Musculoskeletal side effects are the commonest cause of statin cessation. They occur much more frequently in everyday practice than in clinical trials. There is a tendency to blame all musculoskeletal problems on statins. It is essential to determine if it is really the statin that...
Dr Tim Glenie, Interventional Cardiologist at North Shore and Ascot Hospital has prepared today's content. New Oral Anticoagulants (NOACs) are used widely to prevent stroke in atrial fibrillation. Compared to warfarin, there is a lower risk of intracranial bleeding with equal, or in some studies, less...
Many of us will have over-indulged over the holiday break. Eating more healthily and losing weight are common new year resolutions. The Mediterranean diet has the best evidence base for prevention of cardiovascular disease and prolonging life. A recent study linked this diet with increased chromosomal...
Background Clopidogrel is converted to its active metabolite by a liver enzyme (cytochrome P450 2C19) Omeprazole and to a lesser extent Pantoprazole inhibit the activity of CYP450 2C19 In vitro studies show reduced levels of active Clopidogrel metabolite and less inhibition of platelet aggregation when Omeprazole and Clopidogrel...
Observational studies show a consistent relationship between low blood levels of Vitamin D and an increased risk for heart disease, cancer, diabetes and many other conditions e.g. multiple sclerosis. Randomized studies that compare patients treated with Vitamin D to those treated with placebo have been...
Although Low HDL levels are associated with an increased risk of cardiovascular disease, there is no evidence that increasing HDL levels reduces this risk. Studies have shown no reduction in cardiovascular events and in some cases harm, when HDL is raised with fibrates, nicotinic acid...
Dr. Walter Man Der Merwe, Renal physician and expert on hypertension, has prepared today’s content. Deciding which antihypertensive agent to use in patients with a new diagnosis of hypertension can be challenging. Sometimes co-morbid conditions mandate use of a particular class e.g. beta blockers if there...
It’s sometimes difficult to decide whether to stop drug treatment when patients on anti-platelet agents or oral anticoagulants require a procedure or operation. Surgeon’s views vary widely and are often slanted towards stopping therapy to avoid bleeding complications. GP’s know more about the overall health...
Ezetemibe inhibits cholesterol absorption in the intestine. Used alone it has a modest effect on LDL cholesterol. When combined with even a low dose of a statin, substantial LDL reduction occurs. Recently, a randomized trial of 17,000 patients, with an acute coronary syndrome, showed the combination...
As doctors, we are often asked about supplements for cardiovascular health. All we can tell patients is the scientific evidence for their use and warn them if there is risk of doing harm. Omega 3 supplements are sold not for cardiovascular protection, and to reduce cancer, diabetes,...