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What’s The Best Time Of Day To Take Your Medications?

“To everything there is a season, and a time to every purpose under heaven.”

That oft-quoted passage doesn’t apply just to rending and sewing, weeping and laughing, or gathering stones together. Your body has its own set of “seasons,” many of them following the turn of a complete day. Taking some medications at specific times of the day can help them work better. A new study suggests that blood pressure drugs taken at night might improve blood pressure and prevent more heart attacks and strokes than taking the same medications during the day.

Spanish researchers tested Read more »

*This blog post was originally published at Harvard Health Blog*

Do You Know What Metabolic Syndrome Is?

People with metabolic syndrome are twice as likely to develop heart disease, and five times as likely to develop diabetes, as those who don’t have metabolic syndrome. But many people are not yet familiar with this relatively new term. Do you know what metabolic syndrome is?

OECD Country Populations with a BMI > 30 (1996-200

OECD Country Populations with a BMI > 30 (1996-2003)

Metabolic syndrome is the combination of several medical problems associated with morbid obesity. In addition to obesity, these conditions include: Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

The Cost Of Treating Kidney Disease

Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits.

On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent.

Similar amounts were spent on prescription medicines ($1.4 billion) and emergency room visits ($1.5 billion). Hospital stays amounted to $9.1 billion. Medicare paid 40 percent of the total expenditures to treat kidney disease.

*This blog post was originally published at ACP Internist*

We’re Overdosing On Sodium: Whose Responsibility Is It?

I confess to loving Campbell’s tomato bisque soup. I mix it with 1 percent-fat milk and it’s hot and delicious and comforting, but one of the worst food choices I could make because one cup contains more sodium than I should have in a day. Knowing this, I have already relegated it to an occasional treat. But by the end of this blog post I will do more.

We are overdosing on sodium and it is killing us. We need to cut the sodium we eat daily by more than half. The guidelines keep coming. The U.S. government has handed out dietary guidelines telling Americans who are over 50, all African Americans, people with high blood pressure, diabetes, or chronic kidney disease to have no more than 1,500 milligrams (mg) — or two thirds of a teaspoon — of sodium daily. That’s the majority of us — 69 percent. Five years ago the government said that this group would benefit from the lower sodium and now it made this its recommendation. The other 31 percent of the country can have up to 2,300 mg a day, say the guidelines from the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS).

Or should they? The American Heart Association (AHA) recommends that all Americans lower sodium to less than 1,500 mg a day. Excessive sodium, mostly found in salt, is bad for us because it causes high blood pressure which often leads to heart disease, stroke, and kidney disease and can also cause gastric problems. People with heart failure are taught to restrict salt because water follows salt into the blood and causes swelling of the ankles, legs, and abdomen and lung congestion that makes it difficult to breathe.

I saw one recommendation by an individual on the Internet to just drink a lot of water to flush the sodium out of your body rather than worry about eating foods that have less sodium. BAD idea, especially for people with heart problems who need to restrict fluids to help prevent fluid accumulation in their bodies. The salt will draw the water to it.

But cutting our salt consumption by half is quite a tall order for an individual consumer because Americans have been conditioned from childhood to love salt and we on average consume 3,436 mg — nearly one and a half teaspoons — a day. Sodium is pervasive in our food supply. We get most of our sodium from processed foods and restaurant and takeout food, sometime in unexpected places. Read more »

*This blog post was originally published at HeartSense*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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