Nearly 5 million Americans suffer with heart failure, many with significant symptoms or disability, followed by reduced survival. But with adequate treatment the symptoms of heart failure often can be controlled and survival greatly improved.
More About Heart Failure
Heart Disease Blogwith Richard N. Fogoros, M.D.
Unstable Angina
Unstable angina is "unstable" not only because a plaque has ruptured (a situation which always threatens to progress to a myocardial infarction), but also because the symptoms it produces - theangina - generally occurs much more frequently, often at rest, lasts much longer, and begins responding poorly to nitroglycerin.
Read more about unstable angina - how to recognize it and how it is treated - here.
Red Yeast Rice Still Effective?
I have tried to summarize here the story of red yeast rice (RYR), and the FDA's long and convoluted attempts to rid the shelves of RYR that contains the effective ingredient (which is lovastatin, a naturally-occuring statin drug).
But now investigators from Chestnut Hill Hospital in Flourtown, PA report that they performed a small study in which 62 patients who were unable to take statins (due to muscle pain caused by the drugs) were randomized to take either RYR or placebo. After a 12-week period of time (during which all participants also engaged in an intensive lifestyle-management program), those who had been randomized to RYR had significantly improved cholesterol levels.
Furthermore, despite their previous intolerance of statin drugs, all but two of these patients seemed to tolerate RYR without any problems.
The authors caution that the formulation of RYR they used was carefully controlled, in contrast to the RYR you can buy over the counter.
While the FDA believes it has successfully removed from the shelves any RYR that still contains a regulated drug (i.e. lovastatin), RYR is known to contain other compounds that are very similar to lovastatin. Presumably, the cholesterol-lowering effect that was seen in this study (as well as the improved tolerance among statin-intolerant patients) is caused by these not-quite-lovastatin compounds.
It is difficult to know exactly what to do with this intriguing new information. Certainly it would seem that RYR might be worth a try at least in statin-intolerant individuals. But because of the variability in RYR formulations (variability that may actually be larger than it typically is for unregulated "natural supplements," because in this case the FDA has insisted that manufacturers "alter" the naturally occurring RYR to remove lovastatin) it is impossible to know what you're really getting, or how stable the formulations are from bottle to bottle.
Sources:
Becker DJ, Gordon RY, Halbert SC, et al. Red yeast rice for dyslipidemia in statin-intolerant patients. Ann Internal Med 2009; 150:830-839.
Still Laughing at Restless Leg Syndrome?
But RLS is a real physical (and not psychological) disorder that can have serious consequences. And now, it has been associated with increased cardiac risk.
Read here about RLS, and why you should insist that your doctor take it seriously.
Sleep Quality and Blood Pressure
In the June 8 issue of the Archives of Internal Medicine, investigators from Chicago reported on 578 early-middle-aged adults in whom sleep duration was compared with blood pressure levels. These individuals had sleep assessments, using an activity monitor worn on the wrist, for three consecutive nights. The activity monitor allows investigators to quantify the duration of sleep, and the quality of sleep (i.e., the amount of nighttime "restlessness").
The investigators report that individuals who have relatively short sleep duration, or relatively poor sleep quality, tended to have higher systolic and diastolic blood pressures. This study is consistent with a few other studies that have associated suboptimal sleep patterns with hypertension.
Once again, an association does not necessarily mean cause-and-effect. Still, there are many health benefits to making sure you get a good night's sleep - and now it appears as if improving blood pressure control may be another reason.
Sources:
Knutson KL, Van Cauter, E, Rathoua PJ, et al. Association between sleep and blood pressure in midlife. The CARDIA sleep study. Arch Intern Med 2009; 169:1055-61.
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