Thursday, December 11, 2014

From an article "Cardiology's Top 10 Stories of 2014" Medscape. 

John M. Mandrola, M.D. Clinical Electrophysiologist

http://www.medscape.com/viewarticle/836316?src=rss#vp_5

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#10. The Blind Spot of Cardiology

Four in five heart attacks are preventable. These were the beautiful findings of Swedish researchers who studied the effects of five modifiable health measures in 20,721 men from 1997 to 2009.[35] No, lipoprotein(a) levels were not among them. Instead, this group measured the benefits of eating a healthy diet, drinking two (or fewer) alcoholic drinks daily, exercising regularly, having a small belt size, and not smoking. Each factor incrementally lowered the risk for first myocardial infarction, and those men who achieved all five measures were 79% less likely to have a heart attack than those who accomplished none.
Women, too, can prevent heart disease. American researchers performed a similar analysis of data from the Women's Health Initiative.[36] In this study, basic health parameters predicted heart failure
. Over the 11-year follow-up, including 1826 incident cases of heart failure, women who ate well, exercised regularly, maintained a healthy body mass index, and did not smoke enjoyed a 77% lower risk of having heart failure.
Perhaps the strongest support that simple lifestyle factors are potent elixirs for health came from data on AF ablation results. In the ARREST-AF trial, [37] a team of scientists from Australia showed that patients enrolled in an aggressive risk-factor modification clinic increased their chance of ablation success fivefold.
These studies, which yield utterly expected findings, should alarm this generation of caregivers. While we perseverate over statin drugs, or ezetimibe with statin drugs, or cholesterol-efflux capacity, we are witnessing the first group of adults who can expect to live shorter and sicker lives than their parents. This, on our watch. Doctors can't change society alone, but we are health professionals, right? We can start by assessing the right health measures. The word that comes to mind is leadership.
That's it for 2014. Please feel free to agree or disagree with my choices in the comments section.
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