Wednesday, January 16, 2013 – Noon
Dr. Steven Nissen, Chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, hosts a monthly Tweet-Chat @ClevClinicHeart:
A review of recent heart news
HeartRN: The last couple days in the news were all about berries. What do you think about the new claim: Berries Ward Off MI in Women?
Dr. Nissen: Nonsense. Another example of junk science portrayed as fact. Ignore this. If you want to eat berries, eat them because they taste good.
The theory that antioxidants prevent heart disease has not panned out. These nutritional studies from the Nurses Health Study are always wrong.
HeartRN: Another study suggests using calcium scans to predict risk in diabetes. What do you think?
Dr. Nissen: It is not wise to expose people to radiation just to predict risk. None of these studies show an improvement in outcome for patients who have calcium scans. Don't do this.
HeartRN: Another HDL raising drug failed, niacin/laropiprant.
Dr. Nissen: This is a tough one. No benefits and some harms from giving niacin plus a drug used to reduce flushing. A big question is whether niacin didn't work or laropiprant produced harm. We may not know the answer soon.
I haven't given up hope on drugs to raise HDL but it's getting harder to stay positive.
HeartRN: Another story... Migraines with aura increase heart attack risk?
Dr. Nissen: Migraines are caused by "twitchy" blood vessels in the brain. The same thing might happen with the heart. While theoretically possible, this type of research is scientifically weak and no conclusions are possible from the current study.
HeartRN: New guidelines were issued this week on treatment of heart attack by the AHA/ACC. What’s new in the guidelines?
Dr. Nissen: The Guidelines continue to emphasize faster treatment to save lives.
Certain types of heart attack respond very well to stenting if performed quickly after the onset of symptoms. The former guidelines emphasized the time from arrival to hospital until reopening artery in heart catheterization laboratory. The new guidelines emphasize the time from first medical contact until opening the artery.
The key is shortening the time from occlusion of the artery until its reopening including getting patients to hospital faster. For patients that have chest pain, call 911, don't drive yourself to the hospital. Every minute counts.
HeartRN: What do you think about chewing an aspirin when you have heart attack symptoms?
Dr. Nissen: Solid advice to chew a regular aspirin as soon as possible.
HeartRN: Dr. Nissen, it is the New Year. What is your biggest piece of advice for patients in 2013?
Dr. Nissen: Exercise; Exercise; Exercise. The benefits of regular physical exercise are very well documented but too few of us take this important step. Don't expect medications to replace a healthy lifestyle that includes regular physical activity. The more exercise, the better.
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