12.12.2019: Some End-of-Year Stocking Stuffers

To My Patients and Friends,

There’s been a lot of interesting medical news in the last few weeks… enjoy these highlights!

A deeper dive

Recent data compiled by researches at Ohio University have demonstrated that a more thorough analysis of cholesterol in our blood can add a great deal of information with respect to long-term cardiovascular risk.  Standard risk calculators generally look only 10 years ahead.  However for many of us, especially when we are relatively young, lifetime risk is often underestimated.  Cardiovascular risk factors like high cholesterol have the cumulative effect over time, and for many individuals, detrimental changes in blood vessels can begin at a young age.

Using more sophisticated lab analyses, we can learn a great deal about a particular individual’s long-term risk.  These lab panels take into consideration a number of factors, including the size and density of various cholesterol particles.  Although LDL (‘bad”) cholesterol is an important risk marker, we have known for some time that smaller, more dense LDL particles are more associated with increased long-term cardiovascular risk than are larger, “fluffier” ones… yet most practitioners don’t take advantage of these readily-available blood tests.  These panels can also seek out other potentially problematic particles, such as Lipoprotein(a), which often presents in a familial pattern.  Even a very simple calculation based on a non-fasting cholesterol profile (non-HDL cholesterol) can provide a lot of good information about someone’s long-term risk.  So don’t hesitate to ask your doctor about these tests.

Listen up!

As if we need another reason to eat mindfully, according to a study conducted at Brigham and Women’s Hospital just published in the American Journal of Epidemiology, it appears as though eating a healthy diet is associated with a decreased risk for hearing loss as we get older, particularly in women.  Healthy dietary patterns highlighted in the study include the Dietary Approaches to Stopping Hypertension (DASH) and Alternate Mediterranean (AMED) diets.  Hearing loss can have a significant impact on quality-of-life and has been associated with an increased risk for depression and cognitive decline.  This sure seems like a no-brainer approach to decreasing our risk of hearing loss, so eat your veggies!

Our brains on statins

A pair of recent large studies conducted in the UK and Australia provide further evidence that cholesterol-lowering (“statin”) medications like atorvastatin (brand: Lipitor), simvastatin (brand: Zocor) and rosuvastatin (brand: Crestor) do not increase risk for cognitive decline.  In fact, the data suggest a possible benefit for statin users at high risk for developing Alzheimer’s disease.  This presumed connection has been debunked in recent medical literature, but for those who use statin medications, these new studies should provide added reassurance.

Women are not small men

A  majority of women who experience symptoms of angina (heart-related chest pain) have no obvious signs of artery blockage with traditionally-utilized heart imaging techniques, according to a recent study conducted at the Barbara Streisand Women’s Heart Center, Cedars-Sinai Smidt Heart Institute.  This is because in women (unlike men), many of these symptoms can be associated with disease in smaller vessels, which do not readily appear in traditional imaging modalities such as angiographyThe most commonly used tests to look for small-vessel dysfunction include invasive functional coronary angiography, cardiac magnetic resonance imaging (MRI), or positron emission tomography (PET), the latter two of which are noninvasive.  So for women who may fall into this category, I encourage you to be sure your cardiologist goes the extra mile to ensure that small vessel disease is not overlooked.

Vaping injuries

By now, we are all well aware of the concerns related to the negative health effects associated with the use of vaping products. Vaping Product Use-Associated Lung Injury (EVALI) as recently defined by the CDC is indeed a growing concern, especially among our younger population.  First and foremost, it is essential that we discourage everyone from using these dangerous products.  We have been able to define a cluster of symptoms associated with this condition, as follows:

  • Persistent cough
  • Chest pain or shortness of breath
  • Headache
  • Nausea, vomiting or diarrhea
  • Fever
  • Fatigue

Although these symptoms can certainly overlap with numerous other conditions, it is worth bringing them to the attention of your doctor ASAP if you are a user of these products.  For more information on the dangers of vaping, click here.  And keep talking to your kids!

Aspirin for cancer prevention

Although recent guidelines have shifted away from recommending daily aspirin as a means of reducing cardiovascular risk for most people (primarily due to increased bleeding risk), evidence continues to mount for aspirin’s potential preventative properties as related to cancer.  Another study of older adults recently published in the Journal of the American Medical Association again seems to support the use of aspirin for the prevention of cancers, most notably gastrointestinal cancers such as colon cancer.  In this study, the greatest reduction in cancer mortality was noted in those who use aspirin three or more times per week.  This is pretty compelling stuff, although I do recommend discussing the risks versus benefits of aspirin with your doctor before making any final decisions on the matter.

Daily cannabis bests illicit opioids in chronic pain

New research conducted at British Columbia Centre on Substance Abuse (BCCSU) has shown that cannabis use in patients with chronic pain lowers the likelihood that these patients will end up using illegal opioids.  More to come on this controversial but ever-evolving topic.

Beautiful hair, but at what cost?

According to a recent study published in the International Journal of Cancer, the use of permanent hair dyes in chemical hair straighteners may be connected with an increased breast cancer risk.  Previous animal studies have demonstrated a link between tumors and chemicals contained in hair dyes, and we know that formaldehyde, which is contained in many hair straighteners, is a known carcinogen.

That’s all for this installment.  Stay warm and have a safe, happy holiday season… see you next year!

Larry Leibowitz, MD

Matrix Personalized Medicine LLC
45 Grove Street
New Canaan, CT 06840
(203) 920-1772