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Doctoring General Cardiology General Medicine Health Care Healthy Living inflammation

A new way to discuss statin drugs

A new study published last week in an open heart journal changes the conversation about how patients and doctors think about and discuss preventive therapies–such as statins. Dr. Richard Lehman may be the smartest doctor on Twitter. This is what he said: This is a game-changer https://t.co/WgGdLlodbL — Richard Lehman (@RichardLehman1) March 20, 2016 Most […]

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General Cardiology Health Care

Alzheimer’s disease and macular degeneration concerns with Entresto

Three academic physicians, writing in an editorial in the Journal of the American Medical Association, raised serious (but theoretical) concerns about the risk of Alzheimer’s disease and macular degeneration with long-term use of the new heart failure drug, valsartan/sacubitril (Entresto, Novartis). Here is the translation: Sacubitril is a drug that inhibits neprilysin, which is an […]

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Doctoring General Cardiology General Medicine

Think twice before having carotid artery surgery

Hundreds of thousands of people have undergone surgery or stents to “fix” blockages in their carotid arteries. (The left and right carotids are the main arteries to the brain.) Most of the these people (about 90%) reported no complaints. We say they are asymptomatic. The blockages were discovered on exam or by ultrasound of the […]

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Doctoring General Cardiology General Medicine Health Care Reflection

Do cardiologists prescribe too many drugs?

One of the most common reasons people require medical care is their medical care. This is a distinctly modern problem. In times past, doctors treated disease. Patients saw their doctor when they were sick. They had a problem; doctors offered help. The doctor of today often improves health by removing healthcare. It’s one of my […]

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Doctoring General Cardiology General Medicine Health Care Reform

The PCSK9 Drugs — Epic success or epic failure?

This week, an FDA advisory committee recommended approval for the potent cholesterol-lowering drugs, evolocumab and alirocumab. The funny-sounding medications are called PCSK-9 inhibitor drugs. (Keep reading; I’ll tell you more.) Advisory committee members felt the benefits of the drugs outweighed the potential risks, especially in high-risk patients, such as those with Familial Hypercholesterolemia (FH). The […]

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AF ablation Atrial fibrillation Cycling Stuff Doctoring Exercise General Medicine Health Care Health Care Reform ICD/Pacemaker Reflection Social Media/Writing/Blogging

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 […]

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AF ablation Doctoring General Medicine Health Care Healthy Living

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 […]

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AF ablation Athletic heart Atrial fibrillation Doctoring General Medicine Health Care Reform Hospice/Palliative Care ICD/Pacemaker Reflection

Update: Social justice of AF care, NOAC monitoring, population health and two new podcasts

Hi All, Here is a short update of the past week. The first thing to say is the Atrial Fibrillation Care: Put the Catheter (and Rx Pad) Down post has gotten a lot of attention. It stayed on the most popular list all week. It has over a 130 comments, and I have received many […]

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AF ablation Atrial fibrillation Cycling Stuff Exercise Health Care Reform Healthy Living Social Media/Writing/Blogging

An update on cycling and writing and video (gulp)

Hi all, Things have changed for me. I have taken on a larger role at theheart.org | Medscape Cardiology. This means I have less time for hefty original posts here. (This site is not closing–just changing.) I write and read a lot more, though. Almost every day. Writing has morphed into what cycling was: a […]

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Dabigatran/Rivaroxaban/Apixaban Doctoring Health Care Knowledge Reflection

Trust in science and medical experts

This week is a good time to talk about trust in expert opinion and science. For the past forty years, nutrition experts in the US have warned us about cholesterol and fat. Eat too much of it and it will block your arteries, was the proclamation. Americans did what the scientists and experts said. They […]

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AF ablation Doctoring General Medicine Health Care Healthy Living Nutrition Social Media/Writing/Blogging

Medicine, lifestyle disease and the pool-safety post

What follows is an introduction to my most recent post on theHeart.org | Medscape Cardiology. It was published yesterday. Many of the comments are excellent. The link is at the end of this post. You might wonder what pool-safety has to do with lifestyle disease. Here is how they relate: I am currently reading an […]