Cardiology

BREAKING NEWS: New ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

November 13, 2013
BREAKING NEWS: New ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

By Sherif Shoucri, MD

Yesterday, the American College of Cardiology and American Heart Association released new groundbreaking guidelines on the treatment of blood cholesterol. These recommendations, which officially drop LDL target levels for patients on statin therapy, will fundamentally alter the way most primary care physicians and cardiologists treat hyperlipidemia. After reviewing the available data on statins, the authors concluded that there was no evidence to support an LDL target of either 70 or 100. Rather, patients should be placed on either moderate-intensity (lowers LDL …

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The Complicated Story of Saturated Fat

November 8, 2013
The Complicated Story of Saturated Fat

By Gregory Katz, MD

Faculty Peer Reviewed

Everyday in clinic, we tell our patients to choose foods low in saturated fat. Because these foods raise plasma cholesterol, the thinking goes, they cause heart disease. Today, every major medical organization – from the American Heart Association to the Harvard School of Public Health to the USDA – recommends a diet low in saturated fat to prevent and treat heart disease. The fat-cholesterol-heart disease connection is so thoroughly integrated into both medicine and popular culture that …

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To Stent or Not to Stent?

November 6, 2013
To Stent or Not to Stent?

By Anish Vani

Faculty Peer Reviewed

According to the 2010 Heart Disease and Stroke Statistics update of the American Heart Association, there are 17.6 million Americans living with coronary heart disease (CHD) . Fortunately, mortality from heart disease is on the decline in the United States and in countries with advanced health care, likely due to better management of acute coronary syndrome (ACS) and a reduction in lifestyle risk factors such as smoking. However, for the millions of Americans with stable ischemic heart disease (SIHD), …

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From The Archives: Does Heyde Syndrome Exist?

August 8, 2013
From The Archives: Does Heyde Syndrome Exist?

Please enjoy this post from the Archives dated September 29, 2010

By Lara Dunn, MD

Faculty Peer Reviewed

In 1958, EC Heyde published 10 cases of aortic stenosis (AS) and arteriovenous malformations (AVMs) of the gastrointestinal tract in the New England Journal of Medicine . Thus, the association between aortic stenosis and intestinal angiodysplasia became known as Heyde Syndrome. Yet the existence of this syndrome has been controversial.

Contrasting conclusions have been obtained by studies conducted to evaluate this association. In a prospective study, Bhutani …

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Are We Too Hesitant to Anticoagulate Elderly Patients with Atrial Fibrillation? A Risk-Benefit Analysis

June 28, 2013
Are We Too Hesitant to Anticoagulate Elderly Patients with Atrial Fibrillation? A Risk-Benefit Analysis

By Sunny N. Shah, MD

Faculty Peer Reviewed

Background:

Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence increases with age. In fact, the lifetime incidence of AF is approximately 25% in individuals by age 80, with the incidence nearly doubling with each decade of life after age 50. (1) Multiple randomized controlled trials have shown that oral antithrombotic therapy with warfarin or aspirin decreases the risk of ischemic stroke in patients with AF. (2-6) Meta-analyses reveal a relative risk reduction of …

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Is There Evidence to Support a Vegetarian Diet in Common Chronic Diseases?

June 20, 2013
Is There Evidence to Support a Vegetarian Diet in Common Chronic Diseases?

By Christopher Graffeo

Faculty Peer Reviewed

In the age of prevention, primary care is more empowered than ever to educate patients on reducing their risk for common chronic diseases by promoting behavior modifications early in the natural history. In the clinic, this means a focus on hyperlipidemia, hypertension, and diabetes—risk factors that play synergistic roles in causing a wide array of diseases with tremendous morbidity and mortality. Given the large number of risk factors that co-exist for so many patients, astute clinicians are aiming for …

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Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

April 12, 2013
Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

By Tyler R. McClintock

Faculty Peer Reviewed

“Red Meat Kills.” “Red Meat a Ticket to Early Grave.” “A Hot Dog a Day Raises Risk of Dying.” Such were the headlines circulating in popular press last year when the Annals of Internal Medicine released details of an upcoming article out of Frank Hu’s research group at the Harvard School of Public Health . Analyzing long-term prospective data from two large cohort studies, researchers found that individuals who ate a serving of unprocessed red meat each day …

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White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

March 20, 2013
White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

By Lauren Foster

Faculty Peer Reviewed

Hypertension is a pervasive chronic disease affecting approximately 65 million adults in the United States, and a significant cause of morbidity and mortality . Antihypertensives are widely prescribed due to their effectiveness in lowering blood pressure, thereby reducing the risk of cardiovascular events. However, the phenomenon of the “white coat effect” may be a complicating factor in the diagnosis and management of hypertensive patients. It is well established that a considerable number of people experience an elevation of their …

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From The Archives – Myths and Realities: Heart and Wine

September 27, 2012
From The Archives – Myths and Realities: Heart and Wine

Please enjoy this post from the archives dated August 26, 2010

By Aditya Mattoo, MD

Faculty Peer Reviewed

Not too long ago, a patient came to my clinic and said (I’m paraphrasing of course), “I never cared for alcohol, doctor, so I haven’t had much to drink since my college days. Maybe champagne or wine on the rare special occasion, but I keep hearing about how wine is good for your heart, so I am thinking I should start drinking regularly.” For years I have …

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Are Dentists Really Causing Infective Endocarditis?

August 29, 2012
Are Dentists Really Causing Infective Endocarditis?

By Jeffrey Krutoy, DDS

Faculty Peer Reviewed

Bacterial infective endocarditis is a potentially devastating disease, and while it may be an easy tradition to blame the dentist, recent research and new guidelines from the American Heart Association (AHA) indicate that it may not be so simple.

Infective endocarditis (IE), while relatively uncommon (with yearly incidence rates ranging from 2 to 6 cases per 100,000 people), results in high rates of morbidity and mortality even when treated. For this reason, physicians have emphasized the importance of …

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Should We Measure Apolipoproteins to Evaluate Coronary Heart Disease Risk?

August 24, 2012
Should We Measure Apolipoproteins to Evaluate Coronary Heart Disease Risk?

By Navya Nair, MD

Faculty Peer Reviewed

Coronary heart disease (CHD) is the major cause of mortality worldwide. Lipoproteins play a major role in the development of this disease. Current guidelines advocate that low-density lipoprotein (LDL) cholesterol should be the primary target for lipid lowering therapy. However, there is a growing literature on the atherogenic potential of apolipoprotein B (apo B)-containing lipoproteins and the protective effect of apolipoprotein A-one (apo AI)-containing lipoproteins. Many studies suggest that these apolipoproteins be used as markers to evaluate risk …

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Omega-3 Fatty Acids and Atherosclerosis

August 17, 2012
Omega-3 Fatty Acids and Atherosclerosis

By Michael Malone

Faculty Peer Reviewed

Omega-3 long chain polyunsaturated fatty acids (PUFAs) have been popularized in recent years as beneficial nutrients with cardioprotective effects. Omega-3 PUFAs are so named because of a double bond between the 3rd and 4th carbon of the polycarbon chain. They are “poly-unsaturated” with hydrogen atoms, as their carbon chains contain multiple double bonds. Three omega-3 long chain PUFAs are typically discussed in the context of medical therapy, the first being alpha-linolenic acid (ALA). ALA is an essential precursor omega-3 …

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