JAMA Cardiovascular Corner

Cardiovascular Corner Low Lipids, Metformin, and Plant-Based Diets

Substituting red meat with high-quality plant protein sources was associated with more favorable changes in cardiovascular risk factors relative to dietary replacements combined in a recent meta-analysis of randomized clinical trials (RCTs) published in Circulation.

 

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Soy Protein Decreases Circulating LDL and Total Cholesterol Concentrations in Adults

Conclusions

Soy protein significantly reduced LDL cholesterol by approximately 3–4% in adults. Our data support the advice given to the general public internationally to increase plant protein intake. This trial was registered at clinicaltrials.gov as NCT03468127.

A Meta-Analysis of 46 Studies Identified by the FDA Demonstrates that Soy Protein Decreases Circulating LDL and Total Cholesterol Concentrations in Adults

Cardiovascular Events and Mortality in White Coat Hypertension: A Systematic Review and Meta-analysis

Limitation: Paucity of studies evaluating isolated cardiac outcomes or reporting participant race/ethnicity.
Conclusion:  Untreated WCH, but not treated WCE, is associated with an increased risk for cardiovascular events and all-cause mortality. Out-of-office BP monitoring is critical in the diagnosis and management of hypertension.
Read the abstract at Annals of Internal Medicine

Stress related disorders and risk of cardiovascular disease: population based, sibling controlled cohort study

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1255 (Published 10 April 2019) Cite this as: BMJ 2019;365:l1255

Conclusion Stress related disorders are robustly associated with multiple types of cardiovascular disease, independently of familial background, history of somatic/psychiatric diseases, and psychiatric comorbidity.

This study is Open Access and a PDF can be downloaded at the link above.

Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk — Kaiser Health News

Once again, your mother was right. You really do need to eat your vegetables. And while you are at it, put down the bacon and pick up the olive oil, because new research supports the contention that switching to a Mediterranean diet could significantly decrease the risk of heart disease. According to a study published…

via Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk — Kaiser Health News

Coronary Artery Calcium Scan Embraced By New AHA/ACC Cholesterol Guidelines: Will Insurance Coverage Follow?

Thank you Dr. Pearson.

The Skeptical Cardiologist

The skeptical cardiologist has been utilizing coronary artery calcium (CAC) scans to help decide which patients are at high risk for heart attacks, and sudden cardiac death for the last decade. As I first described in 2014, (see here) those with higher than expected calcium scores warrant more aggressive treatment and those with lower scores less aggrressive treatment.

Although , as I have discussed previously, CAC is not the “mammography of the heart” it is incredibly helpful in sorting out personalized cardiovascular risk. We use standard risk factors like lipids, smoking, age, gender and diabetes to stratify individuals according to their 10 year risk of atherosclerotic cardiovascular disease (ASCVD) but many apparent low risk individuals (often due to inherited familial risk) drop dead from ASCVD and many apparent high risk individuals don’t need statin therapy.

Previously, major guidelines from organizations like the AHA and the ACC did not recommend…

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