DAILY ASPIRIN TO PREVENT HEART DISEASE MAY INCREASE RISK OF GI OR GEREBRAL BLEEDING

Journal of the American Medical Association' raised a red flag, saying the risk of bleeding even from low dose aspirin everyday is greater than they thought."

         
CardioSource (6/6) reports, "The study, which looked at 186,425 patients being treated with low-dose aspirin and the same number of control patients not using aspirin, is thought to be the first longitudinal study specifically examining the role of diabetes in the incidence of major bleeding in a cohort of individuals, irrespective of the use of aspirin." The study indicates "that aspirin was associated with a 55 percent increase in major bleeding – a finding that suggests the incidence of major bleeding events is much higher than previously shown in other randomized, prospective clinical trials. There also was a higher risk of bleeding among aspirin users younger than 50, in those being treated for hypertension and those using aspirin to relieve pain."

Posted by:  Steven Almany MD

HEREDITY MAY PLAY SUBSTANTIAL ROLE IN PRE-HYPERTENSION

MedPage Today (6/5, Baron-Faust) reports, "Heredity appears to play a substantial role in pre-hypertension -- a risk factor for high blood pressure, cardiovascular disease, and death -- according to a large cross-sectional study of identical and nonidentical twins and their siblings and family members." Researchers "found that trait heritability affected systolic pressures by about 44.6% (P≤0.001) but not diastolic pressures, while impacting plasma norepinephrine by around 65.2% (P≤0.001), and heart rate by approximately 62.2% (P≤0.001)." The investigators "also found trait heritability for other hemodynamic factors, such as cardiac index of around 60.5%, and 57.3%, for systemic vascular resistance index (P≤0.001 for both), with lesser associations for other factors, such as left ventricular pressure changes over time, they reported in the June issue of the Journal of the American College of Cardiology."

Posted by: Steven Almany M.D.

RESEARCH SUGGESTS CALCIUM SUPPLEMENTS MAY INCREASE HEART-ATTACK RISK

USA Today (5/24, Lloyd) reports, "Taking a calcium supplement to help prevent bones from thinning puts people at a greater risk for heart attacks, says a report out today in the journal Heart." The study involved about "24,000 people between the ages of 35 and 64."

        

The Los Angeles Times (5/24, Maugh) reports that the researchers found "that those who had a moderate amount of calcium in their diet (820 milligrams daily) had a 31% lower risk of having a heart attack than those in the bottom 25% of calcium consumption, but those with a daily intake of more than 1100 mg did not have a lower risk. There was no evidence that any level of calcium intake in the diet affected stroke risk." However, "when the team considered supplements, they found that those who took calcium supplements regularly were 86% more likely to have a heart attack than those who used no supplements." The researchers reported that "for those who took only calcium supplements, and no others, the risk doubled."

        

In a piece taken from Health Magazine, the CNN (5/24) "The Chart" blog reports, "Only the use of calcium supplements, and not overall calcium intake, was associated with an increased risk of heart attack. In fact, people who consumed higher amounts of calcium from foods, such as milk and other dairy, tended to have a lower risk of heart attacks than people who consumed less."

        

On its website, CBS News (5/24) reports, "The reasons for the differing risks aren't entirely clear, but researchers suggested the sudden burst of calcium into the system from supplements may be part of the problem."

        

Many experts, however, expressed skepticism. For instance, on the MSNBC (5/24) "Vitals" blog, Robert Bazell, NBC Chief Science and Health Correspondent writes that "this research...is just the type of experiment that often scares people unnecessarily and gives the science of epidemiology a bad name." According to Bazell, "the study was set up to look at cancer risk and these scientists are 'mining' the data to look for heart disease outcomes. What the researchers unearth is a confusing set of conclusions."

         

HealthDay (5/24, Reinberg) reports that Dr. Robert Recker, director of the Osteoporosis Research Center at Creighton University and president of the National Osteoporosis Foundation, said, "I am doubtful of these findings." According to Dr. Recker, "It's hard to understand why calcium in the diet can reduce the risk of heart attack, but supplements increase the risk." Also covering the story are the UK's Press Association (5/24) and BBC News (5/24, Gallagher).

Posted by:  Steven Almany M.D.

THE FUNCTION OF ANGIOTENSIN

Angiotensin is converted from angiotensinogen and functions to help the body secrete aldosterone (which results in salt and water retention). Angiotensin I converts to angiotensin II, and Angiotensin II has potent vasoconstrictor and proinflammatory effects on the vasculature.

POSTED BY:  STEVEN AJLUNI, MD

WHAT AN ECHOCARDIOGRAM SHOWS

An echo is designed to provide structural and functional data on how the heart contracts and performs as a pump. It also provides valuable information on valvular function, and assessment of pericardial disease. It is helpful in triaging damage after a heart attack.

POSTED BY:  STEVEN AJLUNI, MD

CAUSE OF DIZZINESS

Dizziness has many causes. It could occur secondary to low BP, abnormal heart rhythms, coronary disease, obstructive valvular heart disease (cardiac reasons), or non-cardiac reasons (inner ear, cerebrovascular, psychiatric, vasovagal) .

POSTED BY:  STEVEN AJLUNI, MD

MICHIGAN HEART GROUP INTERGRATES WITH WILLIAM BEAUMONT HOSPITAL

On June 1, 2012 a change occurred at Michigan Heart Group we became integrated with William Beaumont Hospital in the form of a Professional Services Agreement. Our signage will soon read Beaumont Michigan Heart Group, Beaumont Michigan Heart Rhythm Group and Beaumont Western Wayne Heart Group.

This professional agreement will integrate some of the services that we provide with the hospital as well as some of our operations including our outpatient testing and billing, but will allow Michigan Heart Group to maintain operational control of the practice. Management of these operations still occurs locally within Michigan Heart Group. We have not experienced that these changes with Beaumont have disrupted any of the services that you currently receive from your physician.

We believe that with this integration model, we will be best able to provide you with the high quality of care that you have come to expect and deserve from our practice. All of our physicians will continue practicing from their current locations and your records will remain available to your physician without any further actions taken on your part. This is intended to be essentially a transparent change to you, the patient, in terms of how your care is delivered. Such a change has been made necessary after we have experienced years of progressive cuts in insurance reimbursement while our fixed costs have steadily increased. The status quo was no longer a viable option for the future.

You will notice changes specific to billing. Beaumont will bill applicable charges to your insurance. You will receive a billing statement from Beaumont rather than from Michigan Heart Group. You may still call Michigan Heart Group for billing inquiries however questions/determinations will be advised and directed by Beaumont.

We value your loyalty and trust that you have placed in our physicians and staff over the past several years and we continue to look forward to serving you in the future. As we indicated above, we believe that most of these changes will be transparent to your healthcare needs. If you have any questions, please contact our administrator, Darlene Nichols at 248-267-5050, select option 2.

Thank you for choosing Michigan Heart Group, in affiliation with William Beaumont Hospital for your healthcare services. We look forward to serving you now and in the future.

Very truly yours,

Beaumont Michigan Heart Group

CAUSE OF SKIPPED BEATS

A regularly irregular rhythm typically relates to a timed premature beat (either PVC- premature ventricular contraction, or PAC-premature atrial contraction). It can occur spontaneously or as a result of extrinsic stressors than result in adrenalin secretion.

POSTED BY:  STEVEN AJLUNI, MD

CAUSE OF RAPID HEART RATE

Rapid heart rates can be either physiologically appropriate or inappropriate (pathologic). Examples of physiologic appropriate sinus tachycardia might be fast HR due to stress or caffeine. Pathologic tachycardia can involve a wide spectrum of arrhythmias coming either from the atria or ventricular locations.

POSTED BY:  STEVEN AJLUNI, MD

SIDE EFFECTS OF ZETIA

Zetia prevents GI absorption of cholesterol. Most of it side effects are GI --indigestion and changes in bowel habits. As with other cholesterol lowering medications it can occasionally exacerbate muscle aches.

POSTED BY:  STEVEN AJLUNI, MD

BENEFITS OF LOW CHOLESTEROL

Low cholesterol is beneficial in that it reduces long term vascular inflammation and injury which are the hallmarks of atherosclerosis that can lead to heart attacks, strokes, and peripheral arterial disease.

POSTED BY:  STEVEN AJLUNI, MD

HOW OFTEN TO MONITOR BLOOD PRESSURE

BP is an important risk factor for vascular disease. If BP is normal, checking it periodically at doctor visits is probably adequate. If BP is borderline or high orif a family risk for htn is great, spot checking or ambulatory monitoring makes sense.

POSTED BY:  STEVEN AJLUNI, MD

MICHIGAN HEART GROUP'S PHYSICIAN LIAISON IS HERE TO HELP YOU

Michigan Heart Group has a Physician Liaison on staff to assist with questions, concerns or problems you, your staff or your patients may have with our office.

Stacie Batur is available Monday through Thursday at (248) 267-5050 (x6509). She is often between two buildings or visiting referring physician offices. If you get her voice mail, please leave a message and she will call you back shortly. If you need to speak to her immediately you can reach her on her cell phone at (248) 765-4466.

HOW ARHTEROSCLEROSIS AFFECTS BLOOD PRESSUE

A thickened atherosclerotic blood vessel becomes less compliant and can therefore result in a higher BP (same volume of blood traveling in smaller and stiffer pipes). Elevated BP is a potent risk factor for accelerating atherosclerosis.

POSTED BY:  STEVEN AJLUNI, MD