Medication

The Best Defense Against Type 2 Diabetes Is Knowledge

According to the Centers for Disease Control and Prevention, more than 30.3 million people in the U.S. have diabetes. Another 84.1 million have pre-diabetes, a condition that can lead to type 2 diabetes within five years, if it's not treated. Diabetes is a major risk factor for early death from heart attack, stroke and many cancers. It also increases the risk of kidney disease, blindness and amputation. But these outcomes are not inevitable, if you learn about the disease and your role in managing it.
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When Statins Are Not the Answer

In the past, niacin, fenofibrates, bile acid sequestrants and fish oil were widely used to help normalize blood lipid levels. Most have fallen out of favor. But in November, physicians were wowed when a key study revealed that prescription-strength doses of eicosapentaenoic acid (EPA), a form of omega-3 fish oil, reduced the risk of cardiovascular death, heart attack, stroke, revascularization and unstable angina by 25 percent in patients with CAD or diabetes and high triglyceride levels.
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Heart Beat: December 2018

It's very common for people to need multiple anti-hypertension medications to lower their blood pressure into an acceptable range. If you resent taking medications, try diet and exercise. Researchers studied 129 overweight adults with blood pressures between 130 and 160 millimeters of mercury (mmHg) systolic and 80 and 99 mmHg diastolic, but who were not taking anti-hypertension medication. The researchers randomized one-third to the DASH diet (an eating plan designed to lower blood pressure) plus supervised exercise three times a week and behavioral counseling for weight loss. One-third were randomized to the DASH diet only. The remainder made no changes to their diet or exercise habits. Over a 16-week period, those who participated in the diet, exercise and counseling group lost an average of 19 pounds and reduced their blood pressure by an average of 16/10 mmHg. The diet-only group lowered their blood pressure an average of 11/8 mmHg. Blood pressure in the group that made no changes dropped only 3/4 mmHg.
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The Best Heart Bypass Operation Available Today

The study examined only outcomes up to five years after CABG. At this point, no difference was seen in survival rates with either the vein or artery graft. But other studies have confirmed that a second arterial graft significantly increases the likelihood the patient will be alive 10 years after CABG. Cleveland Clinic and other major heart centers follow Society of Thoracic Surgery guidelines and use an artery as a second conduit whenever possible.
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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.
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Heart Beat: November 2018

Patients with heart failure with preserved ejection fraction (HFpEF) find their ability to walk and carry out the American Journal of Medicine suggests lack of vitamin D may be partly responsible. Vitamin D is thought to play a role in cardiovascular and muscle function, but its relationship with exercise capacity has been unknown. Researchers measured vitamin D levels in 112 HFpEF patients and 37 matched controls, all of whom took a six-minute walk test and had their peak oxygen capacity measured. Vitamin D levels were found to be significantly lower in HFpEF patients than in controls. More than 90 percent of HFpEF patients had insufficient vitamin D levels or were frankly deficient. These low levels were associated with more severe exercise intolerance. This study laid the groundwork for a randomized, controlled clinical trial to evaluate whether vitamin D supplementation could be effective in improving exercise tolerance.
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The Evolution of a Heart Attack

Immediate testing is done to determine whether or not a heart attack has occurred. These include an electrocardiogram (ECG) and a blood test for troponin, a protein that spills into the blood when heart muscle dies. If the troponin test is negative, a heart attack has likely not yet occurred. These patients are given several types of medication to prevent their condition from deteriorating.
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Download The Full September 2018 Issue PDF

If you have risk factors for cardiovascular disease, or have been diagnosed with heart or vascular disease, what are you doing to lessen the likelihood you will suffer a heart attack or stroke? Are you eating a heart-healthy diet and exercising? Keeping your blood pressure, blood sugar and cholesterol levels under control? Have you tossed your cigarettes to the curb.
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Small Pumps Help Failing Hearts

Patients with heart failure rely on multiple medications to keep their heart pumping as efficiently as possible. For many, medications slow the progression of heart failure long enough so they can live a normal length and quality of life. But when maximum medical therapy no longer controls the symptoms of heart failure, other measures may be necessary. These options include ventricular assist devices (VADs), which provide new hope for selected patients with advanced heart failure.
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Heart Beat: July 2018

Results of a long-term study of male physicians found no association between the development of heart failure and cancer. Researchers analyzed more than 28,000 patients who were disease-free when they enrolled in one of three clinical trials. After a median of 19.9 years, 1,420 of the participants had developed heart failure, 7,363 had been diagnosed with cancer and 177 had developed both.
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Erectile Dysfunction Closely Tied to Heart Attack Risk

Coronary artery disease (CAD) is one reason some men cant achieve an erection, says Cleveland Clinic cardiologist Michael Rocco, MD. In men ages 40 to 70 who have no symptoms of heart trouble, ED is an independent risk factor for a heart attack within about three to five years.
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Heart Beat: June 2018

Its both a tragedy and an irony when a powerful chemotherapy agent cures a woman of breast cancer, only to leave her with heart failure or cardiomyopathy. It is not uncommon. Some of the most effective chemotherapy drugs used in the fight against breast cancer are known to be toxic to the heart. These include the anthracyclines, such as doxorubicin (Adriamycin), and the monoclonal antibody trastuzumab (Herceptin). The risk is great enough to cause some oncologists to discontinue using these effective drugs.
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