Z-pack and cardiac disease may be a deadly combination
The FDA announced a public warning for the popular antibiotic azithromycin (Zithromax and the antibiotic in the widely prescribed Z-pack). The FDA is warning that this medication increases the risk of a potentially fatal irregular heart rhythm. Patients at risk for this azithromycin-induced arrhythmia include those who already have a prolonged QT interval, low blood levels of potassium or magnesium, and an abnormally slow heart rate, or who take drugs to treat arrhythmias. Elderly patients and patients with cardiac disease also may be more susceptible to the arrhythmogenic effects of the ant...
Source: Dr Portnay - March 12, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Niacin
The results the HPS2-THRIVE trial were presented at the ACC the other day. In this large trial, niacin was shown NOT to prevent major adverse Cardiovascular events any more than placebo. This is despite causing average reductions in LDL of 10 mg/dL and triglycerides of 33 mg/dL, in addition to a 6 mg/dL increase in HDL.
When interpreting a trial like this, it is important to understand the patient population studied. These were patients at high risk that already had LDL < 70mg/dL. This is important to understand. In patients like this, it is clear that niacin does not work. But what about patients who are on statin wi...
Source: Dr Portnay - March 11, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Niacin
theheart.org is reporting today that The European Medicines Agency (EMA) will be launching a review of all niacin (nicotinic acid) agents. This is due to new data from a soon to be reported trial at the ACC in San Francisco, HPS2-THRIVE. It is being reported that a combination of niacin and another agent (which was supposed to reduce the flushing of niacin) "failed to show that the combination reduces the risk of major vascular events (such as heart attack and stroke), and a higher frequency of non-fatal but serious side effects was seen in patients taking the combination." The EMA is launching the review t...
Source: Dr Portnay - March 8, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Veggie Heart
I love this photo I found on the web. (Source: Dr Portnay)
Source: Dr Portnay - March 8, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Danger: Processed Meat
Bacon, sausage, ham, etc has once again to be are strongly associated with all-cause mortality and cardiovascular death. In a large trial recently reported, processed meat by middle-aged adults was associated with a near doubling of the risk of all-cause mortality, compared with low consumption, over a mean of 12 years. The risk CV death was increased by more than 70% among people eating high quantities va those eating small quantities per day. The researchers also found a more than 43% increase in cancer. As the authors pointed out, processed meats contain more saturated fats, cholesterol and sa...
Source: Dr Portnay - March 7, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Usual care was no match for a home blood pressure monitoring
An interesting new study was just published. It compared patients doing home monitoring of their BP and uploading the data to Heart360 vs usual care. American Heart Association's web-based Heart360, a free, online tool for tracking heart health where users can upload blood pressure data and send it to their health providers. After 6 months, blood pressure was significantly better controlled in home monitoring group than in those with usual care. This is important finding. We are gaining more and more evidence that using technology to interact with patients when they are away from the doctors office (Heart360, remin...
Source: Dr Portnay - March 6, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Ramipril improves symptoms of intermittent claudication
http://rdd.me/5pdkv9aqInteresting study which showed that treatment of intermittent claudication with the drug ramipril (an ACE inhibitor known to lower BP and be beneficial in diabetics to help prevent kidney damage) has been shown to significantly improve symptoms. While the drug in this small study did seem to help patients, it was by no means a miracle drug. At the end of the study, patients could walk 4.25 seconds farther. Other known therapies that can help IC include Pletal and a walking program. Maybe the combination of all three would be most beneficial. Hopefully this approach will be formall...
Source: Dr Portnay - March 3, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Just a Little Heart Attack
This is a terrific short video. I was introduced to it yesterday at @HVHeartAssoc (Hudson Valley/Fairfield County American Heart Association) #Go Red for Women luncheon yesterday. I was proud to participate in this annual luncheon to raise awareness for heart disease in women. Heart disease is still the #1 killer of women in this county (1/3 women will die of heart disease).I hope you enjoy this as much as I did. (Source: Dr Portnay)
Source: Dr Portnay - March 1, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
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Here is another terrific resource put out by the AHA -- Life's Simple 7All of these 7 steps have been steps that I have been educating my patients on since I started practicing Cardiology over ten years agoThe core principles:Get activeControl cholesterolEat betterManage blood pressureLose weightReduce blood sugarTop smoking (Source: Dr Portnay)
Source: Dr Portnay - March 1, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
The Science Behind Coffee and Why it's Actually Good for Your Health
http://rdd.me/cohhrx2uGreat article. Cautions:1. If you are prone to palpitations or arrhythmias, consult with a physician before drinking caffeine2. Please read the last paragraph of this article. (Source: Dr Portnay)
Source: Dr Portnay - February 25, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
The Mediterranean-Style Diet Works
A very important study was published this week in the New England Journal of Medicine. In one of the largest trials to date, the Mediterranean-Style Diet (either supplemented with extra-virgin olive oil/EVOO or handfuls of nuts) was compared with a low-fat diet. Over 7000 patients were studied. All patients had no established heart disease but were at high risk for heart disease (diabetes, high cholesterol, obesity ...). The researchers found a 30% reduction in the risk of major cardiovascular events. Mediterranean meant lots of fruit, fish, chicken, beans, tomato sauce, salads, and wine and little baked goods and p...
Source: Dr Portnay - February 25, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Mediterranean Style Diet
Want to read more about the landmark trial showing the benefits of the Mediterranean-Style Diet, check out these articles: http://nej.md/VypTpfhttp://onforb.es/15JjoEahttp://nyti.ms/ZDLAIjhttp://usat.ly/XwcHC1http://nbcnews.to/X6eD4Ihttp://on.wsj.com/X9Pvs7 (Source: Dr Portnay)
Source: Dr Portnay - February 25, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
How 'Crunch Time' Between School And Sleep Shapes Kids' Health : Shots - Health News : NPR
http://www.npr.org/blogs/health/2013/02/22/172717996/how-crunch-time-between-school-and-sleep-shapes-kids-health?ft=1&f=1128&sc=tw How 'Crunch Time' Between School And Sleep Shapes Kids' Health Image courtesy of The Bishop family (left), The Benavides family (top right), NPR (center) and The Jacobs family (bottom right) It's an important question for American families and the nation as a whole: Why do so many kids weigh too much? There are recent hints the epidemic may be abating slightly. ...
Source: Dr Portnay - February 25, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Statin-Exercise Combo Lowers Mortality Risk
http://www.medpagetoday.com/PrimaryCare/GeneralPrimaryCare/36134Statin therapy and physical fitness amounted to a one-two punch for lowering mortality risk in a large cohort of middle-age and older patients with dyslipidemia followed for 10 years.Patients who took statins and were physically fit had as much as a 70% reduction in the risk of dying during the follow-up period as compared with the least physically fit patients who were taking statins, according to Peter Kokkinos, PhD, of George Washington University in Washington, and colleagues.Physical fitness also had an independent effect on mortality risk among patients ...
Source: Dr Portnay - February 21, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Heart Healthy Diet
Here's a recent posting from the Mayo Clinic: 8 steps to prevent heart disease. mayocl.in/rlHABAIt sounds a lot like what I tell my patient everyday. I talk a lot about the Mediterranean Style diet. Here's what to eat:- minimal lean red meat- white meat and fish - olive oil, no butter or margarine- lots of fruits and veggies- legumes and nuts- 1-2 glasses of red wine- whole grains, no white starches (Source: Dr Portnay)
Source: Dr Portnay - February 21, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
