Beta Blockers May Not Prevent Heart Attacks and Strokes

http://abcnews.go.com/Health/video/beta-blockers-effective-previously-thought-17378539

By SYDNEY LUPKIN

Oct. 2, 2012

New research suggests that beta-blocker pills don’t prevent heart attacks, strokes or cardiac deaths in patients with heart disease, but doctors are torn over whether there’s enough in the study to make them want to stop prescribing the drugs. Beta blockers have been a standard heart medication for decades.

The study, published in the Journal of American Medical Association, looked at nearly 45,000 patients with prior heart attacks, coronary artery disease or risk factors for coronary artery disease, and found that those on beta blockers didn’t show significantly lower rates of heart attack, stroke or cardiac death than those not on the medication.

“This is a very compelling study that has the potential to shake up the conventional wisdom that exists regarding the role of beta blockers in the management of patients with cardiovascular disease,” said Dr. Randal Thomas, a cardiovascular specialist at the Mayo Clinic. “At a minimum, it will lead to new studies that address this issue once again.”

Beta blockers work by blocking adrenalin receptors in the brain that become activated when the body is stressed. Beta blockers are used to treat heart disease, high blood pressure, anxiety and other conditions.

Some doctors say they are glad beta blockers are being questioned because their use had been “written in stone” for so many years, but others say using a non-randomized data sample is not as reliable as a randomized drug trial.

While the authors attempted to account for differences between the patient groups that might have had an impact on their health, they did not have access to information on why some patients were prescribed these drugs and some were not, said Dr. Richard Besser, the chief heath and medical editor at ABC News.

Dr. Melvin Rubenfire, who directs cardiovascular medicine at the University of Michigan, said he’d been hoping for a study like this, but it won’t change his prescribing habits because he uses beta blockers only in specific cases. Rubenfire also weans patients off the pills 18 months after they have a heart attack if they experience adverse side effects, such as fatigue and erectile dysfunction.

Rubenfire said the existing data wasn’t enough to determine which patients would benefit from beta blockers, and what kinds of beta blockers are better than others. Beta blockers include at least six brand names, including Sectral, Tenormin and Zebeta.

Even study coauthor Christopher Cannon, a professor at Harvard Medical School, said he will continue to prescribe beta blockers to his patients, adding “I would not make too much of this” because the study is only observational.

“All it can do is raise up an idea for us researchers to consider for further study,” he said.

Cannon said this research shows that it’s unclear whether beta blockers add more benefit than the other therapies developed in the decades since beta blockers became a standard of practice for treating patients with heart disease. Since patients are often taking several drugs, it’s hard to pinpoint how much one agent helps compared with another.

Dr. Steven Nissen, who chairs the department of cardiovascular medicine at the Cleveland Clinic Foundation, said the medicine might not be ideal for all of the patients it’s prescribed to, but a new randomized, controlled trial will be necessary to change guidelines for prescribing beta blockers.

“Abandonment of this type of therapy for post-MI [post-heart attack] patients based upon an observational study is not warranted,” he said.

For the time being, the study raises questions, said Dr. Harlan Kumhulz, a professor of medicine, epidemiology and public health at Yale University.

“The question it raises is about how long after having a heart attack should patients remain on beta blockers?” Kumhulz said, noting that beta-blocker patients didn’t have better outcomes than the other patients did after the first year. “The study cannot definitively answer that question — but raises doubts about the need to continue to take them for the rest of a patient’s life.”

Dr. Lauren Hughes of the ABC News Medical Unit contributed to this report.

http://abcnews.go.com/Health/beta-blockers-prevent-heart-attack-stroke-study-jama/story?id=17378403#.UG32y5jA-Sp

Dr. Esselstyn “If you do what I ask, your disease is history.”

‎”If you do what I ask, your disease is history. Rather than detour around it, squish it with a balloon or brace it open with a wire bracket—either of which is just a temporary angina-relieving procedure—my program can prevent disease altogether, or stop it in its tracks. All the interventional procedures carry considerable risk of morbidity, including new heart attacks, strokes, infections, and, for some, an inevitable loss of cognition. Mine carries none. And the benefits of intervention erode with the passage of time; eventually, you have to have another angioplasty, another bypass procedure, another stent. By contrast, the benefits of my program actually grow with time. The longer you follow it, the healthier you will be.” – Dr. Esselstyn

Frequent red meat eaters at higher risk of stroke

A high-protein diet might benefit health in some ways, but depending on what kind of protein a person consumes, it could raise their stroke risk too, suggests a large new study that finds eating lots of red meat ups the likelihood of having a stroke while poultry lowers it.

“The main message from this paper is that the type of protein or the protein package is really important for the risk of stroke. We have to consider protein in the context of the foods,” said Dr. Frank Hu, a professor at the Harvard School of Public Health and one of the authors of the study.

He and his colleagues collected data from two massive health surveys that tracked tens of thousands of men and women from roughly middle age to their senior and elderly years.

Over 20-some years of the study, nearly 1,400 men and more than 2,600 women had a stroke.

Caused by a blood clot or a burst blood vessel that stops blood flow to the brain, stroke is the third most common cause of death in the United States. Twenty-six out of every 1,000 people in the U.S. have experienced a stroke, according to the Centers for Disease Control and Prevention, and about 800,000 die of stroke each year.

To see what influence different types of dietary protein have on stroke risk, the researchers divided up the people in the study based on how much red meat, poultry, fish, dairy and other sources of protein they typically ate each day.

Men who ate more than two servings of red meat each day — which was at the high end of the meat eaters — had a 28 percent increased risk of stroke compared to men who averaged about a third of a serving of red meat each day, the low end of the red meat eaters.

The researchers considered a serving of red meat as four to six ounces of beef or a hamburger patty.

Women who ate nearly two servings of red meat a day had a 19 percent higher risk of stroke than women who ate less than half a serving each day.

A 19 percent increase in stroke risk means that instead of 26 out of every 1,000 people having a stroke, 31 out of every 1,000 people would have one.

The researchers also looked at the change in stroke risk that would come with substituting different forms of protein for one daily serving of red meat: swapping in one serving a day of poultry lowered stroke risk by 27 percent, a serving of nuts or fish was linked to a 17 percent drop in risk and a serving of dairy dropped the risk by 10 to 11 percent.

Dr. Adam Bernstein, the lead author of the study and a researcher at the Cleveland Clinic, said he was not surprised to see that red meat eaters suffer more strokes.

“We’ve also done work on red meat and diabetes and red meat and coronary heart disease. So it makes sense that these cardio-metabolic diseases are grouped together,” Bernstein told Reuters Health.

An earlier study, led by Susanna Larsson at the Karolinska Institute in Stockholm, Sweden, also found that eating red meat had a link to stroke risk (see Reuters Health story of December 31, 2010).

What was new in the current study, Larsson said, was that frequent poultry eaters showed a lowered risk of stroke.

People who ate the most chicken or turkey each day — about a half serving for women and three-quarters of a serving for men — had a 13 percent reduced risk of stroke compared to those who ate barely more than a serving a day.

One serving was considered four ounces.

“I do not think that poultry has been considered as a protein source that might lower the risk of stroke. This is new,” Larsson told Reuters Health in an email.

Also surprising in the study was that fish seemed to offer no protection against stroke.

Larsson pointed out that earlier work has found fewer strokes among groups who eat fish often.

It’s possible that the benefits of fish depend on how it’s served, Bernstein said.

“There’s a lot of variation in how people cook and prepare fish, and we couldn’t get down to that level,” he said.

The researchers didn’t prove that beef is to blame for the increased number of strokes, but Bernstein said it could be that the fat and iron in red meat play a role.

Larsson said the findings support current recommendations to limit how much red meat people eat, and to opt for chicken and fish instead.

Read more: http://www.foxnews.com/health/2012/01/12/frequent-red-meat-eaters-at-higher-risk-stroke/#ixzz22zp7SJ3k

I Believe That Coronary Artery Disease Is Preventable Dr. Caldwell Esselstyn

Dr. Caldwell B. Esselstyn, Jr.:

“I believe that coronary artery disease is preventable, and that even after it is underway, its progress can be stopped, its insidious effects reversed.  I believe, and my work over the past twenty years has demonstrated, that all this can be accomplished without expensive mechanical intervention and with minimal use of drugs.  The key lies in nutrition — specifically, in abandoning the toxic American diet and maintaining cholesterol levels well below those historically recommended by health policy experts.”

– Dr. Esselstyn

Prevent and Reverse Heart Disease by Caldwell B. Esselstyn, Jr., M.D.

Two Cardiologists & One Cardiac Surgeon Who Follow an Esselstyn-Style Plant-Based Diet. What’s Their Story and What Health Benefits Have They Seen?

“Most of my career I looked at coronary artery disease as a “terminal disease”.  You’d die from it.  But, I began seeing more research showing that not only was it preventable, but it was reversible.

I heard Dr. Caldwell Esselstyn, Jr. speak at meeting three years ago–and it opened my eyes.  

I started studying & doing my own research on others who were doing similar research.  Esselstyn wasn’t alone.  There’s a building body of evidence that coronary artery disease is preventable & reversible. That was eye-opening.”

-Dr. Marc Katz, MD, PhD, cardiac surgeon, Medical Director of the Heart and Vascular Institute and Head of the Minimally Invasive Surgery Program at Bon Secours Richmond Health System–

I love http://www.happyhealthylonglife.com.  Go check it out.  It’s a wonderfully informative blog.

Read the rest of this at :  http://www.happyhealthylonglife.com/happy_healthy_long_life/2012/07/cardiologists.html

‘Dallas’ Star Larry Hagman: Vegan to Help Battle Cancer. Why Wait?

“After being diagnosed with cancer in 2011, Hagman changed his diet to a meatless one to help him in the battle. He is now cancer free.”

Once again a celebrity has changed their diet to a vegan one after being diagnosed with a life threatening illness.  The fact is that a vegan diet may help them survive.  My question is, “Why wait until you get sick?”

“The dietary changes that have helped my patients over the past twenty years can help you, too. They can actually make you immune to heart attacks. And there is considerable evidence that they have benefits far beyond coronary artery disease. If you eat to save your heart, you eat to save yourself from other diseases of nutritional extravagance: from strokes, hypertension, obesity, osteoporosis, adult-onset diabetes, and possibly senile mental impairment, as well. You gain protection from a host of other ailments that have been linked to dietary factors, including impotence and cancers of the breast, prostate, colon, rectum, uterus, and ovaries. And if you are eating for good health in this way, here’s a side benefit you might not have expected: for the rest of your life, you will never again have to count calories or worry about your weight.”  http://www.heartattackproof.com/excerpt.htm

Larry Hagman is known for his role as J.R. Ewing on the popular hit series “Dallas,” but he recently became a fan favorite when he turned vegan. Let’s just say the actor doesn’t miss meat one bit.

After being diagnosed with cancer in 2011, Hagman changed his diet to a meatless one to help him in the battle. He is now cancer free.

In a recent interview, Hagman reflected on his vegan journey, “After the first couple of months, I didn’t miss anything. I’ve lost 30 pounds; I feel better and have more energy. I’m doing good. Working at 80 is kind of nice.”

Back in January the 80-year-old discussed his transition, “The first thing I did when I was diagnosed was to turn vegan. Now I live on fresh vegetable drinks which taste like c**p but which I firmly believe have helped me get through this thing.”

To fully commit to his vegan diet, he hired an organic chef, purchased an industrial sized juicer and took part in strength training, all to stay strong.

The legendary actor noted he wasn’t sure he would stay 100 percent vegan, “I’ve become a bit of a vegan nut but I believe it’s kept me strong. I will probably reintroduce fish and eggs in a couple of weeks but meat is gone forever, and so is milk. I don’t want those hormones and steroids in my body.”

Hagman’s new eating habits have done his body good, and based on his most recent comments, it seems that nearly 6 months later, he’s still fully vegan.

If you want to see Hagman’s portrayal of J.R. you can catch him on TNT’s revival of “Dallas” this Wednesday at 9 p.m. EST.

BY ALLYSON KOERNER JUNE 11, 2012

Photo Credit: Phil Stafford / Shutterstock.com

http://www.ecorazzi.com/2012/06/11/dallas-star-larry-hagman-reflects-on-vegan-diet/