Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

Why don’t people ask their doctors more questions?

I do not get it. Day in and day out, I ask patients why they take a medicine. Many do not know. “My doctor put me on it,” goes the common response. Take statin drugs, for example. I often ask a person why they are taking the drug? With rare exception, the person says it […]

Athletes, AF, Anticoagulants, Statins, Peanuts, and Dishwashers

Here is an update on my recent writing. Athletes and AF: I was honored to be invited back to the Western AF symposium in Park City, Utah. Last year, I presented on social media. This year, Dr. Nassir Marrouche (University of Utah) asked me to tackle the topic of atrial fibrillation in athletes. This is […]

Does the controversy over statin drugs herald a new era of doctoring?

In July, I wrote a short blog post expressing doubt about the value of statin drugs. Medscape republished it on their website and it went viral–in a medical sort of way. The post has 631 comments. It was Tweeted extensively, page views have been off the charts (for me), and I even received an invitation […]

Growing doubt on statin drugs — the problem of drug-lifestyle interaction

My mind is changing about statins. I’m growing increasingly worried about the irrational exuberance over these drugs, especially when used for prevention of heart disease that is yet to happen. An elderly patient called my office last week to tell me thank you…not for a successful procedure or surgery, but rather, for helping with a […]

Do doctors know how to treat high blood pressure and high cholesterol?

Blood pressure and cholesterol problems affect millions. These are the bread, butter and sugary drinks of Internal Medicine and general Cardiology practice. It stands to reason then, that the treatment of these basic maladies would be well agreed upon. Guidelines and expert consensus statements would be clear and up-to-date. But this is far from reality. […]

Do statins impair muscle performance?

On Wednesdays, I try to write on a topic of exercise and health. If you exercise but still have high cholesterol or other risks for heart disease, you may be interested in a new study from my old medical school proving ground–Hartford Hospital. The deftly named STOMP trial looked carefully at the effects of statin […]

Busting myths: In measuring cholesterol and heart health…Keep it simple.

Are you kidding me?

Let’s talk about the newest cholesterol myth gone busted. I can hardly write; I’m so giddy. That’s what happens to me when simplicity and obviousness triumphs over complicated testing that adds nothing to (or even clouds) the big picture. They come to my office with pages of data dissecting the particle sizes and sub-fractions of […]

There is no free lunch–especially with statins

‘Good,’ I say. Let’s spread the word that pills do not hold the answer to preventing heart disease. And while we are shouting, let’s add this one: There’s no such thing as a free lunch! Medicines come with more than just a dollar cost. When an obscure AF doctor blogs about the limitations of statins […]

CW: Three new Statin safety issues

I can’t help myself. The draw is so strong. It’s simply not possible to stay silent on the recent news about statins. Yesterday, the FDA announced important changes in the safety language that comes in the package insert of statin drugs. (I’m late to the show here, as twenty-four hours is an eternity in medical […]

CW: Does your cholesterol level matter?

False thinking

Important challenge to dogma alert: You may have heard that high cholesterol leads to heart disease. Most experts accept the important role that cholesterol plays in heart disease: High cholesterol, particularly LDL (the bad kind), favors build up of plaque, which then leads to obstructed arteries and heart attack. It’s simple. It makes sense. Even […]