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Cardiovascular Disease

Med combo averts MI and stroke in some

December 23, 2009

A simplified method for bundling fixed doses of a generic statin and an ACE inhibitor or angiotensin II receptor blocker (ARB) reduced the risk of hospitalization for MI and stroke in 170,024 people aged 55 years and older who had diabetes, coronary artery disease, or both.

Bradycardia and a pectoralis twitch in a pacemaker patient

Debra Kleinschmidt, PhD, PA, and Giovanni Ciuffo, MD September 11, 2009

Surgery is required for a woman whose right ventricle was perforated by the tip on the lead of her permanent pacemaker.

Some dietary guidelines more heart-friendly

August 17, 2009

The U.S. Department of Agriculture's Dietary Guidelines for Americans are designed to promote health and reduce the risk of chronic diseases, but their impact on existing disease hasn't been adequately studied.

Peculiar violaceous, atraumatic rash

By Esan O. Simon, MD, MBA June 02, 2009

A 79-year-old Caucasian man with a history of chest pain, light-headedness, and diaphoresis was admitted to rule out acute coronary syndrome. He incidentally noted a bruise that had appeared spontaneously on his chest without trauma four days prior to admission.

Primary care on front line for atrial fibrillation

May 22, 2009

Diagnosing atrial fibrillation could sharply reduce strokes in the United States, and primary-care physicians have a key role to play, according to experts at the American College of Cardiology.

Guidelines: How to treat resistant hypertension

By Carl Sherman May 21, 2009

In its first Scientific Statement to focus on this issue, the American Heart Association stresses the need for evaluation that spreads a broad net to identify contributing and secondary causes and treatment options that go beyond the usual antihypertensives.

Coffee every day may keep stroke away

April 22, 2009

The findings of a large study suggest that coffee consumption may modestly reduce the risk of stroke in women.

Hair loss as a side effect of statins?

Question by Jyoti Khatri, MD, Omaha; response by Peter F. Cohn, MD April 15, 2009

A 63-year-old woman wants to discontinue the simvastatin (Zocor) 10 mg she is taking for hypercholesterolemia because she believes the medication is causing her to lose her hair. Is there any evidence supporting this side effect of Zocor?

New findings challenge Framingham heart risk tool

April 14, 2009

Three recent studies indicate that the venerable Framingham risk score goes only so far as a predictor of cardiovascular problems.

Secondary stroke prevention lags

April 07, 2009

Even as researchers are fine-tuning approaches to preventing primary coronary events, a new analysis of unrelated CDC data found that primary-care providers need to focus more on secondary stroke prevention too.

New aspirin guidelines stress gender differences

By Myra Dembrow April 06, 2009

Men and women don't respond the same to prophylactic aspirin therapy. Updated recommendations from the U.S. Preventive Services addresses this aspect of heart disease prevention.

Excessive sleepiness linked to CVD mortality

By Myra Dembrow March 30, 2009

Daytime drowsiness may warn of impending death in elderly people, particularly from cardiovascular causes, new population-based research suggests.

Diet tips for heart failure, COPD updated

March 11, 2009

Registered dietitians have some new advice for your patients with heart failure or chronic obstructive pulmonary disease, now that the American Dietetic Association has published evidence-based guidelines for providing nutrition treatment to patients with these conditions.

Kidney function, genetics may affect warfarin action

March 09, 2009

Research may one day allow clinicians to customize warfarin doses based upon individual genetic profiles and degree of kidney impairment.

The links between oral and systemic health

By Jeffrey Astroth, DDS, MSPH March 05, 2009

While research into specific cause-and-effect relationships continues, there are still plenty of reasons to encourage patients to take care of their mouth.

Simple algorithm predicts chronic kidney disease

February 09, 2009

A new eight-factor algorithm helps predict which patients are most likely to develop chronic kidney disease within a decade. The model is designed for people who have healthy kidneys now but suffer from some other chronic disease.

Cleviprex

February 05, 2009

An IV calcium channel blocker to reduce BP from The Medicines Company

Transient severe breathing difficulty while shoveling snow

By Benjamin M. Kaplan, MD, and Albert J. Miller, MD February 05, 2009

An elderly woman returns home from a balmy South Pacific vacation and finds very cold temperatures. While shoveling snow, she finds that she can't get air into her lungs. With no history of pulmonary or heart disease, what's wrong?

Lowering LDL cholesterol still important, says FDA

January 09, 2009

The agency reaffirmed its position that elevated amounts of LDL are a risk factor for cardiovascular diseases such as heart attack, stroke, and sudden death and that lowering LDL cholesterol reduces the risk of these diseases.

Fibrate used in combination with statin approved

December 16, 2008

The FDA has approved Trilipix (fenofibric acid), a delayed-release capsule for use along with diet to treat dyslipidemia. Trilipix is the first fibrate to be approved for use in combination with a statin.

Statins protect against CVD, not renal disease

December 04, 2008

Statin use does not decrease renal-function loss in patients without cardiovascular disease (CVD) or in those at risk for it, but the drug is effective for primary prevention of CVD, a study found.

Ambulatory BP betters office reads for CV risk

By Delicia Yard November 26, 2008

A recent report found that office BP has no value in predicting cardiovascular (CV) morbidity and mortality in patients with resistant hypertension. Higher ambulatory measurements, however, are good indicators of these outcomes, according to the same report.

Kidney marker warns of heart disease, diabetes

November 20, 2008

A new meta-analysis confirmed "a strong and continuous association between urinary proteinuria and subsequent risk of coronary heart disease (CHD)." Meanwhile, a team of French scientists has tied excessive UAE levels to substantially higher risks of developing diabetes in men.

Osteoporosis drugs increase AF risk

October 24, 2008

Patients who take bisphosphonates for osteoporosis were significantly more likely to experience serious atrial fibrillation, including hospitalization or death, compared with placebo, according to a new study.

Omega 3s plus statins help lipids

October 20, 2008

In patients with mixed dyslipidemia, a combination of statin therapy and prescription omega-3 fatty acids may help improve lipid profiles, according to a report in the Oct. 15 issue of the American Journal of Cardiology. Reported at HealthDay.

Study: Aspirin doesn't prevent CV events

October 17, 2008

Among patients with diabetes and asymptomatic peripheral arterial disease, aspirin did not reduce primary fatal and non-fatal cardiovascular events compared with placebo, according to a study by Jill Belch, MD, of the University of Dundee in Scotland, and colleagues online in BMJ. Reported at MedPage Today.

Secondary heart failure

October 08, 2008

As physicians, we need to remind ourselves that congestive heart failure (CHF) is not a diagnosis but rather a complex of symptoms with one or more of five major causes: myocardial ischemia, valvular heart disease, chronic hypertension, arrhythmias, or cardiomyopathy. Thus, if a patient has symptoms of CHF, the diagnosis would be CHF secondary to one of those five causes.

Chill on fish oil

Clinical Pearl submitted by Jack Wang, MD, Beloit, Wis. October 06, 2008

Storing fish-oil tablets in the freezer will eliminate the fishy smell and aftertaste.

Nighttime aspirin lowers BP

October 02, 2008

Timing is everything in aspirin therapy for prehypertension, according to a new Spanish study. Patients who took low-dose aspirin at bedtime reported much better responses than those who took the medicine in the morning.