5 Steps to prevent Heart Disease

Friday, November 28, 2014

5 years ago The Tubby Theory anticipated IMPROVE-IT positive result in 11-14

Update on Tubby Theory post IMPROVE-IT Trial

IMPROVE-IT trial affirms the validity of combination drug therapy in this positive trial with Vytorin.  A pill that has both simvastatin and ezetimibe (Zetia).

I wrote about Zetia 5 years ago in my book, The Tubby Theory of Topeka. 

IMPROVE-IT affirms the advice of combination drug therapy that I gave in 2010. 

Zetia plus statin is now evidence based. 

This clears the way for Niacin in combination with statin in patients unable to afford Vytorin or Zetia. 

At low dose 1,000 mg Endur-acin (wax matrix niacin) is very safe. 

Safety concerns about Niacin are misplaced, I believe, as written in Laropiprant is the bad one

Wednesday, November 5, 2014

The Statin multiplier effect if started earlier and used longer

Today while writing a critique of a  
Dr. Uffe Pavnskov link article 
and using quotes from
1- Dr. Allan Sniderman et. al.   link
2- NLA point counterpoint article, link

 I coined a term called the
Multiplier effect of statins if used earlier and longer.

Tuesday, November 4, 2014

The Multiplier Effect of Statins if used early and longer

More Validation of Tubby Theory from 2009

First  see Dr. Sniderman on early treatment of risk

 Second article below

Curing Atherosclerosis
 Should Be the Next Major Cardiovascular Prevention Goal
Jennifer G. Robinson, MD, MPH,* Samuel S. Gidding, MDyz
Iowa City, Iowa; Wilmington, Delaware; and Philadelphia, Penn

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in developed and developing countries. Despite decades of effort, unhealthy lifestyle habits and ASCVD risk factor levels remain high and are increasing in many population groups.

A new approach to ASCVD prevention is needed.

Multiple lines of evidence from animal and human studies suggest that atherosclerosis regression and normalization of vessel function can occur when low-density lipoprotein cholesterol (LDL-C) lowering occurs early in the course of atherosclerosis or when very aggressive LDL-C lowering occurs somewhat later.

We propose a new paradigm focused on curing atherosclerosis early in the course of the disease.
An approach that resets the vascular aging clock composed of initial regression therapy followed by periodic retreatment to suppress atherosclerosis development may be possible, with the ultimate goal of preventing subsequent ASCVD events.
Proof-of-concept studies are needed to determine:
1) the optimal age and/or extent of atherosclerosis for intervention and LDL-C–lowering therapy;
2) the intensity and duration of therapy for inducing atherosclerosis regression; and
3) documenting the normalization of vascular function. Ultimately, this new paradigm will need to be evaluated in ASCVD outcomes trials. 

(J Am Coll Cardiol 2014;63:2779–85) a 2014 by the American College of Cardiology Foundation

Saturday, November 1, 2014

Number Needed to Treat for Mediterranean diet

NNTT or number needed to treat before one person benefits from a strict Mediterranean diet after 5 years is 61.  Found on: