Fish oil, vitamin D, new drugs and new cholesterol guidelines – news from the American Heart Association (AHA) conference and the American College of Cardiology about research that combines what prevents heart attacks and other problems, and what doesn't.
As announced this week, the good news from the conference, for everyone, is that, at least in the United States, it doesn't have to starve before a 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 – "food supplements" are mostly unanswered, "don't throw money into this mode" – doctors conclude that as a basis for their health recommend natural foods and balanced nutrition, and only if this is not enough, add vitamin or mineral tablets but not in their own hands, but only on the recommendation of the doctor, individually, only for the patients they need.
After all, they explained, "& # 39; supplements & # 39; are, as the name suggests, & # 39; supplements & # 39; rather than replacing for vitamins and minerals in food which is the best basis for health," said Penny Kris-Eterton, MD, PhD, researcher, professor at State Pennsylvania College.
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So, for example, the doctors at the conference once again confirmed that instead of vitamin D as a "supplement", you need to eat twice as much as fish, or at least take fish oil that is better shown in studies among heart patients than "supplement" .
This and other conclusions agreed at the conference were attended by the authors – doctors, no one was financially connected with drug producers, according to the AP agency.
The two large studies presented at the conference gave mixed results in fish oil or "omega-3 fatty acids". There are also various types, including EPA and DHA.
In a study of 26,000 healthy people, one gram per day of a combination of EPA / DHA, what dosage and type in many diet supplements – "supplements" – did not show a clear possibility to reduce the risk of heart problems or cancer.
But another study, which tested four grams a day EPA concentrated, found that this reduced the heart problems of people at high risk because of high triglycerides – a type of fat in the blood.
The first study of the impact of smaller amounts of fish oil in the general population included the effects 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 a "supplement" has no value associated with it, said Dr. Jane Armitage of the University of Oxford, England. "We don't see any benefit from it."
"Don't waste money on these additives" that are not well regulated and have different qualities, said Dr. Dipak Bat from Boston Women 's Hospital.
All of this is stated in instructions from the Heart Association and the American College of Cardiology, which was approved by another group of doctors.
At a multi-day conference on heart disease, the leading cause of death worldwide, new guidelines for calculating cholesterol levels cause damage to arteries that lead to the heart or stroke.
Five years ago, when guidelines for determining treatment for cholesterol reduction were revised last time, it went beyond the use of only one number on cholesterol levels to determine who needed treatment. It starts with a formula, to expand risk assessment, taking into account age, high blood pressure and other factors.
This is confusing for doctors, so the new guidelines set at last week's conference brought together the two approaches, setting targets based on formulas and taking into account individuals, "personal circumstances" of each patient, such as other health conditions or initial family history of illness. heart.
"This will never be quite simple – the amount of cholesterol," because this does not provide a clear picture of risk, said Dr. Donald Lloyd-Johnson of the University of Northwestern.
If care is needed, the first choice of doctors remains "statins" which are sold as cheap generics. For people at high risk, such as those who have had a heart attack, the guidelines suggest adding another generic drug, also "ezetimibe" is cheap if the "statin" does not reduce cholesterol enough. Only if two drugs are not enough to help should consider a new, powerful but expensive drug called "PCSK9 inhibitor".
Finally, the guidelines say, even if all the analysis is unclear whether necessary treatment is needed, a calcium test in the coronary artery must be done, which is a type of X-ray examination with radiation doses similar to mammography, but some conference participants considered this method. too expensive because the review costs 100 to 300 dollars.
A conference from the American Heart Association confirmed findings that a relatively new drug, approved this year, not only helps diabetics control blood sugar and weight loss, but also reduces the risk of the need for hospitalization due to heart failure, which in many cases is followed by diabetes .
Because diabetics get heart disease, new diabetes drugs must be tested in large studies to show that they are not at risk for the heart.
One drug, generic empagliflozin, surprised doctors several years ago by reducing the risk of heart and stroke, but others, kanagliflozin is generic, then has side effects.
The new study tested a third drug, generic daplegiflozine, for more than 17,000 diabetic patients with other heart risk factors and lower rates of hospitalization due to heart failure, reported this week in the United States after the American Heart Association and American College of Cardiology conference.