Statins in Healthy Patients

Statins in Healthy Patients?

Long term use of statins, cholesterol lowering drugs, is unsure especially in apparently healthy patients. What is apprently healthy. Well if someone comes into the doctors office with high cholesterol, high blood pressure, diabetes, overweight or smoking they may be at risk yet they do not have diagnosed heart disease. It is quite often then we may know the patients risk. However, there is a time and place for recommendations of medications.  I say give the patient a chance to make a change. If they do not respond then yes medications may be an option.


I just recently commented on Dr. Seth Bilazaria’s blog regarding the debate that took place regarding my last post with prescribing statins.

Here is what I commented on:


I really love the debate formats too, especially in the cardiology meetings. I cannot believe in the same breath you are saying that we all know the benefits of exercise and diet yet you require a randomized control trials. Let’s think about  this for a second. We are talking about apparently healthy individuals who may be at risk and asking them to take a statin.
Using carotid IMT to track disease process has been successful yet who in their right mind is going to fund a study with diet and exercise vs a billiion dollar drug industry.

We know the benefits of lifestyle modification and we know the effects that take place on a biological level towards atherosclerosis yet getting out the precription pad seems to be many doctors course of action. Take some time with patients, learn about them and you will see them adopt healthy changes when you have the “serious” discussion that they may be heading for a heart attack or stroke.


Doctors have a power to maek a difference in their patients lives. Taking out a precription pad for apparently healthy individuals with no diagnosed heart disease is not always the answer.
Cardiac rehabilitation programs and heart attack and stroke prevention clinics are the answer, not always drugs. Give the patients a choice, because no drug is free of side effects.


It is your heart. Love it and take care of it.


To your success,


Diamond Fernandes

Predicting your Risk of a Heart Attack

Problems Visiting your Family Doctor for Prevention

Reverse Heart Disease, Prevent a Heart Attack

Visiting your doctor and understanding your risk of a heart attack is not enough. With a meta-analysis of 18 studies confirms that differences in risk-factor burdens in middle age translate into significant differences in lifetime cardiovascular disease risk. Doctors using a tool called Famingham is not enough. This is a 10 year calculation risk of a heart attack or stroke. The problem is that it will underestimate a risk of heart disease. It is based on blood pressure, cholesterol levels, smoking and diabetes.

The risk in people in their 40s or 50s with one or two risk factors such as hypertension or high cholesterol ramps up sharply over their lifetime. Therefore there is a disconnect between short term risk information calculated and what is known with Framingham. Heart disease is an inflammatory disease and can happen for many reasons. Many times the first sign of a heart attack is death. Timely screening and education are important.

Black Tea Lowers Blood Pressure

Black Tea Lowers Blood Pressure

Controlling your blood pressure I feel is the number one most important modifiable risk factor to control. Medications may be an option for you however I have seen many people get off their medication following our heart health advise.

A new study shows that drinking black tea may reduce the risk of developing high blood pressure. The study showed a difference of 2 to 3 mm Hg changes within 3 months consuming 400mg daily.

Why the changes in blood pressure?

Black tea is a common source of flavonoids which have shown to help in heart health.  Flavonoids are antioxidant nutrient found naturally in plants.  Flavanoids increases nitric oxide status which allows the blood vessels to dilate. It also reduces plasma concentration of endotelin-1 which helps with the tone of the arterial wall.

Statin debate

The Statin Debate:



Should we really have statins in our drinking water? Do we always need a pill for prevention of heart attacks? Are you taking a statin?
Statins are cholesterol lowering drugs used to treat LDL cholesterol.
There was a good debate in the Wall Street Journal today. One doctor was for statins in preventing heart attacks (Dr Roger Blumenthal, Johns Hopkins University Medical Center, Baltimore, MD) and the other doctor was for lifestyle intervention (Dr Rita Redberg, University of California, San Francisco).


Here are my thoughts. Although I am not a doctor I have been involved in this field for over a decade and I personally get to spend lots of time with the patients actually taking the drugs.


From a secondary prevention perspective (after a heart attack) the research is evident that taking a statin is beneficial. However, I have seen many patients get off their statins due to aggressive risk factor control through diet, exercise and stress control. I have also seen a fair number of patients get off their statins due to side effects. (if you have not done so do visit our blog on statins and Co Q10


From a primary prevention standpoint (before a heart attack) I feel that you can stop a heart attack from ever happening by focusing on your risk factors to heart disease. But taking pills for prevention? I am kind of against this as I know there is a lot more than you can do than take a pill. I do have a big but! If you know that you are at increased risk from a blood test (HS CRP), Carotid Intima Media Thickness, or Calcium score. Then it may be a good start to be on a statin however, do understand that you can get off of this. Someone who has no diagnosed heart disease and has a blood test with a high LDL in my opinion is not a reason for an automatic statin prescription. Take a look at some other blood tests (what type of LDL, Hs CRP) and other inflammatory markers and then have a good conversation with your healthcare team.


There are side effects to taking statins and it does involve liver and muscular concerns. If the drug was side effect free then I may change my thoughts, but the fact is that it is not. Weigh the pros or cons of taking a statin with your healthcare team. Do understand that heart disease (coronary artery disease) is an inflammatory disease so you can reverse this by focusing on anti-inflammatory sources (healthy nutrition, exercise and stress management).


To your success,


Diamond Fernandes

Are you having a Heart Attack?

Are You Having a Heart Attack?

What is your risk? How do you know if you are having a heart attack? Well the best way to know is to get yourself to emergency. There are 2 tests that they will do to determine if you are having a heart attack.
1. Electrocardiogram(ECG): to determine if there are what we call ST changes.
2. Blood test: to see if your cardiac enzymes are high.

You can have a negative ECG, meaning no ST changes and still be having a heart attack. That is why they do blood tests to determine risk of heart disease.

Even if this is all negative. Something brought you into the hospital. This is where it is important to do some further investigations. You can have chest pains (angina) and have negative tests in the hospital. This is so important to now start a lifestyle modification program and get further screening. A carotid IMT screening may be a great test to see the age of your arteries. Then implementing our suggestions you will reverse heart disease.

Do not neglect your health. You have only one heart. Love it and take care of it.

To your success,


Diamond Fernandes

Shovelling Snow After a Heart Attack

Yes, we just came form a big snow fall. Be careful though. Shoveling snow after a heart attack is possible but it does requires a lot of preparation.


First lets go over the reason why people have heart attacks while shoveling snow.


1. Poor conditioning
2. They have heart disease (they just don’t know it yet) That is why it is important to do a carotid IMT to understand your risk of heart disease and stroke
3. They jumped out in the cold weather. This constricts the blood vessels and can cause clots.
4. They did not warm up. Again pushing big loads of snow with a constricted blood vessel
5. Lastly they are pushing large loads of snow which can cause contractions to your muscles which then clamps the blood vessels.


All a recipe for disaster.
If you want to shovel snow you can just do the opposite of what I said above.
1. get fit
2. Get timely screenings
3. Dress warm
4. Warm up
5. Start resistance training, or don’t push big loads of snow.


There are two ways to be successful. Watch someone who is failing and do the opposite or watch someone who is successful and follow them to your goal.


Take a look at this video link for more information.


to your success,

Diamond

Shovelling Snow After a Heart Attack

Yes, we just came form a big snow fall. Be careful though. is possible but it does requires a lot of preparation.


First lets go over the reason why people have heart attacks while shoveling snow.


1. Poor conditioning
2. They have heart disease (they just don’t know it yet) That is why it is important to do a
carotid IMT to understand your risk of heart disease and stroke
3. They jumped out in the cold weather. This constricts the blood vessels and can cause clots.
4. They did not warm up. Again pushing big loads of snow with a constricted blood vessel
5. Lastly they are pushing large loads of snow which can cause contractions to your muscles which then clamps the blood vessels.


All a recipe for disaster.
If you want to shovel snow you can just do the opposite of what I said above.
1. get fit
2. Get timely screenings
3. Dress warm
4. Warm up
5. Start resistance training, or don’t push big loads of snow.


There are two ways to be successful. Watch someone who is failing and do the opposite or watch someone who is successful and follow them to your goal.


Take a look at this video link for more information.



to your success,

Diamond

Reversing Heart Disease with more Sleep

Reversing Heart Disease with more Sleep

Heart disease can happen to anyone. Many people think they are invincible. Over time poor sleeping habits can lead to poor heart health. When we don’t get enough sleep it causes an inflammatory response inside our arteries.  All the good things that we teach you to do happens when you sleep. The adaptations to exercise and healthy eating happens when we are sleeping. Get your 6 to 8 hours of sleep daily.

To your success,

Diamond Fernandes

Aspirin for Heart Disease and Stroke Prevention

Aspirin for Heart Disease and Stroke Prevention QR77

I was asked to comment on QR77 about heart disease prevention using aspirin. Well I think we know my thoughts on pills for prevention. Yes they can be helpful but as you know walking into a grocery store is like walking into a pharmacy and daily exercise is much better than any pill you can take for prevention.

It is first important to understand your risk of heart disease and stroke. Know your risk factors and understand your overall risk of heart disease and stroke. This can be done with a simple carotid IMT. Yes checking your blood pressure, choleterol and weight are important number to know. But if you truly want to know your risk you have to take the next steps. Over 50% of heart attacks occur with no prior symptoms. Close to 50% of heart attacks occur with people taking aspirin. There is no such thing as a prevention pill. There are always benefit and risk of taking any medication.


IF you dont have to why would you take a medication? The best way to take control of your heart health is to develop a heart healthy routine.

Please find interview attached.

Reversing Heart Disease

Reversing Heart Disease

Happy New Year! I would like to wish everyone a Happy New Year and wish nothing but success with their heart health. I get this question a lot. Can we reverse Heart Disease?
 

YES you can. Remember walking into a grocery store is like walking into your pharmacy, getting your daily exercise is like taking your daily medications and having good stress coping strategies (yoga, meditation, and breathe awareness) is like exercise for your mind. Three simple practices that will bring amazing heart health.
 

Now with the new year here, we are gearing up to make or resume our heart healthy lifestyle. Reversing heart disease does not happen overnight. You cannot think about the past, whether it be good or bad. Focus on today and make a plan for tomorrow. You cannot reverse time, so lets not worry about what we did last week, last month or last year. Too many times I see people let the past haunt them. A very good article I read the other day talked about “failure”. We all have FAILURES in our life. But if we start to change the word FAILURE to PREPARATION it will change our mindset. Failure is nothing but preperation to meet your ultimate goals.
Lets think about this. A failed exercise program or nutrition program is nothing but preperation to meet your goal of heart health. I say keep on failing and you will eventually see success.
 

New Year resolutions are great to refocus on our goals and dreams. Don’t worry about failing. Just keep on failing which means keep on trying and this will prepare you for ultimate success.
 

I would like to wish everyone an amazing 2012, I hope all your dreams and goals come true.
 

To your heart health success,

Diamond Fernandes