The eagerly awaited results of the FOURIER trial were recently presented at the Annual Meeting of the American College of Cardiology (ACC) in Washington DC and simultaneously published in the New England Journal of Medicine (1). The goal of FOURIER was to evaluate the efficacy and safety of evolocumab (Repatha), a PCSK9 inhibitor, among subjects with elevated risk […]
Carbs, Fats and Heart Disease – Time For a Reappraisal Following the PURE Study
Recently many of us were provided an opportunity to watch a highly interesting video on the internet covering a talk given by Dr. Salim Yusuf at a recent Cardiology Update meeting. Dr. Yusuf is the Marion W. Burke Chair in Cardiovascular Disease at McMaster University Medical School in Hamilton, Ontario, Canada and current President of […]
The FOURIER Trial – Are We Entering a New Era in Cardiovascular Medicine?
The results of the recently completed FOURIER trial suggest that we have taken a huge step forward in the pharmacological therapy atherosclerotic cardiovascular disease (ASCVD). On February 2, 2017 the biotechnological company Amgen announced that the FOURIER trial evaluating whether the drug evolocumab (Repatha) reduces the risk of cardiovascular events in patients with clinically evident ASCVD […]
VLDL – The Role of Triglyceride-Rich Lipoproteins and Remnant Cholesterol
Knowing the role of VLDL (very low-density lipoprotein) and chylomicrons is a key factor in understanding how lipids (fats) and lipoproteins are involved in atherosclerotic cardiovascular disease (ASCVD). In the current era of adiposity and metabolic disease, VLDL has gained a bigger role than before and may help explain many of the disorders associated with the obesity epidemic such […]
Niacin (Nicotinic Acid, Vitamin B3) – Who Should Take Niacin?
Niacin (nicotinic acid), also known as vitamin B3, is one of eight known B vitamins. It has been used for decades to lower cholesterol and reduce cardiovascular risk. However, today its use is somewhat debated. Meat and fish are the richest sources of nicotinic acid followed by fortified enriched grain, vegetables, and yeast. Tuna, salmon, chicken, turkey, […]
Why LDL-Cholesterol May Be Overestimated on a Low-Carb, High-Fat (LCHF) Diet
Elevated LDL-cholesterol (LDL-C) is common among people who adopt a low-carb, high-fat (LCHF) lifestyle. That’s why many physicians and nutritionists remain doubtful when it comes to LCHF, despite overwhelming evidence that such a dietary approach improves several other lipid parameters, usually leads to weight loss and positively affects glucose metabolism. Several studies have shown that LDL-C constitutes a major risk factor for the […]
Adiposity, Adipokines, and Adiposopathy – Sick Fat Explained
By now, all of us should know that we are in the throes of an obesity epidemic. Worldwide, over 500 million people are believed to be affected (1). Obesity in children and adolescents is on the rise and so is type 2 diabetes. And, according to the media and the experts, this will have horrible consequences that ultimately will […]
Angina Pectoris – What Is Angina and How Do We Deal With It?
The term angina pectoris or angina is used to describe chest pain or discomfort, often felt like pressure or a squeezing sensation in the chest. The pain may radiate to the shoulders, arms, neck, jaw or the back region between the shoulder blades. Angina is not a disease. It is a symptom, usually caused by inadequate […]
Using Coronary Calcium Score to Target Statin Treatment in Primary Prevention – The Biolmage Study
Cholesterol-lowering medications are being prescribed to almost 30% of US adults aged 40 and over, most of these are statins drugs (1). The number increases with age, and approximately 48% of adults older than 75 are receiving such treatment. It has been suggested that treating more older individuals with statins may prevent a substantial number of cardiovascular events, and that, […]
GLAGOV – The Lipid Hypothesis Gains Ground
The results from the recent GLAGOV trial suggest that aggressive lowering of LDL-cholesterol with a PCSK9-inhibitor on top of statin therapy in patients with coronary artery disease may reduce atherosclerotic plaque burden. Although these results provide support for the lipid hypothesis and may have significant implications for the future of cardiovascular medicine, our eyes are still on safety and […]
Weight Management – The Role of Exercise Revisited
In the midst of the obesity epidemic, one of our most important concerns is the association between body mass index (BMI) and the risk of cardiovascular disease (CVD). However, body weight itself may not be what matters most. Evidence suggests that obesity measures such as BMI, waist circumference, or waist-to-hip ratio, assessed singly or in combination, […]
Swollen Feet and Swollen Ankles – Leg Edema Explained
Swollen feet and swollen ankles are common reasons why people seek medical advice. I’m not talking about inflammation due to injury or infection, but a medical condition commonly called leg edema. Leg edema is not only undesirable due to cosmetic reasons but may lead to thinning of the skin, discoloration or staining (pigmentation) and skin sores (ulcers). Healing may be […]
Apolipoprotein E – ApoE Explained
Apolipoprotein E (ApoE) is one of the proteins the body uses to transport fats (lipids) in the bloodstream from one tissue or cell type to another. It is essential for healthy metabolism of cholesterol and triglycerides, two important types of fats the body has to deal with regularly. The relationship between ApoE and heart disease has been studied quite intensively in recent […]
High Carbohydrate Intake Worse than High Fat for Blood Lipids
Data presented at the World Heart Federation’s World Congress of Cardiology & Cardiovascular Health 2016 (WCC 2016) in Mexico City may radically change our perspective on how carbohydrates and different types of fats affect blood cholesterol and other lipid biomarkers. The presentation was based on data from the Prospective Urban Rural Epidemiological (PURE) study. The data have not been […]
Fructose Restriction – An Effective Lipid Intervention?
The association between lipid disorders and heart disease is well known. Medical checkups usually involve measurements of cholesterol and other lipid parameters, and most doctors advise their patients on how to improve their lipid pattern. Dietary interventions to lower the risk of heart disease commonly aim at reducing blood levels of cholesterol, LDL cholesterol in particular. This is […]