Exercise General Cardiology Healthy Living Nutrition

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. […]

Cycling Wed Exercise Healthy Living

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 […]

General Medicine Healthy Living

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

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 […]

Exercise General Cardiology Nutrition

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 […]

Cycling Wed Healthy Living

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 […]

Cycling Wed General Medicine Healthy Living

CW: Does your cholesterol level matter?

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 […]

General Medicine Healthy Living

More commentary on statin drugs…

I was delighted when my friend, Dr Kevin Pho, accepted my recent post on statin drugs. As a ‘student’ writer, I was also happy to read more than a couple ‘robust’ comments. No worries here, bike racers and heart docs have thick skin. I penned six responses on the KevinMD post. The gist of the […]

Cycling Wed General Medicine Healthy Living inflammation

CW: Really good news about the safety of statin drugs

There was important news this month on statin drugs. As one of the world’s most effective and commonly used medications, statins provide great writing topics. Lots of people have high cholesterol–including cyclists. Lots of people are interested in avoiding our mostly deadly disease. I’d like to tell you about a recently-published (Lancet) landmark study that […]

Doctoring Exercise General Medicine Uncategorized

Are pills better than exercise?

I recently wrote about the incredible sensations that come with vigorous exercise. Perhaps it was the post ride cannabinoid flurry, but it’s possible that I went too far in suggesting that ‘we’ (doctors, patients, the whole of Western Society) default first to pills before healthy living. Two commentors called me out on this snark. They […]

Cycling Wed General Cardiology General Medicine

CW: Important lessons on cholesterol numbers

When cyclists find out that I am a heart doctor, they most frequently ask about cholesterol numbers. “…My cholesterol is this…What do you think?” “…My doctor wants me to take a statin…But I read that these drugs might lower my functional threshold power 2.014 watts/40km.” All this focus on numbers saddens me. Remember, I am […]

General Cardiology General Medicine Health Care Healthy Living

Statins are so misunderstood…

The medical assistant who checked the patient in tells me, “Dr Mandrola, this guy had coronary artery disease since the 1980’s.  He is 90 years-old now, and his only medicines are that statin and aspirin.”  One of the more common questions that arises in cardiology is whether a person should take a statin drug. Despite […]