On a more hopeful note, there was some evidence that omega-3 long-chain polyunsaturated fatty acids (LC-PUFA) were associated with lower risk of heart attack and CAD, and that folic acid may help protect against stroke. However, the primary study on folate that reached this conclusion was conducted in China, where foods are not routinely fortified with folate like they are in the United States.
Low-dose dietary supplements of omega-3 fatty acids have little effect on lowering cardiovascular risk (see article on page 6). However, high doses of omega-3, either eicosapentaenoic acid (EPA) alone or EPA plus docosahexaenoic acid (DHA), can significantly lower cardiovascular risk in patients with high triglyceride levels. The U.S. Food & Drug Administration (FDA) has approved several products-Lovaza, Omtryg, Vascepa and Epanova-that are now available by prescription. Results of the REDUCE-IT trial, presented at the American Heart Association (AHA) 2018 Scientific Sessions, showed that in patients with elevated triglyceride levels and cardiovascular disease or diabetes plus one additional risk factor, 4 grams per day of purified EPA reduced the risk of a major cardiovascular event by 25%. In a science advisory issued Aug. 19 online in Circulation, the AHA summarized the findings of 17 clinical trials in which high-dose EPA or EPA plus DHA reduced triglyceride levels by 30 to 36%. The AHA concluded they are a safe and effective option for reducing triglycerides whether used alone or in combination with other lipid-lowering drugs.
Nevertheless, it may take several hours to determine whether a heart attack has occurred and what kind of treatment is needed. When someone is unsure what their symptoms mean, the thought of spending several hours in the emergency department may deter them from seeking care. Dr. Campbell emphasizes that it's wiser to err on the safe side.
Fostering a sense of gratitude is one way to counter negative emotions, such as anger and depression. There are plenty of studies linking these and other chronic forms of negative psychosocial stress to coronary artery disease. In the INTERHEART study, which included 25,000 people from more than 50 countries, individuals who experienced negative stress on a daily basis had more than twice the risk of heart attack than those without chronic stress.
Its almost Thanksgiving, the iconic American holiday centered on food. The mere mention of Thanksgiving conjures up images of a juicy turkey with all its trimmings and a table full of pies.
Millions of people have no problems with the generic drugs they take. But a growing number of disturbing patient experiences and drug recalls have made it clear that some generics are not being manufactured according to the high standards set by the U.S. Food & Drug Administration (FDA).
In 1984, the U.S. enacted a law that allows generic companies to win FDA approval with limited tests proving their drugs are bioequivalent to the brand-name drug and perform similarly. It may not have exactly the same chemical composition, but it must act the same way in the body and produce the same results. It also must be made in the same format: pill, capsule or liquid. This is why, in theory, generics are considered equivalent to their brand-name counterparts.
Blood pressure (BP) is measured when the heart is contracting (systolic BP, the first number) and when the heart is resting (diastolic BP, the second number). Ever since the Framingham Heart Study identified that high systolic BP was a stronger predictor of cardiovascular outcomes than high diastolic BP, physicians have focused on lowering high systolic pressures. After the definition of hypertension was lowered from 140/90 millimeters of mercury (mmHg) to 130/80 mmHg in 2017-a controversial move-guidelines continued to emphasize treating the higher number. But a study involving more than 1.3 million outpatients published in the New England Journal of Medicine on July 18, 2019, may change this practice. In this study, researchers showed that having either high systolic or high diastolic high BP, or both, increased the risk of heart attack and stroke. Additionally, the negative influence of blood pressure on cardiovascular outcomes was seen at 130/80 mmHg, validating the lower threshold for hypertension.
But when blood pressure regularly spikes higher than normal, it's a sign that something is not right. Doctors call the condition labile hypertension, and it merits investigation.
The good news is that diabetes is not inevitable. The Diabetes Prevention Program (DPP) found that making lifestyle changes can prevent or delay the onset of type 2 diabetes. People who lost 7% to 10% of their body weight and exercised a minimum of 150 minutes per week decreased their risk of developing diabetes by 58% to 90%.
"It is important for anyone who receives this warning to go immediately to the emergency room for treatment to prevent a stroke from occurring," says M. Shazam Hussain, MD, Director of Cleveland Clinic's Cerebrovascular Center."The highest risk for stroke is within two days after the TIA, so no one should wait to get checked."
Heart failure (HF) can be caused by a heart attack or similar event that impairs the heart's pumping function and reduces the amount of blood ejected with each beat (heart failure with reduced ejection fraction, or HFrEF). There is also a second form called heart failure with preserved ejection fraction (HFpEF). These patients typically suffer from heart failure symptoms, but their ejection fraction is normal. Morbidity and mortality are similar in both forms.