Lowering cholesterol protects your heart and brain, regardless of your age
High or abnormal cholesterol levels, inflammation, and endothelial dysfunction play a key role in atherosclerosis and plaque buildup, the most common cause of heart attacks and strokes. (Endothelial dysfunction refers to impaired functioning of the inner lining of blood vessels on the heart’s surface. It results in these vessels inappropriately narrowing instead of widening, which limits blood flow.) There are many different types of cholesterol, including high density lipoprotein (HDL, or good, cholesterol); triglycerides (a byproduct of excess calories consumed, which are stored as fat); and low-density lipoprotein (LD...
Source: Harvard Health Blog - February 24, 2021 Category: Consumer Health News Authors: Hanna Gaggin, MD, MPH Tags: Drugs and Supplements Healthy Eating Heart Health Source Type: blogs

Beyond heart health: Could your statin help prevent liver cancer?
Liver cancer is hard to treat. It’s a top-five cause of cancer-related death worldwide and a growing cause of cancer-related deaths in the United States. Since liver cancer is often found at a late stage, when treatment has limited benefit, there has been increasing interest in prevention. That’s where statin medications might come in. Liver cancer is usually caused by chronic liver disease, so an important way to prevent liver cancer is to treat the underlying trigger. For example, curing hepatitis C infection — an important cause of chronic liver disease — reduces the risk of liver cancer. However, if the liver d...
Source: Harvard Health Blog - January 27, 2020 Category: Consumer Health News Authors: Irun Bhan, MD Tags: Cancer Drugs and Supplements Health Source Type: blogs

MKSAP: 67-year-old man with a carotid bruit
Test your medicine knowledge with the  MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a carotid bruit detected on routine medical examination. He reports no history of previous focal neurologic symptoms or visual loss. He has type 2 diabetes mellitus and hyperlipidemia treat ed with metformin, moderate-intensity pravastatin, and aspirin. […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 23, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > < /span > Tags: Conditions Cardiology Source Type: blogs

What Kmart ’s Settlement Says About Health Care Fraud
This reportedly violated regulations requiring pharmacies to apply their usual and customary charges when billing government payers. The DOJ claims that “[t]he government’s resolution of this matter illustrates the government’s emphasis on combating health care fraud,” It might more accurately have said that the settlement adds to the mountain of evidence showing that the government cannot control even the most obvious forms of health care fraud, a point we make at length in our forthcoming book, Overcharged: Why Americans Pay Too Much For Health Care. For one thing, at the very same time government payers were hon...
Source: The Health Care Blog - February 1, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Charles Silver David Hyman K-Mart Lisinopril Source Type: blogs

Quantifying the Benefits of Statins over the Long Term
Statins work to reduce cardiovascular disease risk by reducing blood lipid levels. In the research here, the authors quantify the benefits that have been obtained through the use of this class of drug over the past few decades. This class of drug is broadly considered to be one of the more important contributions to the reduced rate of cardiovascular mortality over that span of time. The data here suggests that statins should be even more widely used than they are at present: there are incrementally greater gains that might be obtained. The mechanism of cardiovascular damage influenced by statins is one in which lip...
Source: Fight Aging! - September 7, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Skyrocketing prescription prices force patients to skip meds
This article is adapted from the AAFP Leader Voices Blog. Image credit: Shutterstock.com Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 10, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-munger" rel="tag" > Michael Munger, MD < /a > Tags: Meds Medications Source Type: blogs

Welcome to My World: Med Wreck
By HANS DEUVEFELT, MD Part of a series on primary care challenges and their solutions. Medication reconciliation is something we do every day, in the clinic and in the hospital. It shouldn’t be as hard as it is. A patient with multiple medical problems returns for a fifteen minute quarterly visit. He saw his cardiologist three weeks ago and was told to double his metoprolol. There are two ways to catch this change: when the cardiologist’s office note comes in, or as we check the patient in for his visit. The cardiologist’s office note, generated by one of the leading EMRs, runs seven pages and contains entries a...
Source: The Health Care Blog - August 10, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Sulodexide
Brief Review Abstract: Sulodexide is a glycosaminoglycan with antithrombotic properties. The future role of sulodexide is possibly as an agent to prevent recurrent venous thromboembolism in those at higher risk of bleeding with warfarin and novel oral anticoagulants (NOACS). Sulodexide is a glycosaminoglycan with antithrombotic properties. It corresponds to a mixture of heparin and dermatan sulfate having profibrinolytic properties and anti-inflammatory activity demonstrated in vitro [1]. Sulodexide has anti oxidant and anti glucotoxic effects which make it potentially beneficial in the treatment of diabetic kidney di...
Source: Cardiophile MD - November 17, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology antithrombotic glycosaminoglycan SURVET Study Source Type: blogs

Test your medicine knowledge: 58-year-old man with type 2 diabetes
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year-old man is evaluated during a routine appointment. He is asymptomatic. He was diagnosed with type 2 diabetes mellitus 4 years ago and has hypertension, dyslipidemia, and obesity. His medications are enteric-coated low-dose aspirin, lisinopril, fluvastatin (20 mg/d), and metformin. His calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohort Equations is 10%. On physical examination, blood pressure is 126/78 mm Hg and pulse rate is 72/min. The remainder of the ex...
Source: Kevin, M.D. - Medical Weblog - October 3, 2015 Category: Journals (General) Authors: Tags: Conditions Diabetes Heart Source Type: blogs

Medications After a Heart Attack
From: www.secondscount.orgYour heart attack recovery will include medications. Taking these medications exactly as prescribed is one of the best tools at your disposal for avoiding death in the months following a heart attack. According to an article published in Circulation, the journal of the American Heart Association, heart attack patients who had not filled any of their prescriptions within 120 days of being discharged from the hospital had 80 percent greater odds of death than those who filled all of their prescriptions.Medications you are likely to be prescribed after a heart attack fall int...
Source: Dr Portnay - January 23, 2015 Category: Cardiology Authors: Dr Portnay Source Type: blogs

MKSAP: 64-year-old man with knee osteoarthritis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated for a 2-year history of knee osteoarthritis. He has bilateral knee pain that worsens with walking. He has tried topical therapies, physical therapy, and acetaminophen, none of which has provided relief. The patient also has peripheral vascular disease, hyperlipidemia, and hypertension. Medications are hydrochlorothiazide, pravastatin, and a daily aspirin. On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 116/76 mm Hg, pulse rate is 60/min, and respirati...
Source: Kevin, M.D. - Medical Weblog - July 12, 2014 Category: Journals (General) Authors: Tags: Meds Rheumatology Source Type: blogs

Statin Therapy Does Not Improve Cardiovascular Risk for Patients With HIV and Low HDL
The main lipid abnormality of people living with HIV is low high density lipoprotein (HDL).  There are 5 subfractions of HDL: 2a, 2b, 3a, 3b, and 3c, from largest (and most effective in cholesterol removal) to smallest (and least effective). Neither pravastatin nor rosuvastatin changes the distribution of high-density lipoprotein (HDL) subfractions in patients who are HIV-seropositive with (Source: Nelson Vergel's HIV Blog)
Source: Nelson Vergel's HIV Blog - June 5, 2014 Category: HIV AIDS Authors: Nelson Vergel Source Type: blogs

A clear-eyed look at treating the elderly with medicine
A recent case taught me a lot about how people perceive their medicines. I was trying to help a 92-year-old man get off some of his medicine. I can’t go into the details, but suffice to say, there was much opportunity to trim a long list of drugs, many of which were threatening his existence and impairing his quality of life. As I was discussing stopping many of the meds, the patient said (with a quite sincere tone): “You doctors these days just want us old people to go off and die.” That was a zinger, a real punch in the gut. I was trying to do the opposite–allow him to live a longer and better lif...
Source: Dr John M - March 7, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

A clear example of how values matter in judging statins for primary prevention
The new JAMA has an article and an editorial that favor using statins for primary prevention. The clinical evidence and the editorial focus on the relative risk improvement with statins. However, the clinical evidence reports on a number needed to treat for 5 years of 138 to prevent 1 death. So 5 years of statin therapy for 138 patients to prevent 1 death. Is this a reasonable trade off? The lipidologists obviously see this as a victory for their hypothesis. They quote data that patients tolerate statin therapy as well as they tolerate placebo. They now have the evidence. We should give many more patients statins! M...
Source: DB's Medical Rants - December 11, 2013 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Medical Rants Source Type: blogs

How Manipulated Clinical Evidence Could Distort Guidelines - the Case of Statins for Primary Prevention
This study excluded many patient for whom the statins were not contraindicated or warned against: uncontrolled hypertension; type 1 or type 2 diabetes mellitus on insulin or with a HgBA1C at least 10%; and body weight more than 50% "desirable limit for height."  (Based on the official contraindications and warnings for commonly used statins, e.g., see contraindications for Lipitor here, active liver disease, pregnancy for likely to become pregnant, nursing mothers, hypersensitivity to the medicine; and warnings: use of cyclosprine or strong CYP3A4 inhibitors, uncontrolled hypothyroidism, renal impairment.)  Thus ...
Source: Health Care Renewal - December 3, 2013 Category: Health Medicine and Bioethics Commentators Tags: American College of Cardiology American Heart Association clinical trials conflicts of interest evidence-based medicine guidelines manipulating clinical research review articles Source Type: blogs