Perspective

Sitting on a plane I run through the possible subjects to discuss in this week’s blog post. I consider health related matters but cannot bring myself to settle on a topic. I feel compelled instead to introduce a subject that tortures me far more than do the demigods of media and science. It is the conflagration of Muslim extremism that threatens to engulf our world. Wow, where did that come from you might be wondering. In a word, sadness. I am sad for the young Christian girls of Nigeria who have been stolen from their families, and in a 10th century style forced to convert to Islam and threatened with slavery or marriage to Muslim men. They most likely will never again lay their eyes upon their parents, siblings, and other blood relatives. I am sad for the woman who sits beside her 20-month-old child in a Sudanese prison awaiting a sentence of torture followed by hanging. Her crime: marriage to a Christian. I am sad for all the men and women in other nations forced to follow their religious beliefs in silence, lest they be silenced for good. I am sad that the world watches as so many suffer and I am sad we have lost perspective as we fan the flames of our own relatively petty issues. And finally I am sad for us as we watch a world that will most likely collide with ours, potentially ending the freedoms we now take for granted, ones our ancestors struggled so hard to leave as a legacy for us to enjoy.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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Response to “A New Gender Issue: Statins” an Article by Roni Caryn Rabin

There appears to be an endless supply of medically related stories in the lay press that serve nothing more than to create mass misunderstanding of science and medicine. Surely their provocative messages sell papers and airtime. But they have an often-ignored downside as well. Tuesday we saw another such article. In the New York Times’ Rabin piece, a prevalent fear of medications is fueled, and the integrity of a prominent physician is impugned. (Full disclosure – I too unabashedly receive compensation from pharmaceutical companies for consulting and educational purposes.) Statistics are cited; the quintessential anti-statin doctor is quoted; and fabricated conclusions are rendered. The science of statin therapy is much too complex for a single cursory article to do it justice. In fact, entire conferences are devoted to the subject matter. And yet a sweeping conclusion – with potentially devastating ramifications – has again been made. Women reading this article will do what one would expect, either discontinue their statins on their own, or hopefully discuss such an action with their doctors prior to doing so. The article is meant to be terrifying, citing exceedingly rare muscle complications and referring to an unproved complication of statins, memory loss. So much is left unconsidered. For starters, the ACC/AHA risk scoring system cited by Ms. Rabin likely underestimates, not overestimates, CVD risk in women. And, as the leading cause of death in US women is cardiovascular disease, we do not want to make the mistake of under-evaluating and under-treating this segment of the population.

Today in the office I saw a young woman who suffers from premature heart disease that would not have been detected or appropriately treated had the guidelines been followed to a tee. Yet her coronaries have been non-invasively imaged; significant disease was detected; and yes, statins are being utilized. As a result, her life may very well have been saved. Doctors must be able to think and act with fluidity, moving both within and beyond the guidelines, in order to render the best care we can. Articles such as Ms. Rabin’s serve solely to diminish our ability to do so.

To demonstrate more clearly why we need to drastically broaden – not shrink – our efforts to identify and treat cardiovascular disease in women here are a few chilling and sobering statistics:

  • Women are 15 times more likely than men to die within the year following a heart attack.
  • Women with angina have twice the morbidity and mortality as men with angina, even in the absence of obstructive coronary artery disease.
  • 64% of women dying suddenly from heart disease had no prior symptoms.
  • Women under 50 are three times as likely as men under 50 to die after a bypass operation.
  • Marriage decreases cardiovascular risk in men, yet increases it in women (a frightening statistic, yet one that provides fodder for some excellent jokes).

Other similar statistics abound. The point is that we unambiguously understand that women are at great risk for heart disease. Sadly though, we currently have inadequate clinical trials assessing their risk. The appropriate answer is to fight even harder to identify and treat women at risk. It is not to dismiss our vast and growing understanding of the salient role cholesterol plays in the genesis of cardiovascular disease. It is not, as this article implies, to withhold a medication that has done more to thwart heart disease than any other therapy in the last century. I entreat all in the press to be more circumspect and responsible in your reporting. You have a great influence on your readers. Please wield it with caution.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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The National Lipid Association – A Glimmer of Hope

The field of Medicine is undeniably in turmoil. Patients are unhappy with long wait times in doctors offices coupled with ever shortening visits with their physicians. Doctors are dismayed by their unprecedented spike in “busy work,” instigated predominantly by insurance companies and governmental mandates. The fallout from more time spent on paperwork is of course less time spent with patients. There are after all only 24 hours in a day.  So it is eminently fair to say that neither doctors nor patients find themselves happy with the current course Medicine is following. Oftentimes outlooks are so bad that many of us in the field feel there is no hope. In essence we believe the battle has been lost; there is no chance of recovery.

Enter the National Lipid Association (NLA). Currently boasting over 3,000 active members, the NLA is a group of diverse doctors, nurses, dietitians, scientists, and exercise physiologists whose governing goal in participating in the organization is to improve healthcare. I just returned from the 2014 Annual NLA meetings in Orlando Florida and was once again struck by the authenticity of this sentiment. Meetings began as early as 6 AM and extended well into the evening hours. And the seats were not bare. They were filled by groups of highly focused and engaged individuals. Ranging from Cholesterol Guideline discussions, to basic science talks on drugs’ mechanisms of action, to lectures reinforcing the need to amplify our efforts to identify and treat patients with the not so rare but highly lethal disorder Familial Hypercholesterolemia, the topics were fascinating and irrefutably pragmatic. The attendees were riveted. Side conversations were plentiful, including promises of new clinical trials and better ways to help our patients. The pace was quick and the excitement, palpable. All this at a medical meeting!

Although uniformly doctors are troubled by Medicine’s fall from grace, rays of hope were clearly visible at the NLA meeting. Beneath our acrimony doctors, nurses, and others in medicine still have at their core the desire to help. We genuinely want to be the ones who people look to during their oftentimes-darkest moments. We also most definitively strive to keep people from experiencing such grim periods. The best way to achieve these goals is to continuously learn. Curiosity, inquiry, dialogue, knowledge, and caring are the cornerstones of the practice of Medicine. And these are the elements that beat at the heart of the National Lipid Association.

Learn more about preventive cardiology at www.preventivecardiologyinc.com.

For more information more about essential vitamins and supplements visit www.vitalremedymd.com.

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