Heart Disease

February 14, 2019

Putting a little ‘heart’ into public investments in health really can pay off

Take heart, Americans. Taking care of ourselves makes a difference, making us healthier — and saving us money. New research supports policies for spending on the wellness of the elderly, improving heart care, and how smart interventions can reduce rising overall health costs.

This evidence-based approach to figuring the government’s optimal role in individuals’ health also may provide a rebuke of sorts to the way that partisans are imposing draconian new rules to curtail medical assistance for the working poor, poor, aged, and chronically ill Americans.

The rare good news about the nation’s health care costs traces to investigators’ efforts to determine why, in contrast to expectations that spending would leap, Americans’ $3.5 trillion annual medical expenditures increased only slightly. They drilled down, focusing on an area where the “sharpest slowdown” occurred in their research period, 1999-2012: Medicare, a federal program that now enrolls roughly 15 percent of the U.S. population, with beneficiaries 65 and older.

February 8, 2019

FDA ripped for failures on e-cigarettes and flavors for vaping and smoking

by Patrick A. Malone

The federal Food and Drug Administration failed to protect the nation’s young against Big Tobacco’s harms with slow-poke responses to the rise of e-cigarettes, as well as tardy regulation of flavorings for combustible cigarettes and liquids used in “smokeless” vaping, health advocates say.

The American Lung Association, in its annual “State of Tobacco Control” report, ripped FDA Commissioner Scott Gottlieb and his agency for postponing oversight of e-cigarettes and vaping — a hard-won crackdown approved in the Obama Administration — to further study the harms of the devices and practices.

While the agency dawdled, e-cigarette makers, notably the firm behind the small Juul device, stormed the youth market, luring American teens to a raging, e-cigarette fad. Many became addicted to vaping and harmful nicotine, as a result. As the lung association describes it:

November 16, 2018

FDA to play yet more catch-up to crack down on e-cigarettes and flavorings

by Patrick A. Malone

Uncle Sam will rip a page from Big Tobacco’s marketing playbook, targeting the taste and buying-ease of nicotine-containing products with tough new restrictions aimed at better protecting kids. Will these latest steps, however, snuff out the increasingly risky youth vaping craze and long problematic menthol cigarettes and cigars? Or are officials too late and being more helpful than not to tobacco interests?

The Washington Post first reported the outlines of plans by the federal Food and Drug Administration to crack on the hot youth trend of using e-cigarettes by barring sales at gas stations and convenience stores like 7-Eleven of certain flavored liquids and devices used in vaping.

But the FDA, in its formal policy announcement, retreated from that tough stance. Instead, the agency says it will require gas stations and convenience stores to require age verification and keep specified products away from the under-aged. It is unclear if this means vendors simply can stash these items under the counters, or if they must be kept in separate adults-only areas.

October 24, 2018

31 heart studies retracted in latest failure for much-hyped stem-cell therapies

by Patrick A. Malone

Treatments with “stem cells,” therapies that already were sliding into disrepute due to hyped claims and inappropriate use, took another big hit to their scientific credibility when two respected institutions announced they were retracting 31 published studies claiming stem cells could help patients with damaged hearts.

Harvard Medical School and Brigham and Women’s Hospital in Boston jointly denounced Piero Anversa, a once celebrated cardiologist who had worked at both institutions but left in 2015, for putting out false or fabricated data for dozens of studies he and colleagues published. The works — contrary to accepted science — purportedly showed that damaged heart muscle could be regenerated with stem cells, a type of cell that can transform itself into a variety of other cells.

The medical journals that have published Anversa’s studies must decide for themselves their course of action now with his work. The experts at Retraction Watch, a nonprofit that monitors science publishing and pulled papers as part of an effort to provide greater transparency to the scientific process, say it is rare for one researcher to have so many studies determined to be flawed and subject to removal from public view.

October 12, 2018

Unhappy meals: Fast food still tops out too many time-stressed eaters’ menus

by Patrick A. Malone

Americans can’t stop chowing down on fast foods, despite years of warnings about their health harms.

The federal Centers for Disease Control and Prevention has found that 36.6 percent of Americans — 37.9 percent of men and 35.4 percent of women — eat some kind of fast food on any given day.

As the Los Angeles Times reported:

September 26, 2018

‘Fat shaming’ plays ugly role in medicine’s failing campaign to treat obesity

by Patrick A. Malone

The medical establishment needs to take a hard, long look at its failing efforts to combat obesity and overweight, conditions that now affect just under 40 percent of American adults (93.3 million people) and 20 percent of youngsters (13.7 million) in the U.S.

That’s because doctors and medical scientists have “ignored mountains of evidence to wage a cruel and futile war on fat people, poisoning public perception and ruining millions of lives,” Michael Hobbes has reported in a long, strong story on the Huffington Post.

Hobbes has marshaled an array of available data to wag an unhappy finger at U.S. society, acting on conventional medical wisdom, for blaming and shaming those who are overweight or obese, contending that they lack self-control, discipline, and the personal fortitude to deal with what he says is clearly an uncontrolled medical and public health menace.

September 25, 2018

Doctors too readily provide dubious treatments to vulnerable seniors

by Patrick A. Malone

Doctors subject older patients to risky, costly, invasive, and painful tests and treatments, perhaps with good intention but also because they fail to see that the seniors in their care are individuals with specific situations with real needs that must be considered.

If physicians too readily accept conventional wisdom in their field, for example, they may push patients 65 and older to take low-aspirin, with the popular but mistaken belief that this practice will help prevent heart attacks, strokes, and dementia. This doesn’t work, and, it increases the risk in seniors of “significant bleeding in the digestive tract, brain or other sites that required transfusions or admission to the hospital,” the New York Times reported.

The newspaper cited a trio of studies, published in the New England Journal of Medicine and based on “more than 19,000 people, including whites 70 and older, and blacks and Hispanics 65 and older. They took low-dose aspirin — 100 milligrams — or a placebo every day for a median of 4.7 years.”

September 16, 2018

Is FDA’s new crackdown on e-cigarettes too little, too late?

by Patrick A. Malone

Has one of the nation’s top health watchdogs awoken too late, barked too little, and, maybe won’t bite enough as Big Tobacco and its allies have addicted a generation of young people to nicotine?

Scott Gottlieb, commissioner of the federal Food and Drug Administration, captured extensive media attention by hitting the alarm button about “epidemic” vaping and teens’ use of e-cigarettes, notably the wildly trendy Juul device and others of its kind.

He said the FDA has acted against 1,300 retailers for peddling e-cigarettes and their liquid flavorings to underage customers. More key: The agency has told Juul and other leading makers that they have 60 days to show how they can keep their products out of the hands of customers 18 and younger — or the FDA may ban them from the market.

September 14, 2018

Common sense on kids and concussions, adult heart disease, frats and booze

by Patrick A. Malone

Common sense and moderation can matter a ton in maintaining good health, as recent news reports show, particularly with kids and concussions, middle-aged adults and heart disease, and collegiate alcohol abuse.

With youngsters returning to school and so many of them participating in sports and recreation programs, it’s good that the federal Centers for Disease Control and Prevention has issued evidence-based guidance on protecting kids who suffer mild traumatic brain injury or what most of us would call concussions.

These injuries have become a growing concern for parents and young athletes. Sports leagues and sporting groups are coming to a time of reckoning with just how harmful head trauma can be.

August 23, 2018

Doctors and hospitals tussle over surgery for less-invasive heart valve repair

by Patrick A. Malone

When big hospitals and their doctors jostle with competitors in smaller and medium-sized facilities over who gets to perform an important and booming kind of surgery, it’s not a pretty sight — nor might it be obvious with which institutions patients ought to side.

Phil Galewitz of the independent, nonpartisan Kaiser Health News Service does consumers a service with his reporting on recent bureaucratic brawling in Baltimore before federal regulators charged with determining where surgeons may replace leaky valves without open heart procedures.

As Galewitz explains, surgeons and medical device makers for a few years now have worked together to develop a new way to fix defective valves for tens of thousands of patients too frail to undergo open heart operations that, among other things, involve getting their chests cracked open. Surgeons, instead, can snake a catheter through patients’ blood vessels, into their heart, and shove aside the leaking valve, replacing it with a new model.