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Coming Soon: An LDL-Lowering Drug with Few Side Effects

Bempedoic acid may be an alternative for patients who can’t take statins. By Holly Strawbridge Any day now the U.S. Food & Drug Administration is likely to approve a novel cholesterol-lowering agent called bempedoic acid. It is as effective as statins in reducing LDL cholesterol and C-reactive protein (CRP), a marker of inflammation associated with […]

There’s a Type of Cholesterol as Dangerous as LDL

Fortunately, the first drug to treat it is in the pipeline. By Holly Strawbridge Do you know how much lipoprotein(a) is in your blood? This form of cholesterol, widely known as Lp(a) and pronounced “L, P, little a,” is a bad actor that greatly increases the risk of heart attack and stroke. Yet the public […]

Do Statins Give You Achy Muscles?

If symptoms caused you to stop taking these beneficial drugs, try these tips for preventing or minimizing side effects. By Holly Strawbridge Evidence that cholesterol-lowering statins prevent heart attacks and strokes is so compelling that these medications are a “must” for anyone with cardiovascular disease or its risk factors. But statins can sometimes cause symptoms […]

Warning: Common Pain Relievers Unsafe for Heart Patients

The FDA mandated a cardiovascular safety trial of celecoxib (Celebrex). This trial, spearheaded by Dr. Nissen, compared moderate doses of celecoxib to ibuprofen and naproxenin 24,081 arthritis patients at increased cardiovascular risk needing daily pain relief. The cardiovascular risks from celecoxib were no greater than those conferred by the other NSAIDs.

Download The Full December 2018 Issue PDF

If there are specific concerns that you would like to have addressed, please write them down before you leave home and raise them early in the appointment. Please don't wait until the end of the visit to speak up. Knowing what's on your mind helps us plan our time with you, and you will be more likely to leave the office satisfied, if your questions have been answered.

Dieting? Go Ahead and Enjoy a Traditional Thanksgiving Dinner

If you don't want to be seduced by the dessert table, try one of these approaches:
- Take one bite (not one slice) of every dessert you like, so you won't feeldeprived.
- If you can't resist a piece of pie, take one, but pass up the stuffing, rolls andpotatoes.
- Walk around the block instead of eating dessert. Your desire for it will fade, ifyou wait long enough.
- Offer to clean up the dishes instead of eating dessert. By the time you are done, most desserts will be gone, and the remainder will look messy and unappetizing.

Ask The Doctors: November 2018

Whether to continue taking clopidogrel with aspirin over the long term is a different issue. Aspirin alone can increase the risk of bleeding, and this risk increases with the combination of medications. Low-dose aspirin plus clopidogrel or other anti-platelet drug is recommended for up to one year after MI. Continuing the combination beyond that point is not common practice in all patients, since the increased bleeding risk may outweigh the benefits. However, the combination may be continued in certain patients, including those who received a left main artery stent, complex overlapping or branch-point stents, recurrent MI, in-stent clots or vascular events such as a transient ischemic attack while on aspirin alone. Even in these situations, an individuals bleeding risk needs to be considered to ensure safety.

Heart Beat: October 2018

Depression after a heart attack can have serious, even deadly, consequences. However, the effect of antidepressants on outcomes has been unknown. A 300-patient study published in the July 24/31 issue of JAMA suggests that treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram (Lexapro) significantly reduced the risk of a major cardiac event. Patients who had recently suffered a major or minor heart attack were randomized to the antidepressant or placebo for 24 weeks and then followed for a median of eight years. All-cause death, deaths from heart disease, heart attacks and revascularizations with angioplasty and stenting were tracked. At the end of the study, 40.9 percent of the patients on escitalopram had met one of these outcomes, compared with 53.6 percent of those who had received the placebo. When individual outcomes were examined, the SSRI beat placebo in all measures. However, only reduction in heart attack (8.7 percent vs 15.2 percent) was statistically significant.

Stay Active After a Heart Attack

If you were not active before your heart attack, its particularly important that you make exercise a priority. If you were active before your heart attack, dont be afraid to resume the same activities, once you get clearance from your physician, he says. The best way to do this is to enroll in a cardiac rehab program. In fact, we recommend cardiac rehab for all patients after a heart attack.

Cholesterol, a Fat We Love to Hate

When LDL and HDL exist in normal proportion, they are not a health risk. But when levels of LDL or total cholesterol rise, or the amount of HDL falls, the body tends to deposit cholesterol in the arteries. Over time, this causes arteries to become narrow, which can interfere with blood flow and lead to heart attack or stroke.

How Cardiac Rehabilitation Fits in With Pulmonary Rehab

Its not uncommon for someone needing cardiac rehabilitation to simultaneously face other health problems, such as diabetes, arthritis, or Parkinsons disease. But an especially common dual challenge is dealing with heart disease and a lung condition, such as chronic obstructive pulmonary disease (COPD) that requires pulmonary rehabilitation. This presents a unique challenge to the patient and to the rehab specialists designing programs that help improve heart health and make breathing a little easier.

Ask the Doctors: July 2017

I have elevated cholesterol, and for many years when I had blood work I was told to fast for 12 hours. Recently my primary care physician said that a non-fasting measurement would be as accurate. I have diabetes, and episodes of low blood sugar and fasting can sometimes cause a symptomatic drop in my blood sugar. What do you think? Ive read online that there is little evidence to support the use of statins in the primary prevention of cardiovascular disease and that the risks outweigh the benefits. I have no previous cardiovascular disease. How do I know if I should take statins?