Heart Disease

Coffee and Atrial Fibrillation

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At the end of the study, the group that drank coffee experienced a 39% lower risk of recurring AFib episodes. In addition to coffee’s potential anti-inflammatory effects, the researchers proposed that those who drank coffee may have naturally replaced less healthy drinks, such as sugary sodas, with coffee instead. University of California – San Francisco. “Surprising heart study finds daily coffee may cut AFib risk by 39%.” ScienceDaily. http://www.sciencedaily.com/releases/2025/11/251110021046.htm (accessed November 10, 2025).

Journal Reference: Christopher X. Wong, Christopher C. Cheung, Gabrielle Montenegro, Hannah H. Oo, Isabella J. Peña, Janet J. Tang, Samuel J. Tu, Grace Wall, Thomas A. Dewland, Joshua D. Moss, Edward P. Gerstenfeld, Zian H. Tseng, Henry H. Hsia, Randall J. Lee, Jeffrey E. Olgin, Vasanth Vedantham, Melvin M. Scheinman, Catherine Lee, Prashanthan Sanders, Gregory M. Marcus. Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation. JAMA, 2025; DOI: 10.1001/jama.2025.21056

ASCOT-Legacy 20-year follow-up – Long-term Benefits of Atorvastatin

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Patients allocated to atorvastatin had a significant reduction in non-fatal myocardial infarction (MI) and fatal coronary heart disease (CHD) events (HR (95% CI) 0.81 (0.69 to 0.94, p=0.006)), total coronary events (0.88 (0.80 to 0.98, p=0.017)) and CV deaths (0.86 (0.74 to 0.99, p=0.048)). No significant reduction in heart failure (HF), strokes, total CV events and all-cause mortality was observed. Long-term benefits of atorvastatin on the incidence of cardiovascular events: the ASCOT-Legacy 20-year follow-up – https://heart.bmj.com/content/early/2025/03/25/heartjnl-2024-325104

Dr. M. Zann McMahan, thank you.

Heart Attacks Happen in the Young

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Dr Ravi Prakash, senior consultant in cardiology at PSRI Hospital, Delhi, said that data from hospitals across India between 2020 and 2023 show that 50% of heart attack patients are below the age of 40. Doctors and researchers are alarmed by the growing number of cardiac arrests among individuals under 40 years of age. Experts attribute this rise to sedentary lifestyle, stress, poor diet, smoking, alcohol consumption, and even genetic factors. 50% of heart attack cases since 2020 among adults below 40 – https://www.newindianexpress.com/amp/story/xplore/2025/Feb/24/50-of-heart-attack-cases-since-2020-among-adults-below-40

Prevention of MI in young individuals is an important public health problem. Despite being categorized as “low risk” prior to their events, most young individuals who experience an MI have pre-existing risk factors, such as obesity, diabetes, hypertension, and hyperlipidemia. Tobacco use, which occurs in approximately 50% of young adults who experience an MI, remains one of the most important modifiable risk factors. Additionally, substance abuse, tobacco use, diabetes, left ventricular systolic dysfunction, and systemic inflammatory disease are all associated with a worse long-term prognosis in those who experience an MI at a young age. Not All Heart Attacks are Created Equal: Thinking Differently About Acute Myocardial Infarction in the Young – https://journal.houstonmethodist.org/articles/10.14797/mdcvj.345

Yikes.

Cannabis and Arrhythmia Risk, Stroke and Race, Why Weight Loss Drugs Stop Working

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Within 180 days, 42 medical cannabis users and 107 control participants developed arrhythmia, most commonly atrial fibrillation/flutter. Medical cannabis users had a slightly elevated risk for new-onset arrhythmia compared with nonusers (180-day absolute risk, 0.8% vs 0.4%). The 180-day risk ratio with cannabis use was 2.07 (95% CI, 1.34-2.80), and the 1-year risk ratio was 1.36 (95% CI, 1.00-1.73). Adults with cancer or cardiometabolic disease had the highest risk for arrhythmia with cannabis use (180-day absolute risk difference, 1.1% and 0.8%).

Medical Cannabis for Chronic Pain Tied to Arrhythmia Risk – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/medical-cannabis-chronic-pain-tied-arrhythmia-risk

The overall incidence of stroke and ischemic stroke (IS) decreased among both White and Black people over the past two decades, results of an updated analysis of stroke trends in a representative US population showed.

However, the study showed persistent racial disparities, with incident stroke rates 50%-80% higher in Black people than in their White counterparts. Incident stroke also occurred at an earlier age in Black patients than in White patients (mean age, 62 years vs 71 years, respectively).

The findings were published online on January 10, 2024, in Neurology.

New Data on Stroke Incidence Rates by Race – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/new-data-stroke-incidence-rates-race

And my favorite Saturday morning medical update…

But studies also have shown that once people stop taking these drugs — either by choice, because of shortage, or lack of access — they regain most, if not all, the weight they lost. Arguably more frustrating is the fact that those who continue on the drug eventually reach a plateau, at which point, the body seemingly stubbornly refuses to lose more weight. Essentially, it stabilizes at its set point, said Fatima Cody Stanford, MD, MPH, MPA, MBA, an obesity medicine physician at Massachusetts General Hospital and associate professor at Harvard Medical School in Boston.

Every study of weight loss drugs done over the past 40 years or so shows a plateau, Stanford told Medscape Medical News. “If you look at the phentermine/topiramate studies, there’s a plateau. If you look at the bupropion/naltrexone studies, there’s a plateau. Or if we look at bariatric surgery, there’s a plateau. And it’s the same for the newer GLP-1 drugs.”

The reason? “It really depends on where the body gets to,” Stanford said. “The body knows what it needs to do to maintain itself, and the brain knows where it’s supposed to be. And when you lose weight and reach what you feel is a lower set point, the body resists.”When the body goes below its set point, the hunger hormone ghrelin, which is housed in the brain, gets reactivated and gradually starts to reemerge, she explained. GLP-1, which is housed in the distal portion of the small intestine and in the colon, also starts to reemerge over time.

Why Do GLP-1 Drugs Stop Working, and What to Do About It? – Medscape – January 12, 2024 — https://www.medscape.com/viewarticle/why-do-glp-1-drugs-stop-working-and-what-do-about-it

That’s it for this Saturday. Time to go to the Y and read a book later.

Sleep Apnea and Heart Failure

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Sleep apnea affects ∼50% to 75% of patients with heart failure.

Still Too Hot To Blog but I had to share this.

Statin or Supplements?

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So, which is most effective? Researchers at the Cleveland Clinic set out to answer this question by comparing statins to supplements in a clinical trial. They tracked the outcomes of 190 adults, ages 40 to 75. Some participants were given a 5 mg daily dose of rosuvastatin, a statin that is sold under the brand name Crestor for 28 days. Others were given supplements, including fish oil, cinnamon, garlic, turmeric, plant sterols or red yeast rice for the same period.

“What we found was that rosuvastatin lowered LDL cholesterol by almost 38% and that was vastly superior to placebo and any of the six supplements studied in the trial,” study author Luke Laffin, M.D. of the Cleveland Clinic’s Heart, Vascular & Thoracic Institute told NPR. He says this level of reduction is enough to lower the risk of heart attacks and strokes. The findings are published in the Journal of the American College of Cardiology.

Statins vs. supplements: New study finds one is ‘vastly superior’ to cut cholesterol – https://www.npr.org/sections/health-shots/2022/11/06/1134094540/statins-vs-supplements-new-study-finds-one-is-vastly-superior-to-cut-cholesterol

Sometimes diet and exercise alone are not enough to keep cholesterol in check. I currently take a low dose statin 10 mg daily. My test results from 09.27.22: cholesterol 197, HDL 71, LDL 102, triglycerides 69.

Oh, and continuing the theme of full disclosure the thing on my leg Image Challenge – November 2022 was MUD.

What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

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The skeptical cardiologist was asked to give a lecture in July on diet to the cardiology fellows in our training program at Saint Louis University. Needless to say, I didn’t hew to current recommendations from the American Heart Association or the Dietary Guidelines for Americans. For example, these recommendations are still promoting the narrative that…

What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

Great lecture. Thank you Dr. Pearson.

Variation in cardiovascular disease risk factors among older adults in the Hunter Community Study cohort: A comparison of diet quality versus polygenic risk score — Journal of Human Nutrition and Dietetics Notes

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The study of Reay and colleagues was an analysis of data from a subset (n=1703) of the Hunter Community Study cohort, comprising 3253 Australian men and women aged 55-85 at recruitment (between 2004 and 2007). Across the cohort there were 138 participants self-reporting that they suffered angina, 176 atrial fibrillation, 689 high cholesterol, 758 hypertension, 129 a heart attack and 164 an arterial bypass surgery. The CVD phenotypes data had a large number of missing data points (only 1678 subjects responding).

…the ARFS (Australian Recommended Food Score) data suggest that dietary quality was poor across the whole cohort. In the absence of a wide distribution of diet quality it is difficult to evaluate the relationship of diet with disease endpoints (i.e. without a lot of participants consuming a healthy diet it is impossible to detect the effects of a healthy diet on lipids and CVD outcomes)

Variation in cardiovascular disease risk factors among older adults in the Hunter Community Study cohort: A comparison of diet quality versus polygenic risk score — Journal of Human Nutrition and Dietetics Notes

Study shortcomings noted. I am still planning on stir fried veggies with brown rice and Thai sauce for dinner tonight despite not knowing my exact CVD genetic risk.

Dinner. (There’s a fried egg hiding on the bottom of the bowl).

Don’t Take an Aspirin and Call Me in the Morning — A Country Doctor Writes:

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People are asking about the latest US Public Health Service Taskforce on Prevention (USPSTF) recommendation about the use of aspirin to prevent heart disease. It has been a long-standing recommendation for people who already have heart disease. When I turned 50, I started taking a “baby” aspirin. That was their recommendation then. I stopped taking […]

Don’t Take an Aspirin and Call Me in the Morning — A Country Doctor Writes:

Personal Note:

A few years back I was taking 81mg aspirin AND fish oil. I stopped taking the fish oil because every nick, scratch and cut would not stop bleeding and took a long time to clot. Personally I plan on continuing my aspirin therapy at least until my next wellness exam. My physician wanted me to continue aspirin until age 70. We’ll see.