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Stop Watches May Be Better Than CT Scans At Predicting Heart Disease

It is hardly news to say that we need better means to predict who will die of heart disease. No matter how much you may hear about medical errors, hospital acquired infections, or even distracted driving, it’s still heart disease that kills the most of us.

The inflammation that begins narrowing our arteries starts when we are young. It percolates quietly, stealth-like for years. The young usually skate by unscathed. But all the cookies, beers, chips, inactivity and work stress adds up. The tension of life squeezes our arteries, daring them to crack or fissure. This cataclysm is one of the ways that middle age may introduce herself.

A friend, or colleague, or sibling dies suddenly of heart problems. Those of us that our “masters-aged” have likely felt these sensations of sadness, and then the reality that they may be next.

“I should probably come in and get a check-up,” is something I hear frequently in the doctor’s lounge after such a tragedy.

I agree. When you are old enough to use reading glasses it is time to think about what lurks inside your heart’s blood vessels.

But herein lies the catch. Read more »

*This blog post was originally published at Dr John M*

Statin Use Is Increasing Dramatically – Are Americans Healthier For It?

Baseball fans have the Baseball Prospectus annual. Political junkies can get their fix from Nate Silver’s 538 blog.

For those of us with geeky interest in health and medicine statistics, graphs, and charts, the Health, United States, 2010 report from the National Center for Health Statistics is that kind of treat. The 41 charts and graphs and 148 trend tables in the 2010 report (it’s dated 2010 but was released earlier this year) could keep me happily occupied for hours.

One graph that really caught my eye shows the percentage of Americans that take a statin. Statins are prescribed mainly to lower “bad” LDL cholesterol, but they may have other benefits, too. The statins include atorvastatin (sold as Lipitor), rosuvastatin (sold as Crestor), and simvastatin (sold as Zocor but also available as a generic ).

Here is the graph I am talking about:

Many Americans take statins. No surprise there. But half of men, ages to 65 to 74, and 39% of women, ages 75 and older—that’s pretty stunning. Read more »

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

Hormone Replacement Therapy: What We’ve Learned From The Women’s Health Initiative

This is the study that doesn’t end…
The longterm follow up extends…
Some people started studying hormones in menopause,
And they’ll continue publishing more data just because…
(repeat)

In yet another paper in a major journal, we hear once more from the investigators of the Women’s Health Initiative. This time it’s the long term outcomes of women who took estrogen alone, now seven years out from stopping their hormones. What new information can we learn from this extensive analysis of new data?

Nothing.

Really.

The WHI’s been telling us the same thing about ERT (Estrogen replacement therapy) and HRT (Combination estrogen/progestin therapy)  since 2002, and all each subsequent study does is reinforce and expand on that initial data. Unfortunately, it will probably take a few more papers before some folks accept the results of this important study, which, though flawed, continues to inform the practice of menopausal medicine.

Allow me to summarize what we know  – Read more »

*This blog post was originally published at The Blog That Ate Manhattan*

CDC: Americans Are Living Longer Than Ever

The U.S. age-adjusted death rate fell for the tenth consecutive year, to an all-time low of 741 deaths per 100,000 people in 2009, 2.3% lower than 2008, according to preliminary 2009 death statistics released by CDC’s National Center for Health Statistics.

The findings come from “Deaths: Preliminary Data for 2009,” which is based on death certificates from all 50 states, the District of Columbia and U.S. territories.

Life expectancy at birth increased to 78.2 years in 2009, up slightly from 78.0 years in 2008. Life expectancy was up two-tenths of a year for men (75.7 years) and up one-tenth of a year for women (80.6 years). Life expectancy for the U.S. white population increased by two-tenths of a year. Life expectancy for black men (70.9 years) and women (77.4 years) was unchanged in 2009. The gap in life expectancy between the white and black populations was 4.3 years in 2009, two-tenths of a year increase from the gap in 2008 of 4.1 years.
Read more »

*This blog post was originally published at ACP Internist*

More Women Die Of Heart Attack Than Men Do

Several studies have shown that women have a higher mortality rate than men if they have a heart attack. A study published in the American Heart Journal helps to explain why. The researchers looked at data from 2,542 women who had a heart attack. Compared to men, the women were older, less likely to be white, and less likely to smoke. They also had more serious health conditions than the men. They had diabetes, high blood pressure (hypertension), congestive heart failure, and chronic obstructive pulmonary disease (COPD).

We’ve known for a long time that women are about 10 years older than men at the time of their first heart attack. The authors believe that the reason women are more likely to die is because of these other conditions that are present. Women in the study were also more likely to receive a blood transfusion and experience gastrointestinal bleeding, strokes, and vascular complications which lead to death.

They didn’t find any gender difference when they controlled for these other conditions. The number of diseased vessels were the same as was the severity of stenosis.

So what does this tell women? The guidelines for longevity and good health haven’t changed: Don’t smoke, control high blood pressure, and make sure your weight is healthy to prevent diabetes and other vascular problems. Stay active. Heart attacks can be prevented by good lifestyle choices.

*This blog post was originally published at EverythingHealth*

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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