Tag Archives: heart attacks

FDA Reversal: Rosiglitazone DOES NOT Pose Cardiovascular Risk

Rosiglitazone is a type 2 diabetes drug in the thiazolidinedione class. In 2011, the U.S. Food and Drug Administration determined that rosiglitzone posed a substantial risk for causing premature cardiovascular disease such as heart attacks. The agency greatly restricted prescribers, essentially killing the drug’s sales in the U.S. In November, the FDA took another look at the data and decided the risk was minimal or non-existent.

Dr. Steven Nissen of the Cleveland Clinic is on record as opposing the new change.

A lot of personal injury lawyers will be disappointed in the change unless they’ve already settled their cases out of court.

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Eggs Are Linked to Heart Attacks in Diabetics?

The general population doesn’t need to worry about eggs causing strokes or heart attacks according to a new meta-analysis reviewed at Forbes. We still have a question about high egg consumption and heart attacks in diabetics.

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Filed under Heart Disease

Do Calcium Supplements Cause Heart Attacks?

A new European study suggests that calcium supplements almost double the risk of having a heart attack, at least in Germans.  You can read the full report in the current issue of Heart.

The medical literature on this issue is a confusing mess.  In other words, lots of conflicting results.

Huge numbers of women in the U.S. are taking calcium supplements either to treat or prevent osteoporosis and the associated broken bones (e.g., hips, wrists, spine).

What I’d like to know, and what nobody knows, is what is the effect of calcium supplementation on average longevity and quality of life.  Maybe I’d accept a higher risk of heart attack if calcium supplementation prolonged lifespan by two years.

In the interest of brevity, I’ll just say that the best way to get your calcium is probably through food rather than supplements.

Shereen Jegtvig has an article at About.com listing foods rich in calcium.

Exercise can also help keep your bones strong and break-resistant.

Steve Parker, M.D.

PS: If your doctor has you on a calcium supplement, you’d best get his blessing before you stop it.

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Filed under Heart Disease, Supplements

Are Most Statin Prescriptions a Waste of Money?

A recent medical journal article suggests that three of every four statin prescriptions do nothing to prevent death, since they’re taken by people without an established diagnosis of cardiovascular disease.  The researchers don’t address whether statin drugs prevent heart attacks or strokes or otherwise improve quality of life. 

Most of the “healthy” people taking statins are trying to prevent heart attacks associated with high cholesterol levels.  You’d think if statins prevented heart attacks, they’d prolong life.  That’s not what these researchers found.

Details are at my recent Self/NutritionData Heart Health Blog post.

Steve Parker, M.D.

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Filed under coronary heart disease

Medical Heresy: Mediterranean Diet Causes Heart Attacks

Recent media reports suggest that the Mediterranean diet may actually cause heart attacks in certain individuals.  I attempt to debunk this idea in my May 31, 2010, post at NutritionData’s Heart Health Blog.

The Mediterranean diet has long been associated with lower rates of heart disease.

Steve Parker, M.D.

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Red Wine Improves Circulation

Red wine’s beneficial health effects may be related to improved circulation, according to a recent study by Israeli researchers.

Red wine is a time-honored component of the healthy Mediterranean diet.  Consumption is associated with longer lifespan and less cardiovascular disease such as heart attacks. 

Israeli investigators had 14 young healthy volunteers drink 250 cc of red wine daily for 21 days, while monitoring markers of circulatory function.  Endothelial progenitor cells may be particularly important in maintenance, repair, and formation of the arterial circulatory system.

Here’s their conclusion:

The results of the present study indicate that red wine exerts its effect through the up-regulation of CXCR4 expression and activation of the SDF1/CXCR4/Pi3K/Akt/eNOS signaling pathway, which results in increased [endothelial progenitor cell] migration and proliferation and decreased extent of apoptosis. Our findings suggest that these effects could be linked to the mechanism of cardiovascular protection that is associated with the regular consumption of red wine.

I’m not going to tell you I understand all that.  Don’t feel bad if you don’t, either.  My point is to illustrate one way that Science makes progress.  An observant person notices, “Hey, people who drink judicious amounts of red wine seem to live longer and have fewer heart attacks.  I wonder how that works.”  Perhaps a plausible mechanism is identified.  That might lead to isolation of a specific component in red wine that yields the benefit.  Then that component is produced and disseminated, leading to the health benefits, without the risks of alcohol consumption.

It’s an expensive, time-consuming enterprise with many blind alleys.

Steve Parker, M.D.

Reference:  Hamed, Saher, et al.  Red wine consumption improves the in vitro migration of endothelial progenitor cells in young, healthy individuals.  American Journal of Clinical Nutrition, April 14, 2010.    doi:10.3945/ajcn.2009.28408

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Filed under Alcohol, coronary heart disease, Health Benefits, Mediterranean Diet

Fruits and Vegetables DON’T Prevent Heart Disease

Fruit and vegetable consumption does not seem to reduce the risk of heart attacks (coronary heart disease), according to a recent literature review by French epidemiologists.

I recently wrote about a study that found no overall reduced risk of cancer via consumption of fruits and vegetables.

Heart attacks and cancer are the first and second leading causes of death in the developed world.

So just why, again, are we supposed to be eating our fruits and vegetables?

Here’s most of the abstract written by the epidemiologists:

This Review summarizes the evidence for a relationship between fruit and vegetable consumption and the occurrence of coronary heart disease…Most of the evidence supporting a cardioprotective effect comes from observational epidemiological studies; these studies have reported either weak or nonsignificant associations.  Controlled nutritional prevention trials are scarce and the existing data do not show any clear protective effects of fruit and vegetables on coronary heart disease.  Under rigorously controlled experimental conditions, fruit and vegetable consumption is associated with a decrease in blood pressure, which is an important cardiovascular risk factor.  However, the effects of fruit and vegetable consumption on plasma lipid levels, diabetes, and body weight have not yet been thoroughly explored.  Finally, the hypothesis that nutrients in fruit and vegetables have a protective role in reducing the formation of atherosclerotic plaques and preventing complications of atherosclerosis has not been tested in prevention trials.  Evidence that fruit and vegetable consumption reduces the risk of cardiovascular disease remains scarce thus far.

What do they mean by controlled prevention trials?  Here’s an example.  Find 20,000 people with similar characteristics.  Randomly assign half of them to eat significantly more fruits and vegetables, and make sure they do it.  The other half eats their usual way, and make sure they do it.  Analyze the entire group’s health and food consumption after 10 years and see which half has more or less heart disease.   

Such a study is very difficult and costly.  Even if the fruit and veggie group had less heart disease, someone would argue that the heart benefit was gained because of what they cut out of their eating to make way for the fruits and veggies!  “They quit eating Cheetos; that’s why they had fewer heart attacks.”

Bottom Line

Fruits and vegetables don’t prevent heart disease, according to these researchers.

Fruits and vegetables are components of overall healthy diet patterns such as the Mediterranean diet, the DASH diet, and the “prudent diet.”  Is it possible they reduce the risk of stroke, the second leading cause of death?  I’ll leave that for another day.

I’m starting to think if I read enough nutritional literature, I won’t know anything with certainty.

Steve Parker, M.D. 

Dauchet L., Amouyel, P., and Dallongeville, J. (via MedScape).  Fruits, vegetables and coronary heart disease.  Nature Reviews Cardiology, 6 (2009): 599-608.  doi: 1011038/nrcardio.2009.131

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Filed under coronary heart disease, Fruits, Vegetables