Tag: heart disease

The “Polypill” for Heart Disease and Stroke

single pill might be able to reduce heart attacks and strokes by more than 80%, concludes a study from England. Heart attacks, stroke, and other pre­ventable cardiovascular diseases kill or seriously affect 50% of people in Britain.

Professor Nicholas Wald and Malcolm Law propose a “polypill” that would contain six active components—aspirin, a cholesterol-lowering drug, three blood pressure-lowering drugs at half the standard dose, and folic acid. The pill would be taken daily by all people aged 55 and over and is expected to have a huge effect on preventing disease in the Western world.
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Their radical strategy is based on evidence from more than 750 trials involving 400,000 participants.

These medications are well tolerated, and new problems are unlikely because they have been studied extensively and have often been used in combination.

More Intense Statin Therapy May Avert Heart Disease

Heart Disease

Lowering cholesterol far below the level now considered adequate appears to substantially reduce patients’ risk of death from heart attacks. These findings from the “Prove It” Study (Pravastatin generic or Atorvastatin Evaluation and Infection Therapy) may change the way heart disease is treated. The study compared high doses of a powerful statin, or cholesterol-lowering drug, medication atorvastatin calcium (Lipitor®, Pfizer), with a less potent statin, pravastatin sodium (Pravachol®, Bristol-Myers Squibb). The patients taking Lipitor® were much less likely to have heart attacks or to need bypass surgery or angioplasty.

National guidelines currently call for levels of low-density lipoprotein (LDL) cholesterol, which carries cholesterol to arteries, to be below 100 mg/dl in high-risk patients.

In an earlier study, Drug Lipitor halted plaque growth and Pravachol® slowed but did not stop it. The current study suggests that for patients with recent acute coronary syndrome, an intensive lipid-lowering statin regimen might provide greater protection against death or major cardiovascular events than a standard regimen and that patients would benefit from early reduction of LDL cholesterol to below present target levels.

Heart Disease, Bleeding, and SSRIs

Patients with acute coronary syndrome (ACS) who receive selective serotonin reuptake inhibitors (SSRIs) are more likely to have bleeding episodes but less likely to have recurrent myocardial ischemia and heart failure, according to a Johns Hopkins study. The researchers say this is the first study to examine the association.

In the study, 1,254 patients were admitted with ACS and received a glycoprotein IIb/IIIa inhibitor. Approximately one in seven patients had a history of depression; 158 were treated with an SSRI during their hospital stay. Nearly half were given sertraline, followed by fluoxetine canadian (Generic Prozac, Eli Lilly), paroxetine drug (Paxil canadian, GlaxoSmithKline), escitalopram generic (Lexapro medication, Forest), and drug citalopram (Celexa tablet, Forest). Almost all matched patients received aspirin (99%), canadian clopidogrel (Generic Plavix, BMS/Sanofi) (95°%), and heparin (98°%).

Ninety-eight patients experienced major bleeding; 287 had minor bleeding, and 34 had gastrointestinal bleeding. Although patients who received an SSRI were significantly more likely to experience any bleeding (37%), compared with patients not taking SSRIs (27%), the difference was principally a result of an increase in the risk of minor bleeding.

Patients who were not taking SSRIs had twice the risk (14%) of a minor adverse event (e.g., recurrent myocardial ischemia, heart failure, or asymptomatic cardiac enzyme elevation), compared with those not receiving SSRIs (7%).

Reducing Cardiac Events Before Surgery

People with heart disease should take special precautions before undergoing all operations, even noncardiac surgery, to reduce their risk of a cardiac event, according to new joint guidelines issued by the American College of Cardiology and the American Heart Association.