Medivision presents an excerpt from our 60 minute pharmacy education video Improving Cardiovascular Risk, featuring Sian Carr-Lopez PharmD. on the topic of Hypertension and Cardiovascular Risk.
The full length film, along with many other medical education titles, is available on VHS or DVD from health-e-mall.com, and also includes Robert B. Supernaw, PharmD. and Mary J. Ferrill, PharmD. discussing the roles of hyperlipidemia, cholesterol medications and hypertension.
Hypertension is quantitatively the most important risk factor for
premature cardiovascular disease; it is more common than other risk factors such as cigarette
smoking, dyslipidemia, and diabetes.
Hypertension accounts for an estimated 54 percent of all strokes and 47
percent of all ischemic heart disease events globally. Hypertension increases the risk for a variety of cardiovascular
diseases, including stroke, coronary artery disease, heart failure, and
peripheral vascular disease. Coronary disease in men and stroke in women
are the principal first cardiovascular events noted after hypertension
onset, and in view of the evidence that the mortality rates are rising in younger people in the United States and the increasing impact of cardiovascular diseases in developing countries, greater attention must be given to prevention of these diseases. The increase in cardiovascular risk has primarily been described in terms of elevated systolic pressure in those over age 60 and
elevation in diastolic pressure in younger individuals. Pulse pressure,
which is the difference between the systolic and diastolic blood
pressures and is determined primarily by large artery stiffness, is also
a strong predictor of risk.
High concentrations of total and LDL cholesterol and
low levels of high-density lipoprotein (HDL) cholesterol predict
cardiovascular risk in both men and women. High triglyceride levels
have been associated with greater risk in women only.The risk of cardiovascular disease increases by an average of 2% for each corresponding 1% rise in total cholesterol.
Clinical studies have shown that statins significantly reduce the risk
of heart attack and death in patients with proven coronary artery
disease (CAD), and can also reduce cardiac events in patients with high
cholesterol levels who are at increased risk for heart disease. While
best known as drugs that lower cholesterol, statins have several other
beneficial effects that may also improve cardiac risk, and that may turn
out to be even more important than their cholesterol-reducing
properties.
Medivision.com is pleased to present an excerpt from our 2 hour educational video; Cardiology Perspectives: Effective Management of Cholesterol, featuring John Kane, MD; Alan Chait, MD; John LaRose, MD; Tom Bersot, MD; Stephen G. Young, MD; Gustav Schoenfeld, MD and Virgil Brown, MD.
The full length video is available on DVD or VHS from health-e-mall.com and discusses the importance of controlling cholesterol in patients with heart disease and other high risk individuals.
High cholesterol is a well-known risk factor in heart disease, the
number one killer of both women and men in the United States, with more
than a million heart attacks and about a half million deaths annually. High cholesterol doesn't cause overt symptoms, and many people are unaware
of elevated cholesterol levels and how it may influence their
cardiac risk. To complicate matters, high cholesterol is not the only
predictor of cardiovascular events such as heart attack and stroke; somewhere between 30-50 percent of first heart attacks occur in
people with normal cholesterol levels, but it is essential to test and monitor cholesterol levels,
especially for anyone with a family history of heart disease. Lowering
high cholesterol does seem to lessen the risk for developing heart
disease, and reduces the chance of a heart attack or dying of heart
problems if you already have them. However, some research has indicated
that all-cause mortality (that is, dying from any disease, not just
heart disease) actually increases when cholesterol is lowered in those
over age 65.
Genetics and lifestyle both combine in individuals to
create high levels of cholesterol in the blood. Those who are
overweight tend to have increased cholesterol.
Diet is an
important component of controlling cholesterol ratios and maintaining
heart health. Recent evidence indicates that added sugar and
overabundance of flour in the diet are probably greater contributors to heart disease than saturated fat; certain components of full-fat dairy foods may be cardio-protective.
However, a chemically altered type of fat known as trans fatty
acids (TFAs) can worsen cholesterol ratios. TFAs are mostly found in
animal fats and vegetable oils, and are also created in the
hydrogenation process that makes fats more stable, giving them a longer
shelf-life.
In
addition to diet, LDL cholesterol levels appear to be heavily dependent
on genetic factors. Anyone at increased risk of heart disease should have tests for
LDL particle size in addition to the basic lipid profile. Best results
show low numbers of LDL particles overall.
A different cholesterol problem is present when one shows a tendency towards low HDL cholesterol and high
triglycerides. This pattern, sometimes called “Syndrome X,” is
associated with insulin resistance. It is frequently influenced by diet
and lifestyle, but is also genetically driven and appears to affect at
least 30 percent of the population. It carries with it an increased risk
of high blood pressure and diabetes as well as heart disease. Dietary
and nutritional supplement treatments are often quite effective in
treating this pattern, but are a bit different from those for high total
and LDL cholesterol levels.
High cholesterol is treated conventionally with lifestyle changes focusing on
diet, physical activity and weight
management. For patients seen in busy medical practices this
approach is frequently difficult to fully implement and utilize. If
lifestyle changes are not effective, drug therapy is often recommended.
Statin drugs are commonly used to lower cholesterol and protect against
heart disease and heart attacks by blocking an enzyme that is
necessary for the synthesis of cholesterol in the liver. They can be
very effective, and there is growing medical enthusiasm
for them because they also seem to provide antioxidant and
anti-inflammatory properties. These drugs can reduce plaque formation in
coronary arteries by preventing the oxidation of LDL ("bad")
cholesterol, and their anti-inflammatory properties may help prevent
plaque from rupturing.
Despite their benefits, they do have
adverse effects including liver
toxicity: physicians need to monitor liver function carefully in
patients with liver disease of any kind.
According to reported global estimates, 15 million people suffer from a stroke each year, resulting in 5.5 million deaths, with 5 million left permanently disabled. Typical disabilities following stroke include poor neuromuscular control, hemodynamic imbalance, and negative mood state. Tai Chi is an ancient Chinese activity and philosophical exercise aimed at harmonizing the mind and body. It consists of a series of 108 flowing movements used to stimulate the body's flow of natural energy, bringing about a state of self-awareness, health and calmness. There are many versions of Tai Chi. The most popular include Yang, Chen, Wu and Sun. They are named for the families that introduced them. Tai Chi is associated with better balance, lower blood pressure, and improved mood, which are important for stroke survivors. People who have survived strokes may be faced with lingering problems including maintaining their balance. This is more than just an annoyance and uncomfortable feeling that interferes with their quality of life. It also raises the risk of debilitating and possibly fatal falls. But researchers from the University of Illinois at Chicago (UIC) have found tai chi is a drug-free way to treat these stroke-caused balance problems. Earlier research has previously shown tai chi can improve balance and reduce falls among healthy elders. So, while at the Hong Kong Polytechnic University, Christina Hui-Chan, and her colleague Stephanie Au-Yeung decided to see if tai chi would also help stroke survivors. They studied 136 research subjects in Hong Kong who had suffered a stroke more than six months earlier. The participants were randomly placed into two groups for 12 weeks. The control group practiced breathing, stretching and other exercises that included sitting and walking. The tai chi group practiced a simplified form of the ancient martial art consisting of coordinated movements of the head, trunk and limbs that require concentration and attention to balance. At the end of the 12 week study, the research subjects were given several balance tests. Both the tai chi and the control group performed about the same on a test that involved the ability to stand, walk and sit back down. However, when tested on their ability to maintain balance while shifting weight, leaning in different directions, and standing on moving surfaces to simulate a crowded bus, the tai chi group clearly out-performed the control exercise group. The results of the research are set for publication in a forthcoming issue of the journal Neurorehabilitation and Neural Repair. "The tai chi group did particularly better in conditions that required them to use their balance control," Hui-Chan, professor and head of physical therapy at UIC, said in a statement to the media. "In only six weeks, we saw significant improvements. The ability to shift your weight is very important because all reaching tasks require it." In addition to improving balance, Hui-Chan explained tai chi also improves strength and cardiovascular fitness. What's more, tai chi classes can provide seniors with healthy group interactions that help prevent social isolation, too. She added that most people can learn the art of tai chi if they are taught by a trained instructor. The National Institutes of Health (NIH) is also showing interest in the benefits of tai chi. The NIH's National Center for Complementary and Alternative Medicine (NCCAM) is currently sponsoring studies to find out more about tai chi's effects, how it works, and diseases and conditions for which it may be most helpful. Source: Natural News: Tai Chi Provides Natural Treatment for Stroke Damage by Sherry Baker, Health Sciences Editor
