Heart Disease

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.

Just Another Sweet Saturday Morning

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These findings show that the prevalence of food insecurity in the U.S. is highest among Americans for whom a healthy diet is especially critical—Medicaid enrollees with insulin-dependent diabetes and diabetes-related eye or kidney complications (over 40% were food insecure). The problem of co-occurring food insecurity and diabetes among the nation’s disadvantaged has likely worsened during the coronavirus disease 2019 pandemic.

The Prevalence of Food Insecurity Is Highest Among Americans for Whom Diet Is Most Critical to Health — Diabetes Care 2021 Jun; 44(6): e131-e132. https://doi.org/10.2337/dc20-3116

In patients with newly diagnosed T2DM, alcohol abstinence was associated with a low risk of AF development. Lifestyle modifications, such as alcohol abstinence, in patients newly diagnosed with T2DM should be recommended to reduce the risk of AF.

Diabetes Care 2021 Jun; 44(6): 1393-1401. https://doi.org/10.2337/dc20-2607

New research published in Diabetologia has shown that if people achieve and maintain substantial weight loss to manage their type 2 diabetes, many can also effectively control their high blood pressure and stop or cut down on their anti-hypertensive medication.

Diabetologia. “Diabetes remission diet also lowers blood pressure and reduces need for medication.” ScienceDaily. ScienceDaily, 31 May 2021 — https://www.sciencedaily.com/releases/2021/05/210531180422.htm

Sat 6/19

Spice Blend

1 teaspoon ground cumin
1 teaspoon ground coriander
1 teaspoon smoked paprika
½ teaspoon ground turmeric
½ teaspoon dried oregano
½ teaspoon dried chili flakes
¼ teaspoon ground cinnamon

Copied from The First Mess Seven Spice Chickpea Stew recipe https://thefirstmess.com/2016/01/20/vegan-seven-spice-chickpea-stew-recipe/ so I don’t have to look it up online again if I decide to make this dish tonight.

During Pandemic Year One I lost 25 pounds. My PCP was impressed but when I told her how my diet changed she put her “doctor face” on, looked me straight in the eyes and said,

“I can’t wait to see your blood test results.”

Due to my family history my risk of developing DM2 is approximately 25% higher than the average underwriter. When I asked a prominent Endocrinologist for some advice many years ago he too put on his “doctor face” looked me straight in the eyes and said,

“Stay as thin as you can as long as you can.”

Yesterday I went to see Kevin and got a fresh flattop. The first question he asked was,

“Did you lose more weight?”

No, I haven’t. But my face definitely looks thinner without a mask.

BTW my blood work was about the same as last year even with my change in diet.

Preferred Plus NN.

Alcohol (just a wee bit) Lowers CVD Mortality Risk

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Moderate alcohol intake – defined as no more than one alcoholic drink for women and two for men per day – may be associated with a lower risk of dying from cardiovascular disease when compared with individuals who abstain from drinking or partake in excessive drinking, according to a new study. Of the 53,064 participants, 7,905 (15%) experienced a major adverse cardiovascular event: 17% in the low alcohol intake group and 13% in the moderate alcohol intake group. People who reported moderate alcohol intake were found to have a 20% lower chance of having a major event compared to low alcohol intake (in adjusted analysis), and also had lower stress-related brain activity. Kenechukwu Mezue, MD, the study’s lead author, cautions that these findings should not encourage alcohol use, but that they could open doors to new therapeutics or prescribing stress-relieving activities like exercise or yoga to help minimize stress signals in the brain.

SOURCE: American College of Cardiology, news release, May 6, 2021 accessed 05.08.21 — https://www.acc.org/latest-in-cardiology/articles/2021/05/05/14/48/new-acc-21-research-explores-flu-vaccines-sleep-htn-secondhand-smoke-alcohol-and-stress-acc-2021

My liver understands but does not necessarily agree with the findings of this study.

CVD Remains Leading Cause of Death in Type 2 Diabetes – Medscape

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Cardiovascular disease was the leading cause of death among the over 16,000 patients with type 2 diabetes (T2DM) who were enrolled in the SAVOR-TIMI 53 trial.

Two-thirds (66.3%) of all 798 deaths after a median 2.1 years of follow-up were caused by one of five cardiovascular (CV) conditions, with sudden cardiac death accounting for the largest share (30.1%) of the total, Ilaria Cavallari, MD, PhD, and associates said in the Journal of the American College of Cardiology.

It was a pair of laboratory measurements, however, that had the largest subdistribution hazard ratios. “Interestingly, the magnitude of associations of abnormal N-terminal pro–B-type natriuretic peptide [sHR, 2.82] and high-sensitivity troponin T [sHR, 2.46] measured in a stable population were greater than clinical variables in the prediction of all causes of death,” Cavallari and associates said.

CVD Remains Leading Cause of Death in Type 2 Diabetes – Medscape – Apr 06, 2021 — https://www.medscape.com/viewarticle/948849?src=rss

Statins Can Save Lives

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They examined the records of nearly 300,000 adults in the U.S. who had an initial atherosclerotic cardiovascular disease event between 2007 and 2016. These were divided into three groups: coronary heart disease, ischemic stroke or transient ischemic attack, or peripheral artery disease.

When people left the hospital or emergency department in 2007 following a first diagnosis in one of these categories, about half began taking statins within 30 days. By 2016, statin use increased to approximately 60%.

“Based on the guidelines, we hoped to see a much higher uptake among this entire group,” says Dr. Noseworthy. “Statin intolerance was only noted for 4%-5% of the patients, which means as many as 35% of patients are not receiving treatment according to the guidelines.”

Mayo Clinic. “Statins can save lives; are they being used?.” ScienceDaily. http://www.sciencedaily.com/releases/2020/12/201201144030.htm (accessed December 2, 2020) — https://www.sciencedaily.com/releases/2020/12/201201144030.htm

Journal Reference:

Xiaoxi Yao, Nilay D. Shah, Bernard J. Gersh, Francisco Lopez-Jimenez, Peter A. Noseworthy. Assessment of Trends in Statin Therapy for Secondary Prevention of Atherosclerotic Cardiovascular Disease in US Adults From 2007 to 2016. JAMA Network Open, 2020; 3 (11): e2025505 DOI: 10.1001/jamanetworkopen.2020.25505

An Early-Onset Subgroup of Type 2 Diabetes: A Multigenerational, Prospective Analysis in the Framingham Heart Study

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Abstract

OBJECTIVE To assess the relation of type 2 diabetes occurring earlier (age <55 years) versus later in life to the risk of cardiovascular death and to diabetes in offspring.

RESEARCH DESIGN AND METHODS In the Framingham Heart Study, a community-based prospective cohort study, glycemic status was ascertained at serial examinations over six decades among 5,571 first- and second-generation participants with mortality data and 2,123 second-generation participants who initially did not have diabetes with data on parental diabetes status. We assessed cause of death in a case (cardiovascular death)–control (noncardiovascular death) design and incident diabetes in offspring in relation to parental early-onset diabetes.

RESULTS Among the participants in two generations (N = 5,571), there were 1,822 cardiovascular deaths (including 961 coronary deaths). The odds of cardiovascular versus noncardiovascular death increased with decreasing age of diabetes onset (P < 0.001 trend). Compared with never developing diabetes, early-onset diabetes conferred a 1.81-fold odds (95% CI 1.10–2.97, P = 0.02) of cardiovascular death and 1.75-fold odds (0.96–3.21, P = 0.07) of coronary death, whereas later-onset diabetes was not associated with greater risk for either (P = 0.09 for cardiovascular death; P = 0.51 for coronary death). In second-generation participants, having a parent with early-onset diabetes increased diabetes risk by 3.24-fold (1.73–6.07), whereas having one or both parents with late-onset diabetes increased diabetes risk by 2.19-fold (1.50–3.19).

CONCLUSIONS Our findings provide evidence for a diabetes subgroup with an early onset, a stronger association with cardiovascular death, and higher transgenerational transmission.

Diabetes Care 2020 Dec; 43(12): 3086-3093. https://doi.org/10.2337/dc19-1758

Translation – The earlier you develop diabetes your risk of CVD and coronary death is higher. An if one or both of your parents developed either early onset or late onset diabetes you’re screwed.

Mothers’ Lifestyle Predicts When Offspring will have First Heart Attack or Stroke

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Previous research has shown that parents pass on health to their offspring through both genes and shared environment/lifestyle. This was the first study to examine whether parents’ heart health was associated with the age at which offspring develop cardiovascular disease. In addition, it investigated the influence of each parent separately.

The study was conducted in offspring-mother-father trios from the Framingham Heart Study — a total of 1,989 offspring, 1,989 mothers, and 1,989 fathers. Offspring were enrolled at an average age of 32 years and followed over 46 years (1971-2017) for the development of cardiovascular events. “Crucially, the study followed offspring into most of their adult life when heart attacks and strokes actually occur,” explained Dr. Muchira

European Society of Cardiology. “Mothers’ lifestyle predicts when offspring will have first heart attack or stroke.” ScienceDaily, 4 November 2020. www.sciencedaily.com/releases/2020/11/201104194708.htm.

Journal Reference: Muchira JM, Gona PN, Mogos MF, et al. Parental cardiovascular health predicts time to onset of cardiovascular disease in offspring. Eur J Prev Cardiol., 2020 DOI: 10.1093/eurjpc/zwaa072