Dec
11
2012

What a Wonderful World

By | Anti-aging medicine, Arthritis, Cancer, Diabetes, Heart Disease, Men's Health, Nutrition, Prevention, Stroke, Weight loss, Women’s Diseases

Recently I traveled from Palm Springs to the Caribbean and back and I had to think: what a wonderful world! There were connecting flights and there was waiting at various airports. I had lots of time to watch people and to observe what was happening around me.  Louis Armstrong’s song (1967) “What a Wonderful World“ came to mind. I thought that this would be a fitting title for this Blog. Earlier we had come from Canada escaping the winter. The deep blue sky of Southern California and the sight of palm trees (instead of pine trees) is something that makes our hearts beat faster.

The desert is a special place

The desert is a special place. We had friends join us for a week and we had visited Joshua Tree Park with the grotesque looking rock formations. During the flight it was interesting to see the landscape, as we crossed the desert areas of Arizona and New Mexico, seeing what difference people make when large areas are irrigated and the desert transforms into lush, green areas. It is also very visible, where the desert has taken back the land that no longer is irrigated.

Travel to Dallas Fort Worth and Miami

We came to Dallas Fort Worth and the sky was clear. We traveled on to Miami and the sky was showing signs of pollution, although it was a sunny day. After our take-off from Miami we saw the ocean. I have flown over that region many times before, but this time I detected oil slicks on the surface of the ocean of the Gulf of Mexico, leftovers from previous oil spills. So, the Armstrong song of a “wonderful world” came back to me in a different context. I looked at the landscape and what industries can do to it. Erroneously we had just seen several BP commercials while waiting for our plane at the airport where BP was congratulating itself for the role it plays in cleaning up the environment having spent several billion dollars. But there are still oil slicks…

What a Wonderful World

What a Wonderful World

Watching people on the plane

I looked at the people around me in the plane. More than 35% of them were obese; many of their faces looked sagging and prematurely aged, particularly in women. Males, even middle aged ones looked like they were pregnant (abdominal fat) and often their hair was receding, thinning on top and quite a few were bald. All of the texts I had read about anti-aging medicine came back to me. Too bad that people were eating the wrong foods and obviously did nothing to counter their built-in aging clock from depleting hormones as we age.

Menu of the airline

I looked at the menu of the airline. I won’t mention the name of the airline, but I can assure you that 10 different airlines would have almost the same menus. There would only have been one chicken salad that I could have eaten. In the past I tried to order this and I was told that due to popular demand this item was sold out. Instead they wanted to offer me potato chips, cheese and crackers. My wife and I had anticipated this scenario and we had bought a chicken salad and water before we boarded the plane. We also had packed healthy organic energy bars and a trail mix consisting of nuts and raisins to use as snacks during the trip.

Cutting out starchy foods, eating fresh vegetables and lean meat instead

While travelling we stuck to the same principal of cutting out starches, bread, rice, pasta and only eating fresh vegetables, salads and lean meat (chicken, grass fed beef, ribs, lean pork and veal), which we always do since the fall of 2001.  We also avoid all alcoholic beverages and sugar containing sodas. When we returned to Southern California we were delighted to see that our body compositions when measured with the body composition scales were identical to what they were before the trip.

I think we can all contribute to this wonderful world, if we participate in whatever we can do such as these steps.

End wars

End wars because on the long-term they do not lead anywhere to solve conflicts (in my lifetime I am thinking about the Vietnam war, long-winded Ireland crisis, the Korean war and the German reunification at the end of the Cold War). Right now there is the Middle East conflict, which screams for a peaceful solution. As we are conscious about the devastation that is caused by wars, we have to start with ourselves. We have to resolve our own conflicts that may be present in our own lives. Tolerance, acceptance and forgiveness are the tools.

Address pollution 

Pollution needs to be addressed by the US and all of the world’s countries (including Canada where I live most of the time). This means that anti-pollution devices need to be installed in industrial plants and chimneys. Recycling needs to be done on a larger scale. China and India and other emerging market countries need to be taught how these new anti-pollution measures work. This is an ongoing project, but we need more co-operations between government, industry and countries all around the globe. Also we have to start with our own behavior: we can become more aware of reusing and recycling instead of creating more waste in our landfills.

Become better caretakers of our bodies

What can we do to make us part of this wonderful world? We need to become better caretakers of our bodies. Instead of looking at quantity we must look at quality in choosing  natural food wherever possible. Growing up in Germany after the Second World War in the 1960’s and early 1970’s made me witness that high consumption of fat, sugar and starchy foods (potatoes, pasta and bread) caused people to age prematurely and get heart attacks, strokes, high blood pressure, arthritis, obesity, diabetes and cancer. At that time the “Wirtschaftswunder” (translated into English it means “economic miracle”) had propelled Germany into a nation of  high consumers. During the war they had been poor and often went hungry, they were slim and heart attacks were at an all-time low.

Unhealthy foods and snacks

After the war they made up for times of deprivation and overindulged:  pretzels, buns, bread, butter, French fries, sweets, cakes, cookies, jams, chocolates, pralines-everything was consumed with gusto!  What happened to Germany in the 1960’s and 1970’s is happening again right now in front of our eyes with the obesity wave in the US, Canada and all the other civilized countries around the world. Food companies have been very successful with their advertising through the media. Already kids get hooked to the wrong foods! Hyperinsulinism will ensure that we get hungry every two or three hours. Refined carbs and extra calories are turned into fatty acids by the liver and stored as fat. It shows that we have to resist the wrong food temptation and cut out all refined carbs.

Healthier alternatives

It is healthier to stick to salads and vegetables like broccoli, cauliflower, asparagus, and spinach and eat a small piece of lean meat with it. Have probiotics as plain yoghurt (0% to 2% fat). If you need a sweetener, use a small amount of Stevia, which is a natural sweetener that leaves your body chemistry untouched. Have some fruit as a dessert like blueberries, cherries or strawberries. Eat an apple, the occasional grape. Drink lots of purified water or mineral water.

Buy organic food

Buy ORGANIC food whenever possible. Farmers treat most of the vegetables and fruit with insecticides, which contain residuals in them. When these are ingested, they act like estrogenic substances causing breast cancer in women and prostate cancer in men. The safest in our society is to stick to organic foods. More expensive, but the best insurance against future disease. Question politicians whenever possible to make yourself heard. You want unadulterated food and water. And as I’m writing about water, have a water filter under the kitchen sink with a carbon filter. In addition, it is good to have reverse osmosis to get rid of chloride or fluoride from the city water. This is what you use to cook your food. You may want to take an iodine tablet once or twice a day to counteract the negative effects of chlorine from having a bath or shower (the skin absorbs chlorine). Why? Because chlorine and fluoride can displace the iodine of the thyroid hormones and make you hypothyroid.

Regular exercise

Exercise every day. Nobody gets fit in their muscles from sitting in front of the TV for hours. You also don’t get fit from spending hours and hours of computer work. If you have to, counterbalance this with an exercise program of 1 hour per day. Walk 30 minutes on a treadmill and do 30 minutes of weights or use specific exercise machines in a gym to strengthen your upper and lower extremity muscles.

Replace missing hormones with bioidentical ones

Did I mention hormones? Yes, I did above when I mentioned depleting hormones as we age. We know for some time that each hormone of the body has its own peak in life and then it declines in production as we age. Or should I rather say, we age when these hormones decline? I like the latter way of wording it, because we can measure hormone levels and when one of the hormones is too low, we can replace it with a bio-identical hormone and the person’s energy comes back and whatever function was missing is restored. This is in essence what anti-aging medicine does. Many conservative physicians and clinics do not like to hear this. Big Pharma does not like to hear this when I am talking about replacing hormones in the body with bio-identical hormones. But the patented cheap copies that are mass manufactured and sold at inflated prices are no fit to the hormone receptors in the body and therefore are dangerous. The artificial drugs cause heart attacks, strokes and cancer as the Women’s Health Initiative has shown in 2002.

What people need to do

What did I think the people I watched on the plane should have done? Their physicians should have tested the hormones of many of them. Many of the overweight or obese patients would likely have had high fasting insulin levels. The extra fat does not just sit there; it is a hormone producing factory for inflammatory compounds and estrogen-like substances. This causes heart attacks and strokes in women. It causes prostate cancer and hair loss in males as well as impotence (“erectile dysfunction”). What I said above would help these people that I met. When you lose fat through changes in the diet and when you start an exercise program, the body mass index slowly comes down as fat melts away. The estrogen production comes down, the inflammatory substances abate. The person feels more energetic and may even think straighter. This is when you realize what a wonderful world it is.

Saliva hormone test

One special test is a saliva hormone test that looks at 5 steroid hormones: DHEA-S (storage form of DHEA), testosterone, estradiol, progesterone and cortisol. Every man and every woman needs a certain balance between these hormones and this test should be done when there is a change in energy or appearance (hair loss) somewhere when we are 35 to 40 years. In women it is important that the progesterone level is 200 times fold higher than the estradiol level (progesterone/estradiol ratio) or she is at risk of developing breast cancer and other cancers (ovary, colon etc.). In a man it is important that his testosterone to estradiol ratio is higher than 20 to 1. This protects him from cancer of the prostate or other cancers.

Bioidentical hormone creams

The physician or a knowledgeable naturopath can prescribe whatever hormones are missing. The health care provider needs to be familiar with the use of bio-identical hormone creams. This program can prevent diseases like osteoporosis, diabetes, cancer and arthritis. It also prevents disabilities.

With this I leave 2012 behind and I am looking forward to a new year (2013). I am looking forward to the time when more people can see Louis Armstrong’s vision of a “What a wonderful world”.

More information on:

1. Pollution: https://www.askdrray.com/protecting-yourself-from-environmental-toxins/

2. Obesity: https://www.askdrray.com/stop-obesity/

3. Processed food: https://www.askdrray.com/caution-processed-food-ahead/

Apr
01
2008

High Blood Pressure Decreases Cognitive Function

By | Heart Disease, High Blood Pressure, Prevention, Stroke

It is known that high blood pressure that is left untreated gives rise to a host of health problems, some of which are heart attacks and strokes. It is not surprising to Dr. Jose Luchsinger of Columbia University Medical Center in New York that high blood pressure (hypertension) can be related to all kinds of cognitive impairment, which is connected to vascular damage in the brain. A cohort study which was published in the December issue of Archives of Neurology included 918 subjects age 65 or older with no history of mild cognitive impairment (MCI) or dementia at baseline. All participants underwent neurophysical and medical testing every 1 ½ years for more than 4 ½ years. The majority of the individuals had high blood pressure. During the course of the study 334 of the participants developed MCI. 174 cases had impairment in domains such as language and executive function or visual-spatial elements were impaired. 160 individuals had amnestic MCI (affecting memory), which is thought to have the strongest link to Alzheimer’s disease.

High Blood Pressure Decreases Cognitive Function

High Blood Pressure Decreases Cognitive Function

The study showed that hypertension played a significant role in the higher risk of developing any form of cognitive impairment. Detection of hypertension and proper treatment will not only protect against strokes, but certainly also extend its benefits to cognitive function.

More information how strict blood pressure control prevents trouble: http://nethealthbook.com/news/stroke-risk-present-even-borderline-high-blood-pressure/

Reference: The Medical Post, February 5, 2008, page 65 and Dec.2007 issue of Archives of Neurology

Last edited November 3, 2014

Mar
01
2008

High Death Rate In India Due To Smoking

By | Cancer, Heart Disease, Infectious Disease, Lung Disease

Dr. Prabhat Jha of the Centre for Global Health Research, Toronto has published research regarding the risk of mortality associated withs smoking in India, involving data from 1.1 million Indian homes. Data of deceased individuals, all of them in the age group between 30 and 69 years of age, showed that 37% of the men and 5% of the women had been smokers, and smoking doubled the risk for both sexes due to medical causes. Smoking did not only rate as a risk for lung and respiratory cancers but also for tuberculosis, vascular and respiratory disease. Smoking as a causal relationship was estimated to be responsible for 1 in 5 deaths in men and 1 in 20 deaths in women. With the population growth in India the number of death in the age group of 30 to 69 related to smoking is estimated to increase by 3% per year. Currently available data suggests that the rate of smoking is high especially among men in India. Data from other nations show, that smoking bans in public places are effective in turning these statistics around. Italy used to be one of the European nations, where smoking in public was common and as a result the exposure to second hand cigarette smoke was not only an inconvenience but a serious health risk. Cardiovascular events like heart attacks showed a decrease among men and women in Italy after the smoking ban in public places was put into effect in 2005. The findings were related to the improved indoor air quality.

High Death Rate In India Due To Smoking

High Death Rate In India Due To Smoking

There was an increase of sales in stop smoking aids like nicotine replacement products. Sales of cigarettes showed a decrease. Giulia Cesaroni from a local health unit in Rome remarked that even a small reduction in the incidence of cardiovascular disease can have enormous public health implications, as coronary artery disease is the leading cause of deaths in Italy. Compared to before the ban heart attack rates of middle aged (35- to 64-years) Italians dropped by 11%, 65- to 74-year-olds had a reduction of 8%, but those in the 75-84 year age group showed no benefit (as coronary artery disease in them likely was irreversible).

More information about:

1. Chronic obstructive pulmonary disease: http://nethealthbook.com/lung-disease/chronic-obstructive-pulmonary-disease-copd/

2. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/

3. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

References: The Indian data based on www.nejm.org (February 13, 2008); the Italian study was published in Circulation 2008 (Feb. 11)

Last edited November 3, 2014

Feb
01
2007

Lycopene Benefits Backed By Science

By | Cancer, Diabetes, Health, Heart Disease, Nutrition, Osteoporosis

Lately a lot of attention has been directed to the health benefits of vegetables and fruit. Vitamin C has long been an accepted household term, and nobody questions the benefits. Newer buzz words are the terms “bioflavonoids” and “antioxidants”. Some products are aggressively marketed extolling the above named beneficial substances, but often the consumer is left mildly bewildered by exaggerated claims. Often the sale prices of these miracle foods are as lofty as the bold statements that go along with them.
For any shopper it is important to know that some of the most beneficial foods are not high priced items, but very common staples. Take tomatoes, for instance. They are a significant source for the substance lycopene, which lately has received a lot of attention. Lycopene and its dietary sources as well as its benefits have been researched world wide, and the results are now in. It is responsible for the red color in fruit or vegetables, such as tomatoes, and its isomeric form 5-cis-lycopene is the most stable form having the highest antioxidant properties. Common dietary sources are tomatoes, watermelons, pink guava, pink grapefruit, papaya, apricot and other fruit. In the Western diet tomato-based foods account for about 85% of dietary sources of Lycopene. Studies have shown that lycopene is more efficiently absorbed from processed tomato products compared to raw tomatoes. Once it is absorbed it is distributed throughout the body. The highest levels showed up in the testes, the adrenal glands, prostate, breast and liver.
Research going back to 1995 showed an inverse relationship between the consumption of tomatoes and the risk of prostate cancer. A follow up publication in 1999 showed that the same inverse relation of lycopene intake and cancer also included breast, cervical, ovarian, liver and other organ sites. Further studies have followed these initial publications, and the great majority of them suggest that an increased intake of lycopene showed an association with a significant reduction in the risk of many cancers.
Coronary heart disease and lycopene benefits were also examined. The strongest population based evidence comes from a multi center case control study in Europe (EURAMIC). 662 Cases and 717 controls were recruited from 10 different European countries, and there was a significant relationship between levels of lycopene in fatty tissue and the risk of myocardial infarction. Lower lycopene levels were associated with a higher risk of heart attacks.Lycopene was also shown to decrease levels of oxidized LDL (LDL or low density lipoprotein is known as the “bad” cholesterol). Another small study showed that lycopene was reducing total cholesterol levels and as a result was lowering the risk of coronary heart disease (CHD).
The list of benefits does not end here: the dietary oxidant reduces oxidative stress and levels of bone turnover markers, meaning that it may contribute to the bone health, especially reducing the risk of osteoporosis in postmenopausal women.

Lycopene Benefits Backed By Science

Lycopene Benefits Backed By Science

For people with mild hypertension (high blood pressure), consumption of lycopene resulted in significant reductions of systolic and diastolic blood pressures.
Infertility in males was significantly helped by lycopene intake. In a study infertile man received 8 mg lycopene per day in capsule form. Laboratory tests confirmed an increased sperm density along with functional sperm concentration and mobility. This treatment protocol with lycopene supplementation resulted in a success rate of 36% pregnancies in their partners.
Pregnant women with pre-eclampsia who were treated with lycopene supplement significantly improved, which was shown by decreased diastolic blood pressure, the reduction of pre-eclampsia and a decrease of intrauterine growth retardation, resulting in a healthier mother and baby.
Future research is pending surrounding lycopene in metabolic and inflammatory diseases and in its role of possibly preventing neurodegenerative diseases such as Alzheimer’s disease. Other inflammatory conditions such as arthritis and emphysema will likely also be shown to benefit from lycopene. Preliminary data has already indicated this.
The Food and Drug Administration (FDA) of USA has recently approved lycopene as a safe “natural coloring agent” and a Generally Recognized as a Safe (GRAS) component. The Department of Nutritional Sciences , Faculty of Medicine, University of Toronto, c/o Dr. A.V. Rao et al. who completed this meta analysis of the recent literature have recommended that we all consume a regular daily lycopene dose in our food and supplements as part of our diet for good health.

More info about lycopene and prostate cancer: http://nethealthbook.com/news/lycopene-reduces-prostate-cancer-risk/

Reference: The Whitehall-Robins Report, December 2006, Volume 15, No.4

Last edited November 2, 2014

Oct
01
2006

Lowering Cholesterol Aggressively Saves Lives

By | Diabetes, Heart Disease, Obesity, Stroke

A 5-year multinational prospective study (“Treating to New Targets or TNT Study” involving top cardiologists from around the world has found significant benefits in using higher doses of statins. They investigated the effects of increasing the statin concentration (a cholesterol lowering medication) and have now come to new insights how to approach the metabolic syndrome, which is the metabolic derangement associated with obesity. Of 10,001 patients aged 35–75 years with clinically proven heart disease 5,584 patients had metabolic syndrome at the same time. Half of them were put on 10 milligrams of Atorvastatin (brand name: Lipitor, made by Pfizer Inc.), the other half on 80 milligrams per day. They were followed for 5 years and many questions were asked, blood tests done and statistics kept. Of particular concern was whether survival rates and numbers of heart attacks or strokes would be different for the various groups. The major focus of interest was on people who were over weight or obese.

As the image above shows, percentages of complications (heart attacks and strokes) were used as clear end points of cardiovascular complications to measure the response to the statin. The results showed that two subgroups of obese patients, those who have at the same time diabetes and those who don’t, were both benefitting from the higher dose of Lipitor in an equal manner (about a 30% relative reduction of risk).

The amazing result was that dosage of the statin mattered very much. In the past it was thought that taking a pill for high cholesterol was all that mattered. However, now we know that physicians need to watch the blood level response of the bad cholesterol (LDL cholesterol) and titrate the abnormal levels down to a normal level by using adequate dosing. The authors came to the conclusion that metabolic syndrome patients with heart disease, and particularly those where diabetes was present at the same time, would need more intensive statin therapy (higher dosage) than patients who were only having cardiovascular disease. The new goal post for lowering the low-density lipoprotein cholesterol (LDL cholesterol) of 1.8 mmol/L (70 mg/dL) was recommended.

5-Year Study Shows Further Reduction of Major Cardiovascular Complications In Patients
(Expressed as %) With Metabolic Syndrome Using Higher Doses of Atorvastatin(P. Deedwania et al. Lancet 368, No. 9539: 919-928, Sept. 9, 2006)
 

 

 

 

 

 

 

 

 

 

This study showed that there was a 44% increase in absolute risk for an adverse outcome in coronary heart disease patients who also have metabolic syndrome than those without metabolic syndrome. This justifies a very aggressive treatment with Lipitor down to the new target blood values indicated above that your doctor needs to monitor. In high risk patients for heart attacks and strokes where more than 3 cardiovascular risk factors are present the patient’s outlook (longer survival) can be improved by several years. This was shown with treatment using the higher dose of Lipitor when blood levels and cardiovascular complications were compared between 5 years of treatment and the treatment results after the first year of the study.

More information on:

1. Treatment of a heart attack: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/treatment-heart-attack/

2. Metabolic syndrome and obesity: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: The Lancet 2006; 368:919-928 (09 September 2006)

Last edited November 1, 2014

May
01
2005

Burgers, Fries and High Healthcare Costs

By | Cancer, Health, Heart Disease, Nutrition, Obesity, Stroke

“Everything in moderation” and “A little bit cannot harm” are the deceptively soothing terms that can lull consumers into the belief, that fast foods cannot be so bad after all. A study, called the” Coronary Artery Risk Development in Young Adults” however gives us the facts, that paint a more realistic picture: the “little bit” actually has fairly serious consequences!
In this U.S. study a wide cross section of young adults were followed in four U.S centers: Birmingham, Ala., Chicago, Minneapolis and Oakland Calif. 3031 people in the age of 18 to 30 years were recruited in 1985 and followed until 2001.

Lifestyle habits, such as smoking, watching TV and intake of other foods were recorded, and insulin resistance was measured. In addition there were detailed studies of weight, height, waist size and other body measurements. Some interesting facts emerged: women ate fast foods less frequently than men. Fast food intake was associated with lower education, more TV watching, lower physical activity, high intake of trans fats and alcohol intake. In short: fast foods and other unhealthy lifestyle choices were correlated.

Dr. Mark Pereira, PhD of the University of Minnesota School of Public Health, who is one of the authors of the study, points out that it is extremely difficult to eat in a healthy way in a fast foods restaurant. The menus still include foods high in fat, sugar and calories and low in fiber and nutrients. Dr. Arne Astrup from the RVA University in Copenhagen found the same issues: besides the fact that serving sizes have increased two to five fold over the past fifty years, the energy density is twice as high in fast foods as compared to food in healthy diets. Dr. Astrup also points out in his publication, that humans have only a weak innate ability to recognize foods with high energy density and then down-regulate the amount eaten to meet and not exceed energy requirements.

Burgers, Fries and High Healthcare Costs

Burgers, Fries and High Healthcare Costs

If a person ate more than 2 fast food meals per week, which would be a modest increase of the control group that ate less than 1 fast food meal per week, the 2 meals per week group was about 5 kg heavier after 15 years, as opposed to 11 kg in the control group. The insulin resistance increased by an alarming 230 %. This finding is of significance, as insulin resistance (=metabolic syndrome) promotes the occurrence of cardiovascular disease and cancer, especially breast and colorectal cancers. The data are showing that even a modest increase has a unique effect in increasing the risks for these disease patterns, and the message is, that health care costs will only come down, if the root cause of disease is attacked at the societal and lifestyle level.

More information about the metabolic syndrome (insulin resistance): http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: The Medical Post, March 8, 2005, page 20

Last edited October 28, 2014

Oct
01
2004

What Went Wrong With VIOXX

By | Arthritis, Heart Disease, Prevention, Stroke

Merck &. Co., Inc. announced on Sept. 30, 2004 that VIOXX® (rofecoxib), an arthritis and acute pain medication, would be withdrawn voluntarily worldwide. VIOXX was FDA approved as a new anti-inflammatory drug for osteoarthritis in 1999. Later it was also cleared for rheumatoid arthritis. As a Cox-2 inhibitor it was different from aspirin and the conventional anti-inflammatory drugs such as Naproxen, Motrin or Voltaren.

In a study called VIGOR , which is detailed more under this link, VIOXX was compared to Naproxen in terms of gastrointestinal side-effects. It was found that the risks of bleeding ulcers, perforation and bowel obstruction were 50% reduced (frequency of cases with naproxen 1.22% versus VIOXX with a frequency of 0.52%). Surprisingly, in this study of 4000 patients over 1 year the cardiovascular risks such as heart attacks, strokes, blood clots for VIOXX was 1.8%, 3-fold higher than Naproxen, which had only 0.6% such complications. In addition it was noted that high blood pressure was more common in rheumatoid patients. The FDA made Merck add a warning on the drug label regarding these added risks, but this went more or less unnoticed by the public.

It has been known for some time that aspirin (ASA) has polyp preventative action on the colon and thus reduces the risk of colon cancer. A specific study, called APPROVe (Adenomatous Polyp Prevention on VIOXX) trial, was designed to show that VIOXX could do the same as aspirin, but with less toxic side effects. In 2000 Merck started enrolling patients into this 3 year long trial.

What Went Wrong With VIOXX

What Went Wrong With VIOXX

After 18 months into the trial cardiovascular side-effects started to show up that were statistically significant when compared to controls. This is what prompted the recent press release that VIOXX would be taken off the market altogether.

More info on treatment of osteoarthritis: http://nethealthbook.com/arthritis/osteoarthritis/treatment-osteoarthritis/

Comments: One of the potential problems with receptor specific medications is that they can be so specific that the metabolism in the human body is changed. What’s good for the gut may not be good for the circulation, blood pressure and the heart. Merck did the right thing to withraw the medication altogether. It is not known at this time whether other similar medications such as Celebrex, which has a different molecular configuration, will stand up in the future to post-marketing testing.

Addendum on Nov. 6, 2012: In 2005 Bextra was also taken off the market by the FDA, but Celebrex was allowed to stay, but required to label their product with warnings about potentially serious side-effects.

Last edited October 27, 2014

Aug
01
2004

Birth Control Pill Increases Strokes And Heart Attacks

By | Heart Disease, Hormones, Stroke, Women’s Diseases

At the recent 86th Annual Meeting of the Endocrine Society in New Orleans/Louisiana a Canadian delegation presented data from a meta-analysis of 14 trials regarding side effects of the birth control pill (BCP) when taken on a prolonged basis. The researchers were interested to know the risk of heart attacks or strokes that would be associated with the prolonged use of the low dose estrogen BCP. All of the studies between 1980 and October of 2002 were examined and 14 independent studies qualified for the meta-analysis. The strength of such a meta-analysis lies in the pooling of data and the fact that the data is derived from a much larger patient population, which generally makes the results more reliable. Dr. J. Baillargeon from the Centre Hospitalier Universitaire in Sherbrooke, Quebec/Canada, stated that they found a 1.85-fold risk for developing heart attacks with longterm use of the BCP and at the same time there was a risk of 2.54-fold of hemorrhagic strokes with longterm use of the low-dose BCP.

I have depicted these findings below in graph form where the risk is readily seen when compared to women who did not use any birth control pills. In discussions following this presentation the authors explained that with short-term use of the BCP using the modern low dose formulations heart attacks and strokes would likely not be noticeable.

Birth Control Pill Increases Strokes And Heart Attacks

Birth Control Pill Increases Strokes And Heart Attacks

But women should know that long-term use does have this risk. These decisions of whether to take the BCP and for how long needs to be discussed with the treating physician also in the view that other risks such as high blood pressure, diabetes or the metabolic syndrome would be added risks where heart attacks and strokes can occur more frequently. In these conditions the BCP likely should be avoided.

Risk of Developing Heart Attack or Stroke after Longterm Use of The Birth Control Pill
 Birth Control Pill Increases Strokes And Heart Attacks1

 

 

 

 

 

 

 

 

 

Dr. Ricardo Azziz, chairman of obstetrics and gynecology at the Cedars-Sinai Medical Centre in Los Angeles, California, stated that these findings from this meta-analysis would be very important because it was based on such a large data base and was measuring the effect of the BCP over a long period of time. He stressed that the benefits of any medication must always be weighed against the risks by the treating physician. In diabetic patients on the BCP, for instance, the benefits likely outweigh the risks as the metabolism is stabilized through an improved insulin sensitivity, improved managability of the diabetes and avoidance of the high risk pregnancies in diabetics.

More info on:

Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Strokes: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/

Reference: The Medical Post, Vol.40, July 20, 2004, page 20

Comments on Nov. 6, 2012: What was not discussed by these experts is the fact that the BCP contains a mix of two artificial hormones (estrogen and progesterone equivalents) that the body’s estrogen and progesterone hormone receptors cannot recognize. Bio-identical estrogen and progesterone creams on the other hand would be recognized by these receptors, but nobody has researched their use for BCP purposes, only for post-menopausal hormone replacement.

Last edited Oct. 26, 2014

Mar
01
2004

Inflammatory Marker Linked To Blindness

By | Diabetes, Eye Diseases, Heart Disease, Prevention, Stroke

This outline is about “inflammatory marker linked to blindness”. Up to now age-related blindness or “age-related macular degeneration” (AMD) as it is medically called, has been a mystery. Notably, the retina is the light-sensitive area of the eye similar to the film in a camera. Specifically, the “macula” is that part of the retina that has the highest visual acuity. It is important to realize that several studies have been conducted lately regarding age-related blindness. Most compelling evidence sheds more light on this important health hazard of old age. One day these studies might even lead to a cure or powerful preventative measures to avoid AMD from ever developing.

Macular degeneration related to C-reactive protein

Particularly, one such study is the one by Dr. Johanna M. Seddon and co-workers published in the Feb. 11, 2004 issue of the Journal of the American Medical Association. Almost 1000 patients with various degrees of age-related degrees of blindness from the Age-Related Eye Disease Study (AREDS) were classified by the degree of their macular degeneration. As an illustration, I have produced the bar graphs below based on these studies.

Details of AMD in relation to CRP

For one thing, the researchers defined four groups, namely those with no AMD who served as controls. The second group were those with mild AMD, the third group those with moderate AMD. And the fourth group were those with severe AMD who were legally blind. Specifically, they suspected that an inflammatory marker in the blood stream of these patients, called C-reactive protein (CRP), might be present in the more severe cases of blindness when compared to the control group who did not have any inflammatory changes in the macula. Indeed, the bar graphs below show exactly what the test results indicated. Another key point, they also found that smokers (blue bars) tended to have slightly worse blood tests in terms of CRP (more inflammatory substances circulating in the system) within the same severity category of the age-related eye changes.

CRP (mg/L) Levels in Various Degrees of Severity of Age-related Macular Degeneration (AMD)

Inflammatory Marker Linked To Blindness

Inflammatory Marker Linked To Blindness

Risk of AMD depends on value of CRP

The investigators studied the risk for the highest percentile of the CRP tests within various subgroups of AMD. They found several differences as shown in the next table. First there was a low probability to develop AMD in a person with a normal looking macula. The investigators took this risk as the 1.0 point for comparison. In contrast a person with a normal looking macula who smokes has a 1.5-fold risk of developing AMD later. Patients with a moderate degree of AMD have about a 2-fold risk of getting a severe degree of AMD. This is true for smokers and non-smokers. Once the inflammatory cycle has started, the process of causing a moderate degree of AMD is so strong. This means that the effect of smoking will not add that much in comparison.

This is the first study of this kind that established that CRP is useful as a screening for the risk to develop AMD. Physicians already use CRP  as a test for monitoring progress in rheumatoid arthritis or to monitor for the risk of developing a heart attack or stroke.

AMD risk studied by another research group

Another study by Dr. Johanna M. Seddon and co-workers was published recently in the Archives of Ophthalmology. 261 people aged 60 years and older with established AMD were followed for 4.6 years and checked for deterioration. 101 patients had deterioration of their AMD.

Risk of Developing Age-Related Macular Degeneration (AMD) in Highest CRP Percentile
 Inflammatory Marker Linked To Blindness1

Omega-3 fatty acids protect against AMD

The authors analyzed the patients’ diet habits and found that increased fat intake was a high risk factor for deteriorating AMD. Both vegetable and animal fat had a 2-to 3-fold increased risk for deterioration of the AMD to a more severe stage (legal blindness). Fish, omega-3 fatty acid and nuts had a protective effect, but only when omega-6 fatty acid (linoleic acid) intake was low in the same group. The studies showed that the risk of age-related blindness was reduced by 40% when patients ate nuts at least once per week. The authors concluded that a “fat conscious diet” would be good for “maintaining good eye health” and at the same time be beneficial for prevention of heart attacks and strokes.

The authors will do further studies to investigate potential ways of helping patients with AMD and to understand the mechanisms of the disease process better.

References

1. JAMA 2004;291:704-710  2. Arch Ophthalmol – 01-DEC-2003; 121(12): 1728-37

Jul
01
2003

High Blood Pressure On The Increase In The US

By | Heart Disease, High Blood Pressure, Prevention, Stroke

High blood pressure on the rise

Dr. Hajjar, of the University of South Carolina in Columbia and Dr. Kotchen, of the Medical College of Wisconsin in Milwaukee have compared a large group of people in the US in the years 1999-2000 with prior studies in 1988-1991and 1991-1994 where peoples’ blood pressures were measured.

The latest study involved more than 5000 people, the prior studies more than 9000 people each. Almost 29% of the population has a blood pressure of 140/90 or higher in the latest study.

Compared to the 1988-1991study this is a significant increase of 3.7%. More than half of this was explained on the basis that the population’s weight (measured by body mass index calculation) had increased. The sub groups who had the largest increase in blood pressure were as follows:

1. diabetics with high blood pressure. In this high risk group only about 25% had a blood pressure readings of less than 130/85, which is the target value.

2. Mexican Americans had a significantly poorer awareness and control of their elevated blood pressures than the non-Hispanic whites and non-Hispanic blacks.

3. Women as a group were poorer in blood pressure controlling than men.

4. People above the age of 60 had a much higher rate of uncontrolled blood pressure as well.

The study concluded that by concentrating campaigns and efforts on these four target groups significant gains could be made in terms of control of blood pressure, reduction of strokes, heart attacks and kidney damage.

Here are some links regarding high blood pressure, prevention of strokes and heart attacks to various chapters of my nethealthbook.com:

High blood pressure link

Heart attack link

Stroke link

Last edited October 26, 2014