RedScrubs
The Resource for Medical Professionals

A position paper published in the July, 2008 issue of Circulation outlines the new epidemiological approach to obesity prevention. The study noted that obesity has reached epidemic proportions, moving steadily away from the Healthy People 2010 goals of 15% prevalence of obesity in adults and 5% prevalence in children. According to the World Health Organization (WHO), obesity will increase to 1.5 billion if current trends continue.

The American Heart Association (AHA) stance is that it is better to prevent, rather than to treat, obesity. Effective treatment of obesity may improve cardiovascular risk factors, but may not totally reverse all damage done to the organs and tissues from the obesity. According to AHA to prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population based approaches to obesity prevention are complementary to clinical preventive strategies and to existing treatment programs for those already obese.

Evaluation of the lipid profile has become routine practice to determine one’s risk for heart disease. Routinely, health professionals generally agree that low overall and LDL-cholesterol readings and high HDL readings along with low serum triglyceride levels reflect a low risk for disease.

Vitamin D has been in the news a lot lately – studies promoting the positive effects of the “sunshine vitamin” on the immune system, cancer, bone strength, depression. This study, published in the Journal of Cardiovascular Pharmacology, calls vitamin D a heart tranquilizer.

In the study, cells from the cells treated with activated vitamin D did not grow bigger in the heart muscle. The treatments prevented hypertrophy in rats and protected heart muscles from overstimulation and the increased contractions that are commonly associated with the progression of heart failure.

The acute coronary syndrome (ACS) most commonly occurs from an erosion or rupture of a vulnerable atherosclerotic plaque leading to an occlusion. The endothelium plays a key role in vascular health and endothelial dysfunction is of major concern in ACS. Under normal physiological conditions, low levels of microparticles are continually being shed into the blood from the endothelium — the cells that line the inside of blood vessels and some organs. Microparticles, however, can play a role in worsening cardiac injury through inhibition of vasodilation. This study looked at the effects of omega 3 fatty acids on the circulating microparticles.

Several years and many studies later, a newer more controversial study recently emerged from the Journal of the American Medical Association (JAMA) that indicates B vitamins might not lower the risk for cardiovascular disease. The study design included 5442 women aged 42 years or older with either a history of CVD or 3 or more coronary risk factors. It was a randomized, double-blind, placebo –controlled trial using either a placebo or a supplement containing folic acid, vitamin B-12, and vitamin B6. They were treated for seven years. The women were concurrently receiving a trial of antioxidant therapy.

If only we knew what makes people behave the way that they do, we’d be able to solve many of the health-related crises facing our world today: obesity, teenage pregnancy, inactivity, type 2 diabetes, and the list goes on.

Using the BMI rather than blood cholesterol to predict future risk of cardiovascular disease would have profound effects on the affordability and availability of a screening program in developing countries. Initial screening without having to use blood would keep testing to a minimum.

In a new study, published in the April 8 edition of the journal Circulation, it was found that a dose of 10 mg/day of folic acid fed to rats prior to a heart attack yielded smaller infarcts than in the rats fed no supplements. This finding comes on the heels of the international studies in humans which suggested that folic acid supplementation can prevent dementia in the elderly and premature births.

A study recently published in JAMA express highlighted the comparison between two diabetic treatments on progression of coronary atherosclerosis in patients with type 2 diabetes. Up until this point, no study has shown an antidiabetic regimen to reduce the progression of atherosclerosis.

Commonly used glucose lowering agents include the sulfonyureas (ie. Glimerpiride), which are insulin secretagogues and thiazolidinediones, which are insulin sensitizers.