LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Heart Disease, Stroke, Blood Pressure Tips

THREE CHEERS FOR THIS TREAT!

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Many times people are confused over what is good for us and what is bad. Many mistakenly believe that drinking bottled water and milk are good for you and that things like eggs and this wonderful food item are bad for you.

This particular study looked at over 114,000 participants across multiple studies to really answer the question about whether chocolate was good for us. I’ve seen a study where chocolate, in patients who have already had a heart attack, was more powerful at preventing a second heart attack than any medication available (66% reduction in heart deaths).

The authors determined that, at the highest intakes of chocolate there was a 37% reduction in the cases of heart disease and 29% reduction in stroke. This is pretty powerful for an “intervention” like chocolate.  Compare this with statins, which have side effects and are massively expensive–can you imagine the wonderful chocolate you could get for $3 / day!

And, we have to consider that these studies did not focus entirely on dark chocolate. If they did, the protective effect was likely to be even higher. Combine your dark chocolate (the higher the cacao content the better) with some raw nuts and we’ll all have to take up smoking just to have any risk for a heart attack…

WAS THAT CARDIAC STENT REALLY NEEDED?

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Had a cardiac stent put in?  Was it really needed?  Basically, it’s a toss up.  50 / 50.

I’ve written before about the reality of this procedure, which has some pretty severe limitations.  Many patients mistakenly believes that percutaneous cardiac intervention (PCI or angioplasty) will prevent them from having a heart attack in the future.  Many doctors do not discourage this opinion, although it is not true in many cases.

About 50% of the time, the only expected outcome of this procedure is angina / chest pain relief.  Sounds good, until you realize that the procedure involves sticking a scope up into your heart itself to take a peek around and has significant risks AND earns you 6 months to a year of Plavix or Coumidin (which carry risks as well..).

Worse, the procedure costs some $50K or more.  Talk about a waste of healthcare dollars!  As a chiropractor constantly dealing with insurance companies wringing our reimbursements down, in recent examples, 50% lower to save money on a fraction of the costs in healthcare, I find it sickening to see this type of abuse that is allowed to occur virtually unchecked. 

This particular editorial laments the waste and abuse in the cardiology realm with this procedure.  Despite strong research suggesting that 50% of the procedures would have been better treated with medications (a topic we obviously won’t get into here…), there has been no behavioral change among most cardiologists.

So, for those of you that think that the typical cardiologist has their nose stuck in medical journals to keep up with the latest research, you might want to rethink that position.  Or worse, they are aware of the research and choose to ignore it for financial gain.  Take your pick.  Either way, it’s not too pretty.

For me, I’d opt for strong lifestyle changes at this point.  Cheaper.  Cuts across much more than just heart disease.  No long term damage (unless you call improved physiology damaging).  And certainly safer.  A no brainer to me.

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OUR HEALTH CARE SYSTEM IS DOOMED!!

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Let’s start this off by saying that my view on this is apolitical.  I don’t care which side of the fence you’re on, or if you think you can precariously balance in the middle–with no substantives changes in the adoption of prevention of chronic disease in this country NO ONE can afford what’s coming.

You can shift who’s paying.  You can shift how much we pay for stuff.  You can shift cost sharing around.  But when the burden of chronic disease, just taking diabetes, heart disease and Alzheimer’s in account, how is society going to pay for care of half the population when the costs of care per year exceed, say, $100K per sick person?

Could you and your neighbor, spouse or significant other each kick in $50K to pay when one of the two of you needs open heart surgery?  Heck–let’s say the surgery is done in a basement somewhere and the cost is reduced to a measly $10K apiece?  Can you fork that over?

And, WOULD you fork it over if your neighbor watched tv all day, had more dust on his treadmill than the moon and every Monday his garbage can at the curb is filled with beer cans and fast food bags?  This is a very, very serious question we all need to contemplate.

You’re all invited next time my mother and I have a “discussion” where she feels everyone deserves healthcare regardless of how poorly someone takes care of themselves (liver transplants for alcoholics, anyone?) and I feel that personal responsibility trumps all and to a certain degree we need to face financial responsibility for our poor lifestyle choices.  It can get quite animated.  She is, of course, wrong.

So, as the Obamacare plan plays out with only token attention to true prevention, remember that, regardless of who pays for it, we cannot afford where we are headed.  When health”care” spending is 50% of GDP because no one is truly responsible for their actions because entitlement insurance is there to catch you when you fall (which, as we’ve addressed before, is a really false security net), maybe Nabisco, Kraft, Kellogg’s and McDonalds can come up with the new plan.

Remember–the only true answer is, always has been and always will be, prevention through healthy lifestyle changes.

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DIABETICS SHOULD SNACK ON THESE

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Despite massive amounts of evidence and research on how to avoid and / or eliminate diabetes, the public still isn’t receiving the message.  Sometimes small changes that are incredibly simple can make major improvements.

As an example, avoiding bottled water and switching to tea is a simple change moving from BPA loaded water to polyphenol rich tea.  Avoiding all artificial sweeteners.  Burst type aerobic exercise, even if it is just for 10 minutes a week.

This particular study focuses on the power of almonds to improve diabetes.  The authors took “well controlled” diabetics (I personally hate that phrase–no one is ever “well controlled” if they need medication to get there) and had them eat a single serving of almonds with breakfast 5 days / wk for 4 months.

They found a massive 30% reduction in blood sugar levels and a 4% reduction in HbA1c levels in these patients, which, in some patients, may be enough to reverse the diabetes diagnosis.  Few medications than can do this are without side effects.

These results are even more surprising when you take into account the standardized breakfast that the diabetics ate was bagels, butter and juice–ALL absolute no-nos for diabetics!  Despite the pro-diabetic breakfast, the almonds were still powerful enough to drop HbA1c levels.  How simple is that??

Two things to add..

First, raw or dry roasted almonds only.  Nothing that comes out of a can or has any added oils to them.  Big mistake that many make.  And while this study looked at almonds, I would not be surprised to find many other nuts having similar effects.

Second, chew more.  Several studies have found that by merely chewing food more we get a stronger anti-diabetic effect, especially in almonds.

If you’re diabetic, what are you waiting for?  If you’re not, you should make it a habit anyway..

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PRESCRIPTION FISH OILS?

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Everyone is aware of fish oils and the benefits to human physiology.  Did you know that they are available by a prescription?  I really shouldn’t got into this topic because it gets my blood boiling…

This is certainly not the first time that the drug companies have tried to ride the tide of popular natural approaches and monopolize on them, but this may be the most nausea-inspiring.  Why?

We can easily argue that the drug companies are about 30 years behind the research on the benefits of fish oils (the early studies came out in the 70’s).  GlaxoSmithKline has done very little research on the efficacy of fish oils and the conditions they can treat.

What is the excuse most drugs companies give for the exceedingly high cost of their drugs?  You guessed it– Research and Development.  So, we’ve established that GSK did very little of this and are merely riding the coattails of decades of research.  Sure–they’ve done some simple studies on their product Lovaza (formerly known as Omacor), but just enough to satisfy the FDA.

So what’s the problem?  At GSK’s prices for Lovaza, at recommended dosages (4 grams per day…more on that later), even budget conscious Costco is $182 / month.  yes–that is one hundred and eighty dollars for omega 3 fatty acids that for an arguably superior product that we sell in our office the cost is under $30.  Over 6 TIMES the cost.  And it’s certainly not about the R & D and it’s not about the quality.  That’s what’s so sickening.

And worse, some of your insurance is actually picking up the bill.  Yup.  Your insurance wouldn’t pay $30, but they’re willing to pay over $200.  And we wonder why there’s problems with healthcare costs…

Back to this particular study that looked at the cost effectiveness of the massively overpriced Lovaza being used at 4 grams / day and found that the cost per quality adjusted life year (QALY–a standard approach to determining if an intervention is worth the cost…anything under $50K is considered worth the cost) was $47K, or just under the margin.  A little funny when you back out of the data and look at how much the drug costs…..(I’d say it sounds “fishy,” but that would be too punnish..)

If we were looking at a reasonably priced OTC fish oil, this would be closer to $7800.  Ironically, when you take the most recent review of statin (in)effectiveness by the Cochrane Group, the cost of QALY was over $62K.  Not even in the same ballpark.

Of course, none of this addresses the massive benefits and cost savings with you couple healthy lifestyle changes like avoiding refined carbohydrates with a lower dose omega 3 use…

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DID LIPITOR LOWER YOUR CHOLESTEROL?

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If you took a statin and it lowered your cholesterol, my first response would be “So what?”  What does that REALLY mean?  And does anyone really give a squat about their cholesterol, or is it really that they don’t want to have a heart attack or stroke?

I’ve written before about the folly of using surrogate endmarkers like cholesterol in medicine today.  Our entire system is a house of cards built upon this concept.  So what is a surrogate end marker?

Basically, we take a population and look at some value.  To be consistent in this case we’ll look at cholesterol.  Those with lower cholesterol had less risk of heart attacks.  Makes sense.  It is likely that those who take better care of themselves have lower cholesterol.  But it is NOT the lower cholesterol that protects their heart.  Their heart is protected because of the choices they have made.  These choices lower cholesterol.  AND raise HDL.  AND lower blood pressure.  And maintain ideal body composition.  And improve gut health.  And lower uric acid…  The list is endless.

So how do we manage to find a single item on a long list (cholesterol) and decide that, if we lower that single value artificially through drugs, that it will be good for the patient????  It is a concept that has built the foundation of pharmaceutical intervention and it is a failed model.  Society just doesn’t know it yet.

(Just in case you think that my opinion is an isolated one and that using a drug to change a single marker is a great idea, you might want to read Dr. Ray Moynihan’s commentary in BMJ…)

So why do I bring it up?  Looking at this particular study, you see no reference at all to risk of heart disease or death in patients.  It is all about whether the drugs were effective and lowering cholesterol.  There is no doubt these drugs lower cholesterol, but do you want to place the full weight of your life on a surrogate endmarker? 

So this study is a perfect example of how we can use a study to promote the use of a drug…We wave the study high in the air, pound our fists on our chest and proclaim how it saves lives.  But we didn’t look at lives saved.  We looked at whether a single solitary number got better.  Pretty weak.

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ERECTILE DYSFUNCTION?

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Need I say more?  You’d think that this problem, above almost any other besides kidney stones, would drive a male to change their lifestyle.  Unfortunately, I think that there is, once again, an education gap in society today.

Erectile dysfunction IS heart disease (or rather, vascular disease…).  How is that?  Healthy blood flow is required for an erection.  When the blood vessels begin to plaque up, you will have reduced blood flow and inability to maintain an erection.  So if the blood vessels are plaquing, it is only a matter of time before a heart attack or stroke occurs.

This article refers to ED as the “canary” of cardiovascular health.  I love this!  I just wish I had coined it myself, but alas…I’m merely the messenger.

So the use of meds like Viagra, Cialis and Levitra do nothing to fix the problem.  Ironically, these meds can’t be used by a patient currently under treatment for heart disease, which is arguably the reason the ED is present in the first place.

So what does one with ED do?  And, before you ladies shut out the recommendations, decreased libido could arguably be put into the same category…so pay attention.

Once again, lifestyle changes to lower your risk of diabetes and heart disease will help with ED.  That means avoidance of refined carbs, hydrogenated oils and processed foods as well as no drinking our calories.  Increased intake of healthy fats, whole grains, fruits and veggies, tea and exercise.  All on top of a calorie reduced diet.  The list is long to help in this process…

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BUT I DON’T HAVE DIABETES, RIGHT?

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I know I’ve covered this ad nauseam in previous posts, but it’s important enough to stress again.  It doesn’t matter if you have or have not been diagnosed with diabetes.  A large chunk of the US population (likely >60%) are prediabetic or diabetic.  So what’s the difference between the two?

Nothing as far as your blood vessels (and that means your heart and brain) are concerned.  I wish we’d get rid of the term “diabetes” and just tell patients if they are headed towards better or worse glucose control.  That’s all that matters. 

I would have to say that approximately ZERO percent of my patients who are prediabetic truly understand just how dangerous this physiological state is.  Some may never become diabetic because they will die of a heart attack or stroke first.  The others will acquire the diabetic label and then die of a heart attack or stroke (unless they are the lucky few that get kidney failure or Alzheimer’s instead).

Stop thinking you’re ok just because your blood sugar has not passed that magical number.  If you have abdominal obesity, elevated cholesterol or triglycerides, decreased HDL, high blood pressure, PCOS, menstrual irregularity, sleep apnea, elevated liver enzymes….the list can be quite long…you’re likely prediabetic and at the same risk as a diabetic.

We really, really, really need to bring the general public up to speed on just how dangerous the prediabetic state.  Mainstream medicine has failed miserably in this task.  This is also the optimal time to intervene with healthier lifestyles.  Of course, the REAL optimal time is before you ever have any problems so that your never develop the problems…

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