Articles Posted in Stroke

Although some people in cardiac distress need invasive procedures to survive, some heart treatments are overused, and the cost continues to mount.

As explained by patient safety advocate John James in his August newsletter, performing angiography on and inserting stents in patients with stable heart disease not only wastes money, but can be unsafe.

An angiogram is an X-ray of blood vessels made visible after the patient is injected with radioactive dye. It’s often prescribed to detect damaged blood vessels and problems affecting blood flow. After an angiogram locates an occluded coronary artery, a stent, or tiny, self-inflating tube can be inserted to open it, and keep it open.

Coumadin is a commonly prescribed drug for treating blood clots and reducing the risk of developing them. It helps reduce the risk of stroke, heart attack and embolisms (clots) forming in the legs or lungs. Using it requires exact dosing and regular testing of its effects – too little won’t protect you against life-threatening clots, and too much can cause uncontrollable bleeding.

A recent investigation by ProPublica and theWashington Post found that nursing homes often fail to maintain the delicate balance, putting patients in danger. Its analysis of government inspection reports found that from 2011 to 2014, at least 165 nursing home residents were hospitalized or died after errors involving Coumadin or its generic version, warfarin. And possibly thousands more suffer injuries every year that are never investigated.

One of these patients was Loren Peters, 85, who arrived at the emergency room in 2013 with bruises all over his frail body and blood oozing from his gums. He had been prescribed Coumadin for his abnormal heart rhythm. Even though doctors administered vitamin K, which is the antidote for too much Coumadin, Peters died a few days after he was brought to the hospital.

A couple of years ago, the American Heart Association and the American College of Cardiology revised the guidelines for prescribing statins, drugs that compromise the body’s ability to produce cholesterol, to recommend that many more people take statins to prevent heart disease.

It was a controversial decision, as we described in our blog. Last week, the controversy was renewed when a couple of studies bolstered those guidelines.

When the guidelines for statin use were issued in 2013, one analysis estimated the market for the drugs would grow by 12.8 million more than under the previous guidelines, to about 56 million people, or nearly half of all people in the U.S. between the ages of 40 to 75.

According to JAMA Internal Medicine, half of the 346,000 people 35 and older who died from cancer in 2011 had a history of smoking cigarettes. But what’s truly remarkable about the new research is that this is the first study to identify deaths from 11 kinds of cancer besides lung cancer that were associated with cigarette use.

As described by KaiserHealthNews.org, the researchers referred to the 2014 U.S. Surgeon General’s Report as fundamental to their study, which estimated the annual number of smoking-related deaths from cancer generally and from lung cancer specifically between 2005 and 2009.

The study traced how smoking behavior and its association with cancer have changed over time. Between 2000 and 2012, the number of people who smoked decreased from 23 in 100 to 18 in 100, and the number of deaths for most types of cancer tied to smoking also declined.

By the early 1990s, scientific evidence was overwhelming that the artificial fat known as “trans” fat was a huge risk factor for heart disease, and in 2006, the FDA required food manufacturers to include the trans fat content on product labels. U.S. consumers have reduced their intake of the artery-hardening substance, but it’s still such a health threat that last week the feds decreed that it be eliminated altogether from processed foods.

Food companies have three years to comply, but from where we sit, that’s a pretty generous interval. According to the Center for Science in the Public Interest (CSPI), the food industry has known since at least 1999 that artificial trans fat was dangerous and should be eliminated.

As pointed out by Michael Jacobson, executive director of the CSPI, “Labeling alone stimulated many to eliminate trans fat. After lawsuits against companies such as Kraft, McDonald’s, KFC and Burger King, additional trans fat was taken out of the food supply.”

People with depression know that it can be frustratingly persistent, requiring various kinds of treatment, often more than once. Now, a new study suggests that people with long-term depression face another possible challenge – a higher risk of stroke.

The research, published in the Journal of the American Heart Association, not only showed a doubled risk of stroke for middle-aged adults with depression, but that reducing its symptoms might not reduce the elevated risk immediately. So as the study’s lead author said in a news release from the heart association, “Our findings suggest that depression may increase stroke risk over the long term.”

Clinical depression is diagnosed by many factors including severity, duration, persistence and recurrence. People with more severe depressive disorders often have symptoms such as suicidal preoccupations and grave impairments such as an inability to concentrate and hold down a job. Generally, the problem lasts more than two weeks.

The dangers of smoking cigarettes have been well documented for a long time, but new research shows that inhaling tobacco is even more hazardous than we knew.

Scientists writing earlier this month in the New England Journal of Medicine (NEJM) found that in addition to lung cancer, heart disease and stroke, smoking also raises the risk of dying of several other diseases, including several cancers and infections.

As summarized on MedPageToday.com, smoking-related deaths increased by 17% from several diseases that, until now, didn’t have established relationships with cigarettes. This was impressive research that included data from five large cohort studies involving 1 million adult subjects, although there were some limitations to the study.

About once a year, it seems, we caution readers about taking aspirin regularly to guard against heart problems, and now there’s more solid science to reinforce that advice.

A study published this month in the Journal of the American College of Cardiology showed that a significant number of cardiology patients are receiving aspirin primarily to prevent heart disease, despite the risk that the drug outweighs the potential benefit for many patients.

As interpreted by MedPage Today.com, too often aspirin is given to people for whom guidelines suggest no real benefit. The study examined a national registry of cardiology practices, and found that more than 11 in 100 uses of aspirin used preventively by cardiologists were for people outside the recommended risk threshold.

Even though drugs to boost testosterone might cause heart problems, the FDA recently approved another one (see our blog from earlier this month). Now, just weeks later, the agency has moved to require testosterone products to carry labels warnings about possible blood clots.

The concern is over blood clots in the legs which can travel to the lungs with fatal consequences.

As reported by MedPageToday.com, product labels must warn about the general risk of blood clots in the veins, as well as clots that are a consequence of polycythemia, a warning currently found in product information.

Studies have proved that taking testosterone can raise a man’s risk of stroke, heart attack and death, so why did the FDA just approve another testosterone replacement gel?

Not only are there scads of testosterone meds and delivery systems – gel, cream, patch, injection – there are also an increasing number of lawsuits over their side effects. The newest player in the testosterone arena is Vogelxo Gel, manufactured by Upsher-Smith Laboratories. One of the more well-known products is AndroGel, from AbbVie, a subsidiary of Abbott Laboratories.

As reported on AboutLawsuits.com, about 100 AndroGel lawsuits and other claims have been filed so far this year, and several thousand more complaints are anticipated to be filed by individuals in the U.S.

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