Articles Posted in Heart Disease

wheartatttack-238x300As cardiologists and oncologists swap cross-fire about the conditions they treat and how they do so, here’s hoping that, above all, their female patients end up helped and not harmed, getting vital information about risks and benefits of therapies for two of the leading killers of women: heart disease and breast cancer.

What’s behind the medical specialists’ cross currents? Cardiologists and the American Heart Association are pointing to a major therapeutic statement published in the medical journal Circulation.

On the one hand, it provides what many see as an important, needed call to doctors of all kinds to recognize that heart disease among women goes “dangerously under-diagnosed and under-treated,” due in no small part because practitioners still fail to see that women suffer heart attacks in different ways than do many men. They do not, for example, suffer stabbing chest pain, radiating into the arm. Instead, as they experience clogs in tiny veins and arteries, they may feel a constant exhaustion and a discomfort as if they were having their chest squeezed or crushed.

belts-300x163Preventive measures, even small ones, can be life changing and lifesaving. They can safeguard drivers and passengers in car wrecks, protect young folks during a bad flu season, and ensure that fewer Americans still take up one of the proven, major health harms — smoking.

Let’s start with a simple, often overlooked vehicular precaution: Buckle up that seat belt, please. As New York Times columnist David Leonhardt noted in a recent Opinion section roundup, the number of Americans killed on the roads who fail to wear vehicle restraints, notably seat belts, has hovered “between 48 percent and 51 percent in each of the past five years.”

Yes, that’s a correct figure: Roughly half of those killed didn’t use one of the most publicized, almost reflexive safety steps around.

smoker-300x181If money really talks, could financial data persuade smokers, finally, to see the light and give up the habit, knowing that it racks up seven-figure lifetime costs per user in Virginia, Maryland, and the District of Columbia?

WalletHub, a West Coast personal finance site, has posted its crunching of data from the U.S. Census Bureau, Bureau of Labor Statistics, Centers for Disease Control and Prevention, Insurance Information Institute, Campaign for Tobacco-Free Kids, NYsmokefree.com, Federal Reserve Economic Data (FRED), Kaiser Family Foundation and the Independent Insurance Agents & Brokers of America.

Information from these sources was used to calculate the “per-person cost of smoking in each of the 50 states and the District of Columbia [including] potential monetary losses — including both the lifetime and annual cost of a cigarette pack per day, health care expenditures, income losses and other costs — brought on by smoking and exposure to secondhand smoke.”

bp-300x169Did you feel yourself just get less well? U.S. heart experts have just issued new guidelines on what Americans’ optimal blood pressure should be—effectively and suddenly shifting just under half of the adults in the nation younger than 45 into an unhealthful status as hypertensive.

Doctors say there’s no doubting data that shows that blood pressure readings exceeding 130 over 80 can be detrimental to patients’ health. That’s down from the previous warning level of 140 over 90.

But what exactly has the medical establishment wrought with this sweeping metric? Have they deemed so many of us unwell in this way that we’re about to see public doubt and confusion—even profiteering—as has surrounded the description of tens of millions of Americans as “prediabetic?”

alcohol-248x300When topics like booze and health flow together, common sense seems to disappear. So let’s give credit to the context-restoring efforts of Aaron Carroll— a pediatrics faculty member at Indiana University medical school, a health policy researcher, and a writer for the New York Times’ “Upshot” column—and healthnewsreview.org, a health information watch dog site.

Both addressed a “panic” in certain quarters generated by a new caution issued by the American Society of Clinical Oncologists. The respected organization of cancer medical specialists said that even light alcohol consumption can add to drinkers’ cancer risks.

As Carroll summarized the cancer experts warning:

pacemaker-300x186Big medical device makers, like Big Pharma, have complained relentlessly that Uncle Sam hamstrings them with red tape and bureaucracy that slows or prevents innovative, life changing and lifesaving products from reaching the public. Most of this criticism has been targeted at the federal Food and Drug Administration, which under the Trump Administration, has promised to speed and ease its industry oversight.

But internal watchdogs for the Health and Human Services department have provided a rebuke to the move-faster crowd, detailing the costly cleanup—paid for by taxpayers like you and me— that results from defective medical devices.

The HHS inspector general’s office, in what some patient advocates are calling “a drop in the bucket” of the magnitude of this concern, has found that Medicare paid “at least $1.5 billion over a decade to replace seven types of defective heart devices [that] apparently failed for thousands of patients,” according to a story by Pro Publica, the Pulitzer Prize-winning investigative reporting web site.

cdccancer-271x300Those carrying around a few pounds extra, or maybe even a lot more, may want to get moving and to drop that excess weight for yet more compelling health causes: That’s because more than 630,000 Americans were diagnosed in 2014 with cancers linked to obesity or overweight, the federal Centers for Disease Control and Prevention has reported.

The CDC says 40 percent of all diagnosed cancers were associated with obesity. At a time when the nation is seeing some success in reducing overall rates of diagnosed cancers, a baker’s dozen of overweight-related cancers increased 7 percent between 2005 and 2014. Two out of three of the cancers occurred in those 50- to 74-years-old.

Federal officials have found that more than half of Americans don’t know there’s a connection between 13 kinds of cancers (see diagram) and excess weight. It took public health officials decades to persuade the public that smoking posed cancer health risks and people needed to stop—and Big Tobacco still resorts to unceasing, deceptive tactics to undermine this awareness.

CAR-T-image-300x274Drug makers have just shown not only their verve in pursuing new ways to treat cancer and heart disease but also their nerve in pricing these novel therapies as if sick patients had the wealth of mega lottery winners. Just look at what Novartis is doing with the medications Kymirah and canakinumab, a drug now marketed under the brand name Ilaris.

One the one hand, it’s hard not to admire the medical science behind both, notably first Kymirah. The drug has been newly approved by the federal Food and Drug Administration to treat children and young adults for B-cell acute lymphoblastic leukemia, a “devastating and deadly” form of the blood cancer that has resisted standard treatment and often resulted in disheartening relapses.

But Kymirah, regulators agreed, offers a treatment “milestone” because it “genetically alters a patient’s own cells to fight cancer,” converting them into a “living drug,” and training them “to recognize and attack the disease.” This Chimeric Antigen Receptor (CAR) T-Cell Therapy (see illustration) “is part of the rapidly growing field of immunotherapy that bolsters the immune system through drugs and other therapies and has, in some cases, led to long remissions and possibly even cures,” as the New York Times has reported.

heart-300x190Hospitals and heart doctors may need to rethink their common test to determine if their patients have suffered a heart attack, and whether a newer alternative open-heart procedure carries with it more risks than benefits.

Health News Review, a health information watchdog site, has raised interesting questions as to why mainstream media outlets haven’t paid much attention to the recommendation by the High Value Practice Academic Alliance (HVPAA), a blue-chip group of medical scientists and institutions (including Johns Hopkins), for the phase out of the creatine kinase-myocardial band. CK-MB is the “go-to blood test doctors used to determine if a patient’s heart muscle had been damaged by a heart attack (or myocardial infarction).”

To the tune of $400 million or so annually, doctors turn to CK-MB tests millions of times each year to distinguish, along with patient symptoms and EKGs, if the person before them has suffered a heart attack, HVPAA members write in the medical journal JAMA Internal Medicine.

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