November 14, 2018 22:28 |
Fish oil, vitamin D, new drugs and new guidelines for cholesterol – news from a conference of the American Heart Association (AHA) and the American College of Cardiology on research that combine what prevents heart attacks and other problems, and what not.
As announced this week, good news from the conference, for all, is that, at least in the United States, it does not have to starve before the blood test to check cholesterol – it's okay for most people to let something eat before taking blood for analysis.
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Food supplements in tablets and capsules – "dietary supplements" are mostly missed, "do not throw money in this way" – doctors have concluded that as a basis of health they recommend natural foods and balanced nutrition, and only if this is not enough, by adding vitamin or mineral tablets, but not by the hands themselves, but only on the recommendation of the doctor, individually, only to the patient who needs it.
Ultimately, they explained: "Supplements are, what is their name," supplementation "rather than substitution for vitamins and minerals in food, which is the best basis for" health, "said Penny Kris-Eterton, PhD, researcher , professor of State Pennsilvania College.
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For example, doctors at the conference once again confirmed that instead of vitamin D as "supplements" it is necessary to eat twice as much fat as fish, or at least take fish oil that is better shown in research in patients with patients than "supplements".
These and other conclusions approved at the conference were attended by authors – doctors, none of which is financially connected with drug makers, according to the AP agency.
Two large studies presented at the conference gave mixed results on fish oil or "omega-3 fatty acids". There are also different types, including EPA and DHA.
In a study of 26,000 healthy people, one gram per day of a combination of EPA / DHA, doses and types in many supplements – have not shown a clear possibility of reducing the risk of cardiac or cancer.
But another study, which tested four grams of daily concentrated EPA, found that this was a reduction in heart problems in people at higher risk due to high triglycerides – a type of fats in the blood.
The first study on the effect of a smaller amount of fish oil on the general population included the effect of vitamin D, one of the most popular supplements, and found that it did not reduce the risk of cancer or heart problems.
"We must accept that this test is good," and that vitamin D as "supplements" has no value to be attributed, Dr. Jane Armitage of the University of Okford, United Kingdom. "We do not see any benefit from him."
"Do not Throw Your Money On These Accessories" that are not well-regulated and have a different quality, said Dr Dipak Bat of the Boston Women's Hospital.
All this is stated in the instructions of the Heart Association and the American College of Cardiology, approved by other groups of doctors.
At a multi-day conference on heart disease, the leading cause of death worldwide, new guidelines for calculating cholesterol levels lead to damage to the artery leading to heart or stroke.
Five years ago, when the guidelines for determining cholesterol reduction therapy were last revised, it only exceeded the use of a single cholesterol level to determine who needs treatment. It started with a formula that, for the purpose of expanding risk assessment, takes into account age, high blood pressure and other factors.
This was confusing for doctors, so that the new guidelines established at the last week's conference link both approaches, set goals based on the formula and take into account individual "personal circumstances" of each patient, such as other health conditions or family history of early heart disease.
"It will never be quite simple – the number of cholesterol", because it does not give a clear picture of the risk, said Dr. Donald Lloyd-Johnson of the University of Northwestern.
If treatment is required, the first choice of a doctor remains a "statin" that is sold as a cheap generic medicine. For high-risk people, such as those who have already had a heart attack, the guidelines suggest adding another generic drug, also a cheap "ezetimibe" if "statin" does not reduce enough cholesterol. Only if these two drugs do not help enough should take into account powerful, but expensive new drugs, called "PCSK9 inhibitors".
Finally, the instructions state that even after all the analyzes it is not clear whether the necessary treatment is necessary, a calcium test in the coronary artery should be performed, which is a type of X-ray examination with a dose of radiation similar to mammography, but some of the conference participants consider this method too expensive because the review costs 100 to 300 dollars.
The Conference of the American Heart Association confirmed the conclusion that a relatively new drug was approved this year not only to help people with diabetes control blood sugar and reduce weight, but also reduce the risk of need for hospitalization due to heart failure, which is in Many cases are followed by diabetes.
As people with diabetes have heart disease, new diabetes medicines have to be tested in large studies to show that they are not a risk to the heart.
One such drug, generic empagliflozin, surprised the doctor several years ago reducing the risk of heart attack and stroke, but other, generic kanagliflozin, later had side effects.
The new study tested the third drug, generic daplegiflozine, to more than 17,000 patients with diabetes with other cardiac risk factors and reduced hospitalization rates due to heart failure, was reported this week in the United States after a conference of the American Heart Association and the American College of Cardiology .