JULY 2016
Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness


Dr. M. P. Ravindra Nathan

By M. P. Ravindra Nathan,

Here’s an assortment of information gleaned from the discussions of a panel of national and international experts during the April ACC Convention in Chicago.

  1. What’s new in hypertension? The topic was discussed extensively because the incidence of the disease – called the “silent killer – continues to be high in the United States. Now we have the ability to prevent or at least delay its onset. That’s probably a better strategy than treating the disease with drugs even to the guideline levels because of the substantial gain realized in terms of preventing future complications. You can keep your blood pressure within normal limits (about 120/80) with salt restriction, regular exercise, avoiding unnecessary use of anti-inflammatory drugs such as ibuprofen, and stress reduction through yoga and meditation. The totality of scientific evidence supports lowering sodium consumption from the present level of about 3.5 G/ day to 1.5 gm or even less. In other words: Be proactive about hypertension prevention.

  2. Early heart attack care: You are likely aware that “every minute counts when you are having a heart attack.” Often patients wait hours trying to make sure the symptoms (chest discomfort, shortness of breath, sweating, etc.) won’t go away. Those who call 911 and reach a hospital emergency room without delay definitely have a better outcome than those who wait. “How do I know what I am experiencing is the beginning of a heart attack?” you ask, and it’s a valid question. So, you need to know the leading symptoms and early warning signs of heart attacks. Also, keep in mind that women may have atypical symptoms such as fatigue and exhaustion. A grassroots effort launched by AHA and ACC to educate the public is under way with the aim of improving outcomes.

  3. Nuts and bolts of heart failure therapy: Recent CDC findings suggest that heart failure-related mortality in the United States has steadily increased during the years. Two new drugs, Corlanor (Ivabridine) and Entresto (Sacubitril/Valsartan), the latest to emerge in more than a decade, appear to hold a lot of promise in improving the quality and survival of HF patients.

  4. The evolving cholesterol landscape: Robust evidence exists that reducing the blood levels of Low Density Lipoprotein (LDL or bad cholesterol) results in significant reduction of heart attacks and strokes. Several studies showed that in many patients the level of LDL remains unacceptably high despite adequate therapy with current lipid-lowering agents. That means many still remain at an unacceptably high risk of having future cardiovascular events. Illustrative case presentations of patients with high residual risk were presented and a “framework for combo therapy” was discussed in clinical focus sessions. A new agent – PCSK enzyme inhibitor, marketed as Repatha (evolocumab) and Praluent (alirocumab) – appears to be effective in reducing the LDL significantly either alone or in combination with statins. Current consensus among the experts is “the lower the better” when it comes to LDL in high-risk patients; keeping it low at 70 or even 50 may be more beneficial.

  5. Stroke risk in atrial fibrillation: Perhaps the most common cause for stroke in older population is a cardiac rhythm disorder called “atrial fibrillation (AF).” When patients present with “cryptogenic stroke” (stroke of undetermined cause),” the culprit may be undiagnosed AF. AF predisposes to clots in the left atrium, especially in the LA appendage, that can break loose and land in the brain occluding an artery. Such strokes can be prevented with anticoagulant therapy using warfarin or one of the many newer agents like dabigatran or apixaban. Often, the AF can be paroxysmal and hence may elude detection. There are new techniques for long-term monitoring of these patients to detect paroxysmal AF. Suffice it to say that if you are ever diagnosed with AF, you must be on anticoagulants and not antiplatelet agents such as aspirin.

This series on ACC 2016 will conclude in the next issue of Khaas Baat.

M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. His book Stories from My Heartwas recently released. (www.amazon.com or www.bn.com).

homeeventsbiz directorysubscribecontact uscontent newseditor's notehealthimmigration
financeayurveda/NUTRITIONmoviesfashionmusic/art/dancebooks/getawaysUS-Indo businessbeat
IIFA 2014astrologyyouthcuisinemotoringplaces of worshipclassifiedsarchivesBLOGFACEBOOK
Read the Editor's Blog. By Nitish Rele Classifieds Motoring Cuisine Astrology Art/Youth Books Fashion Movies Finance Immigration Health Editorial News Content Find us on Facebook!