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HeartDiseases

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Dietary fats: a new look at old data challenges established wisdom

It is widely accepted that diets rich in polyunsaturated fats protect against heart disease. Recently, the Global Burden of Disease team reported that each year insufficient intake of omega-6 polyunsaturated fats, the most common subgroup of polyunsaturated fats, results in over 700 000 deaths from coronary heart disease.1 Or does it? A linked study by Ramsden and colleagues (doi:10.1136/bmj.i1246) adds to the doubts around the health benefits of replacing saturated fat with polyunsaturated fats.2  
feeds.bmj.com
over 3 years ago
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Is Vegetable Oil Really Good for You?

Cooking with vegetable oil to reduce saturated fats can lower cholesterol, but it may not help curb the risk of heart disease or add years to your life, U.S. researchers say.  
medscape.com
over 3 years ago
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Palliative care in patients with heart failure

Despite advances in cardiac therapy, heart failure (HF) remains a progressive, highly symptomatic, and deadly disease that places great demands on patients, caregivers, and healthcare systems. Palliative care is a multidisciplinary approach to care that focuses on communication, shared decision making, and advance care planning; provides relief from pain and other distressing symptoms; integrates psychological and spiritual aspects of care; and offers a support system to help families cope during illness and bereavement. Palliative care has applications across the stages of heart failure, including early in the course of illness, often in conjunction with other therapies that are intended to prolong life. However, the incorporation of palliative care into the management of heart failure has been suboptimal for several reasons: uncertainty in the disease trajectory, failure to reward communication between healthcare providers and patients, siloed care, lack of knowledge, overlay of comorbidity and frailty, life saving devices with complex trade-offs, and a limited evidence base. This review will summarize the current literature on the emerging role of palliative care in patients with heart failure and the challenges and opportunities for its integration into routine care. It will discuss current initiatives and future directions of the collaborative relationship between the palliative care and heart failure disciplines.  
feeds.bmj.com
over 3 years ago
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Palliative care in patients with heart failure

Despite advances in cardiac therapy, heart failure (HF) remains a progressive, highly symptomatic, and deadly disease that places great demands on patients, caregivers, and healthcare systems. Palliative care is a multidisciplinary approach to care that focuses on communication, shared decision making, and advance care planning; provides relief from pain and other distressing symptoms; integrates psychological and spiritual aspects of care; and offers a support system to help families cope during illness and bereavement. Palliative care has applications across the stages of heart failure, including early in the course of illness, often in conjunction with other therapies that are intended to prolong life. However, the incorporation of palliative care into the management of heart failure has been suboptimal for several reasons: uncertainty in the disease trajectory, failure to reward communication between healthcare providers and patients, siloed care, lack of knowledge, overlay of comorbidity and frailty, life saving devices with complex trade-offs, and a limited evidence base. This review will summarize the current literature on the emerging role of palliative care in patients with heart failure and the challenges and opportunities for its integration into routine care. It will discuss current initiatives and future directions of the collaborative relationship between the palliative care and heart failure disciplines.  
feeds.bmj.com
over 3 years ago
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How big a problem is heart failure with a normal ejection fraction?

Treatment of heart failure with normal ejection fraction does not improve survival: however, offer symptom relief with diuretics and treat hypertension and other comorbidities  
feeds.bmj.com
over 3 years ago
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How big a problem is heart failure with a normal ejection fraction?

Treatment of heart failure with normal ejection fraction does not improve survival: however, offer symptom relief with diuretics and treat hypertension and other comorbidities  
feeds.bmj.com
over 3 years ago
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How big a problem is heart failure with a normal ejection fraction?

Treatment of heart failure with normal ejection fraction does not improve survival: however, offer symptom relief with diuretics and treat hypertension and other comorbidities  
feeds.bmj.com
over 3 years ago
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Pharmacotherapies in Cardiac Critical Care Immune Therapy

In this article, the current immunomodulatory treatments in pediatric cardiac disease and heart transplantation patients are reviewed.  
medscape.com
over 3 years ago
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β blockers for heart failure

In their linked article, Kotecha and colleagues (doi:10.1136/bmj.i1855) present a meta-analysis of individual patient data (IPD) and conclude that β blockers reduce all cause mortality and admission to hospital related to heart failure in patients with heart failure with reduced ejection fraction (HFrEF) and in sinus rhythm, irrespective of age and sex.1 These findings reinforce the recommendations of current clinical guidelines.2 3 In daily clinical practice, however, prescription rates of β blockers and the doses taken are lower than might be expected based on the available evidence. β blockers seem to be underused, especially in women and older adults of both sexes. Studies from secondary care clearly show suboptimal prescribing, although reported prescription rates vary considerably.4 5 In primary care, uptake of β blockers is even lower.6 7  
feeds.bmj.com
over 3 years ago
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Effect of age and sex on efficacy and tolerability of β blockers in patients with heart failure with reduced ejection fraction: individual patient data meta-analysis

Objectives To determine the efficacy and tolerability of β blockers in a broad age range of women and men with heart failure with reduced ejection fraction (HFrEF) by pooling individual patient data from placebo controlled randomised trials.  
feeds.bmj.com
over 3 years ago
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ATMOSPHERE and the RAS Blockade Ceiling in Heart Failure

Dr Pina interviews Prof McMurray about the trial on aliskiren and enalapril in HF and the perils of retrospective subgroup analyses.  
medscape.com
over 3 years ago
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Loneliness is associated with higher risk of stroke and heart disease, study finds

Loneliness and isolation are associated with a 30% higher risk of having a stroke or developing coronary heart disease, shows a review of available evidence that found a similar effect to that of other recognised risk factors such as anxiety or having a stressful job.1  
feeds.bmj.com
over 3 years ago
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Preventing sudden cardiac death in athletes

Sudden cardiac death is a tragic complication of several underlying heart diseases.1 In young people (<35 years), particularly athletes, genetic heart diseases such as hypertrophic cardiomyopathy are a major cause.2 Few question the importance of developing effective measures to help prevent sudden cardiac deaths in athletes worldwide, but much controversy exists about whether preparticipation screening of athletes is effective in reducing risk .  
feeds.bmj.com
over 3 years ago
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Loneliness is associated with higher risk of stroke and heart disease, study finds

Loneliness and isolation are associated with a 30% higher risk of having a stroke or developing coronary heart disease, shows a review of available evidence that found a similar effect to that of other recognised risk factors such as anxiety or having a stressful job.1  
feeds.bmj.com
over 3 years ago
E4e1308ee13c9f05aaf279ba04722f3b52e17ab606693800587078058
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Congestive Cardiac Failure

 
Mrs Malaika Smith
over 3 years ago
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Health anxiety: the silent, disabling epidemic

“We are glad to say, Mr Jones, that all your test results are normal and you have nothing to fear.” Mr Jones has received this message many times after being examined for many severe diseases such as cancer, multiple sclerosis, and heart disease, which over the years he has been convinced he must have. Yet, this is the core of his problem—despite how much he would like to, he cannot do what the doctor says: stop worrying. He used to attend his general practitioner frequently to be reassured that nothing was wrong with him, but the reassurance was only short lived and then the worrying started all over again. After many years of distress, Mr Jones is embarrassed that he cannot control his health worries and preoccupation and has lately avoided contact with his GP, knowing it does not help him very much.  
feeds.bmj.com
over 3 years ago
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Mediterranean diet reduces cardiovascular events in people with heart disease, study shows

Although eating a Mediterranean diet high in vegetables, fruit, fish, and whole grains is associated with a lower risk of cardiovascular events in people with stable coronary heart disease, eating a Western-style diet does not increase this risk, a large follow-up study has shown.1  
feeds.bmj.com
over 3 years ago
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Health anxiety: the silent, disabling epidemic

“We are glad to say, Mr Jones, that all your test results are normal and you have nothing to fear.” Mr Jones has received this message many times after being examined for many severe diseases such as cancer, multiple sclerosis, and heart disease, which over the years he has been convinced he must have. Yet, this is the core of his problem—despite how much he would like to, he cannot do what the doctor says: stop worrying. He used to attend his general practitioner frequently to be reassured that nothing was wrong with him, but the reassurance was only short lived and then the worrying started all over again. After many years of distress, Mr Jones is embarrassed that he cannot control his health worries and preoccupation and has lately avoided contact with his GP, knowing it does not help him very much.  
feeds.bmj.com
over 3 years ago
Preview
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Mediterranean diet reduces cardiovascular events in people with heart disease, study shows

Although eating a Mediterranean diet high in vegetables, fruit, fish, and whole grains is associated with a lower risk of cardiovascular events in people with stable coronary heart disease, eating a Western-style diet does not increase this risk, a large follow-up study has shown.1  
feeds.bmj.com
over 3 years ago