A long-term Finnish study published in the Journal of Clinical Endocrinology & Metabolism has reported that vitamin D deficiency in childhood may be linked to hardening of the arteries later in life. In 1980 the researchers enrolled 2,148 children aged 3 to 18 who underwent periodic physical exams measuring serum vitamin D levels and other cardiovascular markers until they were 45 years old. During this time, doctors used ultrasound to examine their arteries (including the carotid artery in the neck) for thickening as a marker of increased cardiovascular risk. After adjusting for age, sex and other cardiovascular risk factors, the results showed children in the lowest one-quarter for vitamin D levels were nearly twice as likely to have thickening of the carotid artery as those in the other three quarters. This evidence suggests Vitamin D is important for good artery health. What are your typical sources of Vitamin D? How often do you recommend your patients to get their Vitamin D levels checked?
Several research studies have come to the same conclusion that sitting for long hours may lead to an increased risk of cardiovascular events, worsening mental health and risk of being disabled even with a consistent exercise regimen. Furthermore, results of a recent study published in the American Journal of Preventative Medicine, reported study participants who sat for more than 11 hours daily were at highest risk of mortality during the 12- year follow up. Sitting can lead to an increase in appetite and reduced muscle movement; thus the article suggests to break up sitting time about every half hour at work or home. How much time do you spend sitting daily? What are some methods you would recommend to your patients on how to reduce sitting time?
The article can be found at WebMD
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We are traditionally taught that exercise promotes a healthier lifestyle, however, where do we draw the line at too much exercise. Recent study performed by the American College of Cardiology suggests that those who run more than 20 miles a week do not have an increased life expectancy compared to those who run less. The article references a 2012 study performed by the Mayo Clinic suggest that excessive training may cause cardiovascular damage. With this being said, the author notes that like everything in life, moderation is key. How will this information change your workout and your recommendations to your patients?
The article can be found at CNN
The study can be found at ACC
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There has been debate whether high school students participating in organized sports should be screened for cardiac conditions before they participate in sports. Those who favor screening advocate use of an electrocardiography (ECG) while others recommend only a thorough history and physical examination. The Clinical Decisions series presented a case of whether to initiate screening in high school athletes and a panel of physician experts presented their views. Readers were allowed to join the debate by voting and posting comments on NEJM.org. The case was also presented by the same four physicians at the American Heart Association (AHA) in November 2013. Online polls received 1,266 votes from 86 countries. 18% opposed cardiac screening, 24% favored screening with history and physical examination only and 58% favored screening with ECG, history and physical examination. U.S. voters preferred screening with only a history and physical exam. Many of the comments pointed to the lack of evidence that screening prevents death, the unfavorable cost-benefit of screening, who would be paid to read and interpret millions of ECGs, as well as what recommendations should be given to children with abnormal ECG readings. Europe is recommending ECG screening for all young athletes while currently the AHA and American Academy of Family Physicians recommend screening with only a history and physical examination. What are your thoughts regarding whether screening for cardiac conditions should be expanded to include ECG along with a history and physical examination?
For additional information, please see NEJM.
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In a recent study published in Nature Medicine, researchers at the Cleveland Clinic found that high-density lipoprotein (HDL) or “good” cholesterol can become dysfunctional and lose its protective properties. When HDL becomes abnormal, it may enter the bloodstream and clog the arteries. Of the 627 patients in the study, researchers found that those who had higher blood levels of abnormal HDL were at greater risk of heart disease. What are your thoughts about this study?
For additional information, please click BCC.
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A recent randomized trial published in the Journal of the American Medical Association examined the association between Mediterranean diet and the incidence of symptomatic peripheral artery disease (PAD). Patients were randomly selected to participate in one of the following groups: a Mediterranean diet high in extra-virgin olive oil; a Mediterranean diet high in nuts; or a low-fat diet. The results of the study found that both Mediterranean diet groups had a significantly lower occurrence of PAD compared to the low-fat diet group and no significant difference was found between the two intervention groups. How often do you recommend Mediterranean diet to your patients?
For additional information, please click JAMA.
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In a recent study published in the journal Neurology, researchers found that lycopene, a bright red chemical found in fruits and vegetables such as tomatoes and peppers,is associated with a decrease in the risk of stroke in men. This 12-year prospective cohort study, which evaluated 1,031 Finnish men between the ages of 46 and 65, showed that men with higher concentrations of lycopene in the blood had a 59% lower risk of ischemic stroke and a 55% lower risk of any stroke. How will this research change your recommendations topatients who are at risk for stroke?
For more information, please read the abstract in Neurology.