In the last of our three part exploration of the cardiovascular disease epidemic, Irish doctor Ivor Cummings interviews Dr William Davis consultant cardiologist about what really prevents and reduces coronary artery atheroma. Also discussed is the most effective way to increase your magnesium intake which relaxes smooth muscle thereby reducing blood pressure.
Dr Cummings’s runs his blog known as the Fat Emperor.
In part two of this series on cardiovascular disease Dr Aseem Malhotra, consultant cardiologist explains why putting faith in statins to resolve the cardiovascular disease epidemic is misguided. He explains that they only extend life by a matter of a few days yet need to be prescribed for years at considerable cost to the health service. Furthermore, he thinks that their side effects are not being explained to patients.
This is a medium length article which contains information on statins not readily seen in a single document.
This is part one of a three part series on how we have ended up with a cardiovascular disease epidemic, what treatments we are using which don’t work, and what treatments do work.
The in first episode Belinda Fettke discusses the history behind the 7th Day Adventists who genuinely believed that they were bringing health to the USA population by promoting a grain based diet.
This is a long video but entertaining as well as informative.
Adapted from Intensive lifestyle counselling and cardiovascular outcomes in patients with diabetes. September 14 2019 Diabetes in Control by Nour Salhab. Pharm. D from Zhang et al Lifestyle counselling and long term clinical outcomes in patients with diabetes. Diabetes Care. Aug. 2019.
Intensive lifestyle counselling has been shown to improve blood sugars in the Look AHEAD study but it was too underpowered to show any significant conclusions regarding cardiac outcomes.
This new study looked at patients with both type one and type two diabetes who had HbAICs over 7% and were over the age of 18. Lifestyle counselling involved diet, exercise and weight loss management. The goal was to get the patient’s HBAICs under 7%.
19,293 patients were involved and the mean HbAIC at the start was 7.8%. My comment: This is a very good average compared to British diabetics!
The mean counselling sessions were 0.46 a month and the study ran for 5.4 years.
HbAIC reduced by 1.8% for patients who got monthly counselling and 0.7% for those who got less than monthly counselling.
The primary end point was time to the first episode of angina, heart attack or stroke or death from any cause. There was a small but significant decrease in the group who had monthly counselling compared to three monthly counselling.
The counselling occurred in academic centres so may not be applicable to other settings.
My comment: This level of counselling is much more intensive than can probably be delivered in the NHS population. The blood sugar levels in the patients was also much better to start with compared to the UK population.
From Scottish Medicines Consortium 9 September 2019
Dapagliflozin has been accepted for the treatment of inadequately controlled type one diabetes mellitus as an adjunct to insulin if their body mass index is at or above 27.
The combination significantly improves glycaemic control.
My comment: In my experience the combination is also good for weight control. These findings have been known for several years from USA research so it is good that Scottish doctors are being encouraged in its use.
Adapted from Annals of Family Medicine 2019 doi:10.1370/afm.2421
People diagnosed by their GP with type two diabetes had a 40-50% lower mortality rate over the next ten years if they experienced their GP and practice nurses as empathetic during the year after diagnosis, compared to those who considered that their primary health carers had low empathy.
This study looked at 879 patients recruited from 49 GP practices in the east of England.
My comment: The first year is when patients get their head round the fact that they have a long term condition that could affect how long they will live and the quality of the life they have left. At diagnosis many are willing to look at lifestyle changes. Encouraging them, helping them, and helping them set appropriate goals makes a good difference to a person’s ability to change their daily routines. If you are newly diagnosed and don’t get on with your health care providers for any reason, then maybe a change of provider makes sense in the light of this research.