LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Heart Disease, Stroke, Blood Pressure Tips

AND YOU THOUGHT THE HEART PROBLEM WAS BAD NEWS

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The problem with the way the body works and the way medicine is set up is that our bodies do not respect these artificial barriers of specialties.  That means that, when we treat ourselves badly, it is not just one organ (i.e the heart) that is affected.  It is not just diabetes that occurs.  It is not just weak bones that occur.  It is not just cancer.
The sad fact is that the risks for all of these track together.  If you have one, you’ve got them ALL, just not always to the point of getting a named disease or condition.
In this particular study (and it’s not the first one along the exact same lines), researchers looked at patients who were found to have colorectal masses on colonoscopy.  As if this isn’t bad enough news, in those patients who had mass, they had a much higher risk of also having heart blockages.  The reverse was also tru–those having cardiac procedures (in this case angioplasty) had a much, much greater risk of having colorectal masses.
Herein lies the problem with using medications designed to treat a single disease.  They are designed to address only ONE condition (and usually do a pretty poor job of even that).  Lifestyle changes, on the other hand, cut across every disease state we know of.

 

The Cost of Medical Research; It’s Not What You Think

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health care spending
Kenishirotie/Dollar Photo Club

The drug companies use the cost of drug development as a rationale for charging massive amounts for new drugs when they get brought to market under a patent.

The reality is that many of these drugs are priced far above what it cost to bring it to market and definitely beyond what it costs to produce.  In other words, it has nothing to do with what the drug company’s costs were or are; it instead has to do with how much the market will bear the costs.  This leads to massive profits.

But this is NOT were the true cost of these drugs lie for society.

The true cost lies with the fact that many of these drugs are a complete waste of money.  (This of course does not begin to account for the damage done from drugs that are later taken off the market or given black box warnings for safety reasons discovered after the drug was launched)

Sound a little extremist?

Before you judge me, you need to understand the concept of SURROGATE END MARKERS, which I have discussed many times before.  A surrogate end marker is used in drug research studies to basically save money and time.

The ultimate classic example is cholesterol lowering drugs.  Lipotor was initially approved and based on its ability to lower cholesterol levels.  What I usually point out is that no one really gives a hoot about his or her cholesterol levels, it’s just that no one wants to have a heart attack or stroke.  Using cholesterol as the surrogate end marker for heart attacks, the Pfizer did not need to run years-longer, more expensive studies to see if Lipitor actually lowered rates of heart attacks.

And that’s what happened.  It took YEARS before the studies on statins were done and published to see if cholesterol lowering drugs actually lowered rates of heart attacks.  When the dust finally settled on the topic, the results were less-than-stunning.  About a 1% absolute reduction in the rates of heart attacks.

The amount of money wasted (and continuing to be wasted) on this class of drugs is beyond most of our comprehension.

If this was an isolated example everything would be maybe OK, but it’s not.

Blood pressure medications for stage 1 hypertension (systolic <160 or diastolic <100) do not lower the risk of heart attack, stroke or death.  What the heck are we wasted BILLIONS of dollars on them then???  (I’d love an answer, but I fear the question is largely rhetorical)

Fancy new cancer drugs that improve “disease free survival” do not actually help cancer patients live longer but cost tens of thousands of dollars more per patient.

But we can’t leave diabetes medications out of the mix.  About a decade ago, there began a massive shift in research dollars towards a gut hormone called GLP-1 that happened after researchers found that a compound in Gila monster spit could act the same in our bodies.

Since that time, published research on this hormone and the class of drugs that could slow down our body’s own breakdown of GLP-1 (normally only last about 1-2 minutes in our own body) has dominated the diabetes medical journal landscape.  These two types of drugs (GLP-1 like drugs and drugs that slow down our body’s breakdown of this same hormone) hit the diabetes drug market at a full-on sprint with names like Byetta, Vicotoza, Januvia and Onglyza.

And they weren’t cheap (lots of variables, but on average $300+ / month)

But no one could argue that they did a better job of control blood sugar (if you can ignore those pesky side effects like acute pancreatitis and pancreatic cancer).  But one COULD argue that the lesson from the past about using surrogate end markers almost always ends up to be a bad plan.

You see, most diabetics die of heart-related complications.  This means that any drug used to treat diabetes really has to have an impact on heart disease if it’s going to be worth squat.

I’m betting you can see where I’m going with this….

In this particular study, researchers evaluated any published studies done on the benefit of DPP-4 inhibitors (the drugs that block the enzyme that breaks down GLP-2 so quickly) and major adverse cardiovascular events (MACE).  Here’s what they found when they looked over 69 different trials with almost 68,000 patients:

  • Luckily, when compared to another class of diabetes drugs called sulfonylureas, DPP-4 inhibitors were associated with a 42% lower risk of MACE.
  • But when the DPP-4 inhibitors were compared to the newest class of drug for diabetes (SGLT2 inhibitors, which allow sugar to be lost through the kidneys) they were linked to a 89% higher risk of MACE.
  • When compared to placebo the expensive, heavily used, new class of drugs that mess with the GLP-1 pathway, there was no benefit on major cardiovascular events.

To sum this up, an entire new class of drugs designed to help diabetics manage blood sugar are pretty much worthless at preventing the major complication in diabetics.

With this in mind, it doesn’t matter squat what it cost to develop or what it costs to manufacture because the drug doesn’t really help diabetics in the long run.  This means that cost to society is equal to pretty much every dime spent by the healthcare system on this class of drugs PLUS the medical costs associated with the sometimes dangerous and fatal side effects from the drugs.

Good thing more people have access to drugs through the Affordable Care Act.

My Biggest Frustration with Migraines

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chronic migraines as a progressive brain disorder
Chronic migraines as a progressive brain disorder

I have dedicated a significant amount of time to migraines.  From treatment in my office to hundreds of review articles of medical studies to publishing a book on Migraines And Epilepsy, I consider myself quite educated on the topic.

While there have been a few exceptions in my office (literally less than a handful over the past 18+ years), if patients are willing to make the changes I recommend, they get better.  My recommendations range from a course of treatment in the office to exercise to managing stress to major lifestyle overhauls.  If patients are willing to make these changes, I can almost guarantee that migraines will be history.

Why?  How can patients get better with my recommendations versus the neurologist that they’ve been seeing for years and practice out of a very well-known hospital system?

Because the “why” is far more important to me than suppressing the symptoms of a migraine.  It is VERY rare that I have a chronic migraine patients come into my office that has been educated on the underlying cause of his or her migraine headaches.

But before I get into the secret of migraine headaches I need to make a very important distinction.

By the time patients make it into my office they have accumulated multiple types of headaches.  The two biggest classifications are structural and migrainous.  And I can say, with a high degree of confidence, that every migraine patient has aspects of both.

The structural headaches are related to the soft tissues (ligaments, tendons, muscles and fascia) and joints.  While my opinion is strongly biased, these types of headaches HAVE to be addressed by a chiropractor that understands and treats the soft tissues.  Adjusting alone, exercises alone, Botox alone (and yes-if someone responds to Botox it is because they have been improperly diagnosed with migraines instead of a structural headache) or soft tissue work alone is not going to completely fix the problem.

But, as I mentioned, it’s my bias based on almost 20 years of treatment migraine patients who have not responded elsewhere.

The true migraine headaches, however, do not respond well to good structural care.  This is because the true cause is not one that can be addressed from outside the body.

If you experience chronic migraine headaches and you really, really want to get rid of your headaches, you’re going to have to address the health of your blood vessels.

Period.

Anything less will not guarantee a fix for your headaches.  And medications?  Not a damn one of them will fix your blood vessels.  Some will actually make it worse.  And even if medications control your headaches, they have not fixed the problem.

Poor blood vessel health, endothelial dysfunction, vascular dysfunction.  It goes by different names depending upon who you are speaking to, but they all mean the same thing.

The blood vessels of a true migraine patient have lost the ability to respond appropriate to changes in demand for blood supply.  This system—where the blood vessels open and constrict based on how much oxygen the tissues need—is an incredibly dynamic process, with changes occurring by the second.  If your blood vessel is no longer able to respond to needs of your brain cells your brain cells are not going to be happy with you and can trigger a migraine.

THIS is the key to understanding your migraines.  THIS is the key to lifestyle changes that will help your chronic migraine headaches.

I have certainly spent time on migraine message boards and there are a lot of headache patients who get pissed off at my suggestion that headaches can be fixed.  These patients, however, have not achieved ideal body weight.  They are stressing too much.  They are not eating the right foods (even if he or she thinks his or her diet is ideal).  They are not exercising.  They are smokers.

I would suggest that, as much as it may be offensive to some, patients with true migraine headaches have not made the correct choices for his or her blood vessels and brain.

The details of these changes are beyond the scope of this article, but are outlined very readily in my book Migraines and Epilepsy that can be purchased by clicking here.

While many migraine sufferers care about getting rid of or controlling headaches, there is a bigger problem looming.  Poor blood vessel health has everything to do with risk of heart attack or stroke in the future.  This is absolutely, unquestionable solidly demonstrated in medical research study after research study.

Most of these research studies, however, have focused on migraine with aura.  Most of the studies that have linked future risk of heart disease or stroke have been on migraine with aura.  This particular study is yet another one in the long list of studies linking heart disease risk and migraines, except this one covered ALL migraines, not just those with aura.  Here’s the details on this large study of 17,531 women with migraines who were followed up for 20 years:

  • Migraine was associated with a 50% higher risk for major cardiovascular disease.
  • They had a 39% higher risk of a heart attack.
  • There was a 62% higher risk of having suffered a stroke.’
  • Sufferers had a 74% higher risk of having chest pain or having had a coronary angiogram.
  • Furthermore, migraines were linked to a 37% higher risk of dying from heart disease.

The relationship is so strong that, in a linked editorial, the suggestion is that migraine should be viewed as a risk factor for heart disease just like high blood pressure and cholesterol.  This is a strong statement and one that is not entertained by the average treating neurologist or primary care doctor.

It also reinforces my concern that the vast majority of true migraine patients are not getting the education needed to understand and improve the condition.  Chronic migraine sufferers HAVE to address the underlying dysfunction of the blood vessels through lifestyle changes geared towards protecting the heart.  This include diet, stress management, exercise and focus on reducing exposure to environmental chemicals that damage the heart and blood vessels.

Anything less is only a band-aid.

Can a Simple Mineral Beat Statins for the Heart?

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There are times when it seems like the only answer in medicine is another drug.  For heart stuff this is unquestionably statins.
Have high cholesterol?  Take Lipitor.  Have a family history of heart disease?  Take Crestor.  Your dog’s litter mates’ cousins’ owner had a heart attack?  Take atorvastatin.
You get the idea.
But when it comes to natural approaches which are JUST as powerful without a long list of potentially fatal side effects, it seems like “we just need more research.”
In this particular study, we see a simple approach…those with the highest levels of magnesium in their bloodstream had a 40% reduced risk of suffering sudden cardiac death.
At a cost that is just a fraction of even a generic statin and no side effects when taken orally.

 

Common Heart Treatments Increase Heart Disease??

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You follow your cardiologist’s advice, thinking it will protect you in the long run.  But what if this is not the case?

It will come to no surprise for regular readers of my blog that I think that lifestyle changes are the ONLY answer for heart disease.  Unfortunately, many patients opt not to make the right changes, or worse–these changes are not even discussed with patients because of a lack of knowledge on the part of the provider.

This particular study looks at outcomes of medical treatment (i.e. drugs), coronary angioplasty (PCI) or open heart surgery (CABG) ten years later.  Here’s the disturbing findings after following 611 patients who had CABG, PCI or standard medical therapy (MT=drugs):

  • 10-year rates of needing additional invasive procedures (revascularizations) were 7.4% with CABG, 41.9% with PCI, and 39.4% with MT.
  • Those in the drug only group had a 235% higher risk of future cardiac events (including deaths) than in the CABG group.
  • Those in the PCI group had a 185% higher risk of future cardiac events than in the CABG group.
  • 10-year rates of freedom from angina were 64% with CABG, 59% with PCI, and 43% with MT (P<0.001).

The bottom line?  Medical treatment or PCI actually INCREASED the risk of the need for more stents, heart attacks and / or cardiac death.

Wow.  I know that it SOUNDS like doing procedures is a good thing and it all seems well and dandy on paper, but when translated to the patient the outcomes just don’t work out.  So it boils down to having your sternum cracked open and some blood vessels taken from another area of your body to replace the disease ones that are needed to get nutrients and oxygen to your heart.

Or…

Eat better / stress less / exercise.  Hmmm…tough decision…

Info on Heart Failure Your Cardiologist Probably Doesn’t Know

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Prevent heart disease
McCarony/Dollar Photo Club

Heart disease remains the biggest killer in the Western world. This is despite billions of dollars pumped into this condition.

Billions of dollars into research, drug development, drug use and cardiology procedures. And yet, all we have to show for it is a slight reduction in deaths from heart disease, but an increasing number of people living with heart disease.

What this tells me is that we are getting better at keeping people alive who have had a heart attack, but we still suck at doing anything to keep people from getting there in the first place.  Most cardiologists and primary care doctors would point to the statin class of drugs as the singlemost important discovery in cardiologist ever.

Which pretty much explains why we’re in the mess we’re in because statins pretty much suck at preventing heart disease. Period. (in case you think this isn’t true, I’d invite you to read through my 100+ page eBook on cholesterol and we can talk after that…)

One thing we HAVE discovered from all the billions of dollars that have gone into cardiovascular research is that heart disease is almost 100% preventable.

Yup.

Seems hard to reconcile that the #1 killer in the Western world is almost entirely preventable. All we need to do is exercise more and eat better.

Except that it’s not quite that simple.

At the surface, yes, healthy dietary choices, not smoking and exercising regularly will eliminate a huge chunk of heart disease in this country. Then there’s the specifics, things like:

  1. Short burst aerobic exercise instead of merely walking 30 minutes a day
  2. More healthy fats (monounsaturated, omega-3) instead of trans and omega-6 fats
  3. Managing stress
  4. Avoiding refined carbohydrates and eat more whole grains
  5. Avoiding toxic environmental chemical exposure like BPA

But sometimes the answers are far more complex. And way beyond the realm of the average cardiologist.

You see, the human body has never respected the artificial boundaries of medical specialties that we have created. The examples of neurology crossing into gastroenterology, endocrinology crossing into cardiology and obstetrics crossing into psychology are all over the place.

This particular article is no different. In it, researchers looked at 60 stable patients with mild CHF (half with NYHA functional class I to II) and moderate to severe CHF (half with NYHA functional class III to IV) and evaluated the composition of the inhabitants of the gut. Here’s what they found when these heart failure patients were compared to normal patients:

  • The entire heart failure population had massive quantities of pathogenic bacteria and Candida.

You can bet these findings will be the key topic of discussion at the next joint Cardiovascular / Gastroenterology convention.

(Yeah, don’t hold your breath waiting for the invite to this event…)

But seriously, these are some VERY striking differences between the heart failure patients and the normal participants. The question is whether the changes in the gut were the cause or the result of the chronic heart failure.

As with everything, the answer likely lies somewhere in between. We already have strong evidence that the bacteria in the gut contribute to obesity and diabetes. It would not be a big stretch to link bad bacteria balance in the gut with the later development of heart disease.

Personally, I’ll keep an eye on the research as it comes out over the next few years linking the gut bacteria and heart disease. In the meantime, I would do everything possible to make sure I’m living a lifestyle that is consistent with a healthy bacterial flora in the gut as well as avoiding antibiotics in all but the most life-threatening situations.

Your heart will must likely thank you for it.

Does Your Cardiologist Perform this Invasive Procedure?

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If you have any interactions with a cardiologist, this is a must read.  And read VERY carefully.

Percutaneous coronary intervention (PCI) is the procedure where a stent is (almost always) placed into a coronary artery.  Most know this as coronary angioplasty.  This procedure largely did not even exist a decade ago (it began to blossom in the late 80’s, but it seems to me like the past decade has seen major increases).   It has created an entire field within cardiology called interventional cardiology.

It has been established that coronary angioplasty for non-emergency chest pain really does nothing but makes the patient feel better temporarily, until they actually have a heart attack sometime in the near future.  To make this a little more problematic, this is NOT a cheap procedure (runs around $35K) and has its list of side effects, including death.

But does your cardiologist know this?  In this particular study, researchers asked this very same question of a group of 27 cardiologists (10 interventional and 17 referring).  Here’s what they found:

  • 63% of cardiologists surveyed agreed that PCI is ONLY good for symptom relief.  Symptom relief only.
  • Almost 3/4 of patients felt that, without the PCI, they would definitely suffer a heart attack in the next 5 years
  • 88% of patients, however, mistakenly believed this procedure would prevent a future heart .  Talk about a disconnect!
  • The real deeper problem here, however, is that, despite the fact that this procedure would only manage symptoms and not really fix anything, 43% of cardiologists would STILL PERFORM THE PROCEDURE!!

Yes–almost half of the cardiologist would still perform a $35,000 procdure with death as a potential side effect that does little other than help with chest pain.

And your insurance will gladly pay for it.  No wonder our system is so screwed up!

Are Your Cooking Pans Damaging Your Child’s Health?

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You know those wonderful, non-stick pans that you love so well?  I hope you realize that many of today’s “conveniences” like non-stick cookware come with a price beyond the initial purchase.

The wonderful Teflon that keeps all your foods from sticking to the pan is no exception.  The chemical compounds typically found in non-stick cookware include 25 cent words like perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS).  Toxic compounds like these have been found to affect thyroid function, cancer risk and heart disease.

In this particular study, researchers looked at the relationship between PFOA and PFOS levels and cholesterol levels in 12,476 children.  Here’s what they found:

  • PFOA was linked to higher total cholesterol and LDL-C
  • PFOS was linked to higher total cholesterol, HDL-C, and LDL-C

Even if these compounds were not linked to heart-disease-friendly changes in blood lipids, do we really want something called “perfluorooctanoic acid” in our children’s blood anyway when the word is too long to even fit on a Scrabble board??

Toss your non-stick cookware and buy stainless steel.