What Is New In Preventing Heart Disease?

So, here we are, into February. An important month after you have recovered from Christmas and New Year celebrations. Valentine’s Day, Family Day and heart month fall into February. And as a bonus, this year the Valentine’s Day falls on the same long weekend as the Family Day. It should be a good weekend for the whole family to bond and have fun and have lots of chocolates……yum!

Ok, let us get back to our heart. If you do not have a good heart or a strong heart then you cannot have much fun. That is why for me each month is a heart month. The reason for that is quite simple – heart disease and stroke is the number one killer.

So, today I will devote this space to see if there is anything new to report about preventing heart disease. I will summarize the American Heart Association’s Scientific Sessions Report (November 8-12, 2008, New Orleans, Louisiana) published by the Canadian Medical Association.

How do you assess cardiac risk factors in individuals whose risk is not readily apparent? Do we have a scoring system, biomarkers of cardiovascular risk or genetic testing which would determine their life-time risk of cardiac disease?

No, we don’t. Lot of research is going on but clinically useful data is yet to come. But management is clear in patients who are obviously at high or low risk. These patients are identified by their age, body mass index, cholesterol levels, smoking and family history.

Is there any justification for the use of Statins to prevent heart disease in people with average or low levels of cholesterol to prevent heart disease?

In a study called JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin), patients with normal cholesterol levels were tested for high-density C-reactive protein (hsCRP). They found the rates for a first major cardiovascular event and death from any cause were significantly reduced among those who received rosuvastatin compared with those who received placebo. The clinical implications and cost effectiveness needs further investigations before this can be recommended to the general public.

Other important presentations at the conference were:

-After a heart attack, early intervention within 24-hours (angiography, angioplasty, coronary artery bypass) is just as safe and effective as delaying treatment more than 36-hours for low-risk unstable angina patients and those without ST-elevation heart attack. They also found there was a trend toward better outcomes among those receiving early treatment. So, if possible, it would be nice to get on the table for an angiogram within 24-hours of a heart attack.
-Regular intake of vitamin C and E failed to protect against major cardiovascular events. These vitamins are among the most widely used by the general population. So spend your money carefully.
-A large trial involving heart attack survivors has confirmed the safety of folic acid and vitamin B12, but failed to show that they have a protective effect against heart disease or stroke.

Well, February is a good month to get back into regular exercise, laughter, meditation, organic/healthy food, stress relief and to stop smoking. That sounds like my favourite pet ELMOSS. And February is a good month to consume my favourite dark chocolates….yum.

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