Self-Managing Cholesterol
By David Spero
As a recent study indicates, reducing LDL (“bad" cholesterol) can help prevent complications in most people with diabetes. Why is LDL cholesterol a bad thing, and how do you get to a healthy level?
First, what is cholesterol? Discovered in 1769 by analyzing gallstones, cholesterol is a fat-like organic chemical that is an essential part of animal cell membranes. Without it, cells won't function properly.
Cholesterol is made into bile, which is needed for digesting fats. It is also helps produce the body's natural steroids, including our sex hormones and the vital stress hormone cortisol. Cholesterol ...
Source: Diabetes Self-Management - May 15, 2013 Category: Diabetes Authors: David Spero Source Type: blogs
Will you survive Wheat Belly?
Dietitian Kristi King reviewed Wheat Belly for the Academy of Nutrition and Dietetics (AND), full text here.
Among her comments:
” . . . there is very little guidance as to what are appropriate substitutions during meals, therefore, one who does not review this diet with a registered dietitian could potentially set themselves up for vitamin and mineral deficiencies, such as B vitamins, calcium, and vitamin D just to name a few.”
“Review this diet with a registered dietitian”? Is she serious? This is indeed consistent with the agenda that the Academy has been pursuing for many years, trying to make ...
Source: Wheat Belly Blog - March 23, 2013 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly counterattacks Source Type: blogs
#182: ACC 2013: Stopping rivaroxaban and warfarin temporarily in AF patients yields similar risks; PREVAIL yanked from ACC program; Watchman device meets safety end point; Niacin full results in HPS2-THRIVE; Another strike for digoxin in AF
ACC 2013: Stopping rivaroxaban and warfarin temporarily in AF patients yields similar risks; PREVAIL yanked from ACC program; Watchman device meets safety end point; Niacin full results in HPS2-THRIVE; Another strike for digoxin in AF (Source: Blogs@theHeart.org)
Source: Blogs@theHeart.org - March 13, 2013 Category: Cardiology Authors: theheart.org Tags: This week in cardiology from heartwire Source Type: blogs
Niacin
The results the HPS2-THRIVE trial were presented at the ACC the other day. In this large trial, niacin was shown NOT to prevent major adverse Cardiovascular events any more than placebo. This is despite causing average reductions in LDL of 10 mg/dL and triglycerides of 33 mg/dL, in addition to a 6 mg/dL increase in HDL.
When interpreting a trial like this, it is important to understand the patient population studied. These were patients at high risk that already had LDL < 70mg/dL. This is important to understand. In patients like this, it is clear that niacin does not work. But what about patients who are on statin wi...
Source: Dr Portnay - March 11, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
HPS2-THRIVE: A ‘Disappointing But Clear’ Result
The results of HPS2-THRIVE were “disappointing but clear,” said Jane Armitage, who presented the results this morning at the ACC in San Francisco. HPS2-THRIVE randomized 25,673 high-risk patients who could tolerate niacin to either placebo or extended-release niacin plus laropiprant (Tredaptive, Merck), an anti-flushing agent, in addition to background therapy. The primary endpoint was the time to first major vascular event, defined as the composite of non-fatal MI or coronary death, any stroke or any arterial revascularization. Major vascular events occurred in 13.2% of the niacin arm and 13.7% of the plac...
Source: CardioBrief - March 9, 2013 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Prevention, Epidemiology & Outcomes High-density lipoprotein HPS2-THRIVE LDL Low-density lipoprotein niacin Source Type: blogs
Niacin
theheart.org is reporting today that The European Medicines Agency (EMA) will be launching a review of all niacin (nicotinic acid) agents. This is due to new data from a soon to be reported trial at the ACC in San Francisco, HPS2-THRIVE. It is being reported that a combination of niacin and another agent (which was supposed to reduce the flushing of niacin) "failed to show that the combination reduces the risk of major vascular events (such as heart attack and stroke), and a higher frequency of non-fatal but serious side effects was seen in patients taking the combination." The EMA is launching the review t...
Source: Dr Portnay - March 8, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
The "Buzz" on ACC.13 Late-Breaking Clinical Trials
This post is authored by Christopher P. Cannon, MD, FACC, is editor-in-chief of CardioSource Science and Quality.
Late-breaking clinical trials (LBCTs) have become the centerpiece of major cardiology scientific sessions. On the upside, they produce significant advances that will reshape the practice of medicine (if and when we ever adopt them), and, more recently, they’ve challenged long-held beliefs about the benefits of various older treatments. On the other hand, they can sometimes lead to disappointment (ie. when a study produces negative findings or is too small to be definitive).
So, LBCTs—are th...
Source: ACC in Touch Blog - March 6, 2013 Category: Cardiology Authors: Administrator Tags: ACC Scientific Session Science Source Type: blogs
#180: "Choosing wisely" now targets over 130 dubious tests, therapies; HPS2-THRIVE: High myopathy risk with niacin/laropiprant; unrestricted Mediterranean diets beat low-fat advice for primary CVD prevention; large proportion of raised LDL cholesterol...
Choosing wisely now targets over 130 dubious tests, therapies; HPS2-THRIVE: High myopathy risk with niacin/laropiprant; unrestricted Mediterranean diets beat low-fat advice for primary CVD prevention; large proportion of raised LDL cholesterol in (Source: Blogs@theHeart.org)
Source: Blogs@theHeart.org - March 1, 2013 Category: Cardiology Authors: theheart.org Tags: This week in cardiology from heartwire Source Type: blogs
Top stories in health and medicine, February 28, 2013
This series is brought to you by MedPage Today.1. 5 Psych Disorders Have Common Genetics. Autism, attention deficit-hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, and schizophrenia share common genetic underpinnings — despite differences in symptoms and course of disease.2. Imaging Suggests Wide Window for Alzheimer’s Tx. The biological path to Alzheimer’s disease might continue for more than a decade, suggesting a broad window of opportunity for intervention.3. Side Effects Dim Niacin Promise. A highly significant increase in adverse events, in particular myopathy, appears to...
Source: Kevin, M.D. - Medical Weblog - February 28, 2013 Category: Family Physicians Tags: News Heart Neurology Psychiatry Source Type: blogs
HPS2-THRIVE Coming Attraction: First Look At What Went Wrong With Niacin
In a few weeks, on March 9, the main results of the HPS2-THRIVE (Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events) study will be presented in San Francisco at the annual meeting of the American College of Cardiology. These results have been eagerly awaited since Merck’s brief announcement in December that the trial had not met its primary endpoint and that it would no longer pursue approval of Tredaptive, the combination of extended-release niacin and laropiprant, in the US. The trial was designed to assess whether adding the niacin/laropiprant combination to standard st...
Source: CardioBrief - February 27, 2013 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes European Heart Journal High-density lipoprotein Laropiprant Merck niacin Statin Tredaptive Source Type: blogs
Ken Frazier's at Davos
Merck CEO says jury out on raising good cholesterol
DAVOS, Switzerland (Reuters) - The jury is still out on the benefits of increasing "good" HDL cholesterol, but the strategy remains worth pursuing, despite recent setbacks, the chief executive of Merck & Co said on Thursday.
Confidence in the HDL thesis suffered a fresh blow last month when a major clinical trial of Merck's Tredaptive medicine failed. That followed earlier failures with two other HDL-boosting drugs from Pfizer and Roche.
The Pfizer and Roche drugs worked differently to Tredaptive, by inhibiting a protein called CETP, and Merck is also developing a ke...
Source: PharmaGossip - January 24, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Trials Of Niacin And Atrial Fibrillation Device Will Headline American College Of Cardiology Program
Two big trials will highlight this year’s American College of Cardiology meeting in March in San Francisco. First is the PREVAIL trial testing Boston Scientific‘s long-anticipated Watchman left atrial appendage closure device for stroke prevention in patients with atrial fibrillation. Second is the detailed presentation of the controversial failed HPS2-THRIVE trial of extended-release niacin and laropiprant. Read my complete story on Forbes, along with a list of the late-breakers. (Source: CardioBrief)
Source: CardioBrief - January 22, 2013 Category: Cardiology Authors: Larry Husten Tags: Heart Failure Heart Rhythms Interventional Cardiology & Surgery MI/ACS People, Places & Events American College of Cardiology atrial fibrillation Boston Scientific niacin San Francisco Watchman Source Type: blogs
#174: Niacin/laropiprant products to be suspended; JNC 8, ATP 4 guidelines; new meta-analysis on sugar sparks old debate; two antihypertensives plus NSAID ups risk of acute kidney injury
Niacin/laropiprant products to be suspended; JNC 8, ATP 4 guidelines; new meta-analysis on sugar sparks old debate; two antihypertensives plus NSAID ups risk of acute kidney injury (Source: Blogs@theHeart.org)
Source: Blogs@theHeart.org - January 18, 2013 Category: Cardiology Authors: theheart.org Tags: This week in cardiology from heartwire Source Type: blogs
How nutritious is horse meat?
Just a quick round-up cribbed from NutritionData via KQED to address the issue of how nutritious is horse meat compared to beef in the wake of “StableGate” (horse DNA allegedly present in value burgers sold by UK and Iris supermarkets).
Horse meat is about 120 vs beef’s 130 kilocalories per 100 grams. They have similar cholesterol levels and pretty much the same protein content when comparing lean cuts. Horse meat has twice the iron of beef and more than twice the vitamin B12, but less B6, niacin and folate.
The levels of omega-3 fatty acids – supposedly linked to reduced risk of heart disease strok...
Source: Sciencebase Science Blog - January 16, 2013 Category: Medical Scientists Authors: David Bradley Tags: Science Source Type: blogs
Do doctors know how to treat high blood pressure and high cholesterol?
Blood pressure and cholesterol problems affect millions. These are the bread, butter and sugary drinks of Internal Medicine and general Cardiology practice.
It stands to reason then, that the treatment of these basic maladies would be well agreed upon. Guidelines and expert consensus statements would be clear and up-to-date.
But this is far from reality.
This recent story on theHeart.org chronicled the fact that treatment guidelines for high blood pressure and high cholesterol are a decade old. (And the last word on best practice for obesity treatment was 15 years ago.)
Surely this death of clarity is worthy of comment. A ...
Source: Dr John M - January 16, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
