: best patient care, save healthcare dollars.

 

Calling all interventionalists: What five practices would you highlight to promote best patient care and save healthcare dollars? Here are 5 ideas from my community practice perspectives:

1. Use FFR liberally for intermediate lesions but not for severe ones
2. Use bare-metal stents if there's any doubt about the patient's insurance status
3. Do complete angiography before intervention
4. Don't send patients home without complete revascularization
5. Take up the radial approach

 

What's on your list?

more...
No comment yet.
Rescooped by Seth Bilazarian, MD from Health literacy
Scoop.it!

How Many Times Per Month Do Certain Types of Patients Seek Online Health Information?

How Many Times Per Month Do Certain Types of Patients Seek Online Health Information? | Heart and Vascular Health | Scoop.it
The average U.S. adult goes online to look up health information about three times per month, while U.S.

Via callooh
more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Can a Hospital Say, 'Only Thin Doctors Can Work Here'?

Can a Hospital Say, 'Only Thin Doctors Can Work Here'? | Heart and Vascular Health | Scoop.it

Texas hospital refuses to hire overweight staff, including doctors and nurses. Is this ethical -- or sensible?

From the Vlog: I can think of a major problem, and that's treating healthcare risks equally. If you want to go after overweight, then who is going to sit in the hospital parking lot and see who is speeding when they come in? Who is going to make sure that someone arriving on a motorcycle or a bicycle is wearing a helmet? Who is going to make sure that they are wearing their seatbelts when they come to work? And to take this a bit further, in Texas, who is going to make sure that they are not riding horses at home because it is dangerous; or own a gun, which turns out to be a big health risk? There are a lot of other equally risky things besides weight that doctors or nurses or healthcare staff might do, and the question is, are we going to control that?

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Coffee May Be Linked to Longer Life, But…

Coffee May Be Linked to Longer Life, But… | Heart and Vascular Health | Scoop.it
Coffee drinkers are getting a bit more reassurance that their beverage of choice may not be bad for them, and might even be linked to living longer.

The upshot was that the more coffee people drank, the less risk they had of dying within the study’s time span. Men who drank six or more cups of coffee a day had a 10% lower risk than those who drank none, while for women it was 15% lower. The trend was consistent for deaths from a number of major causes such as heart disease, diabetes, stroke and even injuries and accidents. (The authors noted that the association “could reflect chance.”) One major exception was cancer, where coffee drinkers saw no advantage.
The findings weren’t affected by whether the coffee was caffeinated or not, but it’s unclear what, if anything, in the drink might have a positive health impact 

Indeed, the study has lots of limits. One is the risk that the effect of other things that change health, like smoking, may not have been completely filtered out. When all of these other influences were left in, coffee drinkers actually tended to have a higher risk of dying than those who abstained. 

more...
No comment yet.