Friday, May 25, 2018
Health

Tampa Bay cardiologists: New heart guidelines will help patients, doctors

TAMPA — New guidelines for managing heart disease risk will change how some doctors practice medicine and will put more emphasis on patients' behavior, local physicians said Wednesday, a day after the changes were announced by the nation's leading heart organizations.

The new guidance revises how cholesterol-lowering statin drugs should be used, and stresses the importance of diet, exercise and smoking cessation in reducing the risk of heart attack as well as stroke.

"Many of us feel that we've been blindly treating a number and we reflexively give statins to anyone with an LDL (so-called bad cholesterol) over 100," said Dr. Arthur Labovitz, chairman of the department of cardiovascular sciences at USF Health and director of non-invasive cardiology at Tampa General Hospital.

"Now, we must shift our focus to assess the whole patient and give greater emphasis to their other risk factors."

The American Heart Association and the American College of Cardiology urge doctors considering statins to consider not only LDL, but also the patient's other risk factors such as age, gender, race, body mass index, physical activity, smoking status, family and personal history of heart disease, diabetes, and total cholesterol.

"This is the way many of us have been practicing medicine for years. It's the way I was taught in medical school, that we need to treat patients, not numbers," said Dr. Jeremy Bock, a Morton Plant Mease interventional cardiologist. "A cholesterol of 227 doesn't mean anything unless it's attached to a patient. It's the high-risk patients, not just the ones with high cholesterol numbers, that we need to put on statins."

Experts say a small number of patients will come off statins because of the new guidelines. For example, those with LDL between 120 and 150 and no other risk factors might not need a statin. But it's likely that many more people will be advised to go on the medication. The American Heart Association estimates that 33 million Americans who don't have heart disease, but are considered at high risk should be on statins as a preventative measure.

The new guidelines recommend statins for people who:

• Have had a heart attack, stroke or angina

• Have diabetes

• Have genetically high LDL cholesterol of 190 or above

• Have a 10-year heart attack or stroke risk score greater than 7.5 percent.

The risk calculator doctors use to determine a patient's risk considers age, gender, race, total cholesterol, heart attack or stroke history, diabetes, BMI or weight, smoking status, and blood pressure. Until now, a 10-year risk score of 20 percent or higher warranted taking statins. Now it's only 7.5 percent because stroke history has been included.

Labovitz says the message is clear that cholesterol alone isn't an indicator of risk. "If, for example, you've had a heart attack or stroke, it doesn't matter what your LDL is, take the medication. No matter what it is, it isn't low enough," he said.

The new guidelines may also help primary care doctors. "Now they can quickly evaluate patients and make a decision about statins without having to send the patient to a cardiologist or other specialist," said Dr. Augustine Agocha, a cardiologist at St. Joseph's Hospital in Tampa.

They also could help doctors deliver a message many patients don't want to hear, Agocha, Bock and Labovitz agreed.

"We can tell patients that medications alone won't lower your risk. Lifestyle factors like weight, physical activity, smoking, as well as cholesterol, blood pressure and family history all factor into it,'' Agocha said. "This will help us in discussions with our patients."

This article has been revised to reflect the following correction: The surname of interventional cardiologist Jeremy Bock was misspelled in an earlier version.

Comments
Stroke stories can have a happy ending: What you should know

Stroke stories can have a happy ending: What you should know

Arto Woods and his wife, Syvilla, had a good flight from Baltimore to Tampa in early May. En route, they talked about how convenient it would have been to fly directly into Orlando, where the conference that brought them to Florida was being held, bu...
Updated: 12 hours ago
Finding a yoga retreat to stretch the mind and body

Finding a yoga retreat to stretch the mind and body

Before I attended my first yoga retreat on a trip to see my sister in Oregon, I did exactly zero preparation. Turns out, that’s just fine, and it opened up the wider world of what a yoga getaway can give you.With four hours of yoga classes a day, my ...
Published: 05/25/18
Music makes us happy, motivated, determined … and hungry?

Music makes us happy, motivated, determined … and hungry?

Music is the ultimate mood setter. Faster beats gets us pumped up to work out. A slower rhythm can set a romantic mood or help one unwind at the end of a long day.Music can also influence the kinds of food we crave. A study co-authored by a Universit...
Updated: 11 hours ago
Estimated 7,000 bodies may be buried at former asylum

Estimated 7,000 bodies may be buried at former asylum

STARKVILLE, Miss. — Some of the boxes stacked inside anthropologist Molly Zuckerman’s laboratory contain full bones — a skull, a jaw, or a leg. Others contain only plastic bags of bone fragments that Zuckerman describes as "grit." These humble remain...
Published: 05/23/18
FDA warns teething medicines are unsafe for babies

FDA warns teething medicines are unsafe for babies

WASHINGTON — Federal health officials warned parents Wednesday about the dangers of teething remedies that contain a popular numbing ingredient and asked manufacturers to stop selling their products intended for babies and toddlers. The Food and Drug...
Published: 05/23/18
A chronic lack of sleep could lead to decreased brain function, study finds

A chronic lack of sleep could lead to decreased brain function, study finds

A sleep study revealed that less than six hours of sleep a day can limit the brain’s ability to function properly.The study, published on Monday in the journal Proceedings of the National Academy of Sciences, found that people experiencing less than...
Published: 05/23/18
Many cancer patients juggle care along with financial pain

Many cancer patients juggle care along with financial pain

Josephine Rizo survived chemotherapy, surgery and radiation, but breast cancer treatment wrecked her finances.Money was already tight when doctors told the Phoenix resident she had an aggressive form of the disease. Then she took a pay cut after goin...
Published: 05/22/18

Hernando County officials gather to remedy ‘dearth of services’ for youth with mental illness

BROOKSVILLE — Educators, court officials, law enforcement officers and health care professionals met Friday to identify the best ways to keep local youth with mental illnesses out of the court system and provide treatment for those already in the sys...
Published: 05/22/18
Give your arms a workout, too

Give your arms a workout, too

In addition to appearance, it is very important to maintain strength in those arms, as they are needed for practically every upper body movement we perform. We often take our 23 arm muscles for granted, until we reach a point where it suddenly become...
Published: 05/22/18
Intermittent fasting seems to be a good thing, new report suggests

Intermittent fasting seems to be a good thing, new report suggests

Going long hours without eating isn’t good for us, we are often told. Our bodies need fuel regularly. Otherwise, we may become lethargic, tired and hungry. Our thinking can become mushy, our ability to work, and even play, hampered.Not so fast.A new ...
Published: 05/22/18