We think of AF as a different condition to atherosclerotic vascular disease. But the same patients often get both disorders. Inflammation in the wall of the atrium may be induced by the same factors that initiate the inflammatory response in atherosclerosis. Recently cardiologists in Adelaide reported remarkable...
At a recent conference I attended at Harvard Medical School, Dr. Balady gave a fascinating lecture on exercise and the heart. He introduced the concept of skeletal muscle as an endocrine organ. Exercise triggers the release from muscle of numerous factors that improve endothelial function...
There are now 3 new oral anticoagulants available. Pradaxa (Dabigatran) is fully funded, taken twice daily with a dose reduction to 110mg bd in elderly patients or when Creatinine clearance is 30-50mls/min. Gastro-intestinal discomfort is the commonest side effect. Xarelto (Rivaroxaban) is taken once daily with a dose reduction from...
In primary prevention the coronary calcium (CA) score is useful to help decide on treatment in borderline cases (e.g a patient with a strongly positive family history but normal lipids). It is sometimes ordered in low or medium risk patients on lipid lowering therapy who...
By Dr. Warwick Jaffe Last week one of my colleagues asked me to review a 63-year-old smoker prior to planned peripheral vascular surgery. The man did not complain of any cardiac symptoms. After just 2 minutes on the treadmill he stopped with claudication. He was surprisingly...
By Dr. Warwick Jaffe After water, coffee is the beverage we consume most. Adverse effects include anxiety, insomnia, tremulousness and palpitations. Slight bone loss may also occur. Some forms of coffee also raise cholesterol (boiled unfiltered methods). The beneficial effects of coffee include decreasing the risk of cardiovascular...
By Dr. Warwick Jaffe Masked hypertension refers to relatively normal office blood pressure but abnormal home or ambulatory blood pressure (ABU) measurements. It should be suspected in office normotensive patients in the following circumstances: (1) Borderline high office measurements (2) High measurements taken (by chance) elsewhere (3) Evidence of...
The Look Ahead study randomly assigned 10000 Americans to intensive dietary advice and exercise (weekly counselling for several years and less often after that) or routine advice (counselling 1 or 2 times per year). The study was stopped after 9.5 years as there was no...