Rank #1: What to Know About the Latest Recommended Guidelines for High Blood Pressure in Adults
Guest: Robert Carey, MD, FAHA
Under the 2017 Hypertension Guidelines, 46 percent of U.S. adults have high blood pressure which is up from 32 percent under the old benchmark. This interview covers the key information physicians need to know from the new guidelines in order to improve blood pressure control rates.
Host Dr. Jennifer Caudle talks with Dr. Robert Carey, vice chair of the 2017 hypertension guidelines about the new recommendations and their impact on clinical practice.
The American Medical Association's M.A.P. framework and blood pressure improvement program is dedicated to helping health care providers improve blood pressure control in their adult patient populations, and a new AMA resource can help you succeed in Medicare’s Merit-Based Incentive Payment System (MIPS) while you manage and treat high blood pressure. This resource outlines the different measures that relate to hypertension management in each MIPS performance category, potential MIPS score results, and related AMA resources that can help you improve the health of your patients with hypertension while checking all your MIPS boxes along the way. Please click here to access the New AMA resource pairs BP quality improvement with MIPS
Jan 29 2018
Rank #2: Combination of Diet and Exercise Offers Benefits in Patients with a Common Type of Heart Failure
Among obese older patients with an increasingly common type of heart failure, calorie restriction and/or exercise training improved their ability to participate in physical activity without experiencing shortness of breath, according to a new study.
Heart failure with preserved ejection fraction (HFPEF) is the most rapidly increasing form of heart failure in the United States. Although the heart pumps normally, it does not fill with enough blood because the lower chamber of the heart is too stiff. More than eighty percent of patients with HFPEF are overweight or obese. Despite multiple studies, so far, no currently available medications have improved symptoms in patients with HFPEF.
Researchers from the Wake Forest School of Medicine randomly assigned 100 older obese participants with HFPEF to 20 weeks of diet, exercise, or both. They found that the exercise participants lost three percent of body weight, the diet group lost seven percent and the combined group lost ten percent of body weight. Patients in both the diet and exercise groups showed improvement in their ability to participate in exercise without significant symptoms.
Jan 26 2016
Rank #3: Caring for the Heart: Mayo Clinic and the Rise of Specialization
Dr. Bruce Fye's unique book, Caring for the Heart: Mayo Clinic and the Rise of Specialization, weaves together three important themes. It describes major developments in the diagnosis and treatment of heart disease in the twentieth century, explains how the Mayo Clinic evolved from a family practice in Minnesota into one of the world's leading medical centers, and reveals how the invention of new technologies and procedures promoted specialization among physicians and surgeons. Join Dr. John Russell in overviewing with Dr. Fye this pivotal epoch in American medical history.
Jun 22 2015
Rank #4: Treating Erectile Dysfunction: Key Cardiovascular Considerations
Live from the Clinical Lipid Update of the National Lipid Association in Amelia Island, FL, host Dr. Alan Brown welcomes Dr. Robert Kloner, Vice President of Translation at Huntington Medical Research Institutes and Professor of Medicine in the Cardiovascular Division of Keck School of Medicine at the University of Southern California.
Dr. Kloner discusses the cardiovascular risk factors associated with erectile dysfunction, safety and efficacy of erectile disfunction drugs, and benefits vs risks of supplementing with testosterone.
Oct 10 2016
Rank #5: Healing a Broken Heart: Depression Screening for Patients With Heart Disease
Host: Lauren Streicher, MD
Screening for depression is simple but can be life changing for a patient with heart disease. The American Heart Association is now recommending that all patients with cardiac issues be screened for depression, stress and anxiety. Dr. Kim Lebowitz joins host Dr. Lauren Streicher to discuss how doctors can recognize depression in their cardiac patients and what they can do to get them back on a healthy path both mentally and physically. The two also discuss the role of a cardiac psychologist in heart transplant patients both readying them for surgery and dealing with a new heart following their operation.
Oct 03 2008
Rank #6: New Medication for High Cholesterol Not Cost-Effective
The FDA recently approved a new class of cholesterol-lowering drugs called PCSK9 inhibitors. These new medications could substantially reduce heart attacks, strokes and cardiovascular deaths, however they are very expensive. A new study evaluated the cost-effectiveness of this therapy and how increased use might affect the U.S. healthcare system.
Researchers from the University of California San Francisco used a simulation model that included all U.S. adults 35 and older and evaluated outcomes such as expected numbers of deaths due to cardiovascular disease, heart attacks and strokes, and balanced this with the cost and potential benefits of these drugs.
With an estimated 9 million people eligible for this therapy and a price of $14,000 per patient per year, researchers estimated that total prescription drugs expenditures could increase by 40 percent. In order to be cost-effective, the PCSK9 inhibitor costs would have to come down to about $4,000 a year.
Aug 16 2016
Rank #7: How Statins May Protect Men's Urologic Health
Host: Lee Freedman, MD
Guest: Jennifer St. Sauver, PhD
Three recent observational studies from the Olmsted County Study of Urinary Health Status among Men, which is a cohort study of male residents of Olmsted County, Minnesota, have shown that statins may have a protective effect on prostate health. How might statins reduce the risk of prostate cancer, prostate enlargement and erectile dysfunction? Tune in to hear two of the study authors discuss this exciting new research: Dr. Jeffrey Karnes, assistant professor in urologic oncology, and Dr. Jennifer St. Sauver, assistant professor of epidemiology, both from the Mayo Clinic in Rochester, Minnesota. Dr. Lee Freedman hosts.
May 26 2009
Rank #8: PCSK9 Antibodies for Dyslipidemia: Efficacy, Safety, and Non-Lipid Effects
Live from the Clinical Lipid Update of the National Lipid Association in Amelia Island, FL, host Dr. Alan Brown welcomes Dr. Eugenia Gianos. Dr. Gianos is an assistant professor in the Department of Medicine and co-clinical director of the Center for the Prevention of Cardiovascular Disease at the NYU School of Medicine.
Dr. Gianos discusses the effectiveness, potential side effects, and patient outcomes with PCSK9 antibodies for management of dyslipidemia.
Sep 19 2016
Rank #9: Study Finds Survival After Cardiac Arrest Improves When More Patients Receive Bystander CPR and External Defibrillation
Out-of-hospital cardiac arrest is a major public health issue, accounting for approximately 200,000 deaths per year in the United States. A new study examined whether increased use of defibrillators and cardiopulmonary resuscitation (CPR) by first responders and bystanders could help increase survival for people who experience an out-of-hospital heart attack.
In recent years, statewide initiatives in North Carolina have encouraged improvement in the use of CPR and automated external defibrillators (AEDs) by training more members of the general public.
Bystander-initiated CPR was associated with a greater likelihood of survival with favorable neurologic outcome. The combination of bystander CPR and first responder defibrillation increased from 14 percent in 2010 to 23 percent in 2013. Results found, patients who received bystander or first responder interventions before arrival of the emergency medical services (EMS) were more likely to survive compared to those who received EMS intervention alone.
JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.
Sep 08 2015
Rank #10: Erectile Dysfunction: A Window Into Cardiovascular Health
Host: Larry Kaskel, MD
Are younger men with erectile dysfunction (ED) at considerably higher risk of heart disease, and if so, why? It is known that the condition can be an important predictor of coronary events, but with men under age fifty, it appears there is an interval between the onset of ED and the onset of heart trouble. Could this change our approach to treating younger men with ED, and perhaps delaying or preventing cardiovascular disease? Dr. Martin Miner, co-director of the Men's Health Center at Miriam Hospital in Providence, Rhode Island, explains how he would evaluate the younger patient who presents with erectile dysfunction in this conversation with host Dr. Larry Kaskel.
May 07 2009
Rank #11: The Clinically Broken Heart: Stress-Induced Cardiomyopathy
Guest: Scott Sharkey, MD
Takotsubo, or stress-induced cardiomyopathy (also known as 'broken heart syndrome'), was first recognized in Japan in the 1990s. Acute emotional or physical stress trigger the condition, which mimics the symptoms of a myocardial infarction (or MI). How can physicians differentiate between stress-induced cardiomyopathy and a more conventional MI, and how is stress-induced cardiomyopathy treated? What characteristics might make a patient more susceptible to developing this condition? Our guest is Dr. Scott Sharkey, senior consulting cardiologist at Minneapolis Heart Institute and director of the Takotsubo cardiomyopathy research program at the Minneapolis Heart Institute Foundation in Minnesota, shares some of the key diagnostic tests for differentiating between stress-induced cardiomyopathy and conventional MI. How common is this condition, and how can we limit the effects of stress-induced cardiomyopathy? Dr. Janet Wright hosts.
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Jul 15 2010
Rank #12: Device Reduces Risk of Brain Injury After Heart Valve Replacement
Patients who might benefit from a heart valve replacement but are too ill for open heart surgery can sometimes undergo a less invasive procedure known as transcatheter aortic valve implantation or "TAVI". About 10% of patients undergoing TAVI can experience small strokes and related brain injury as a complication. A new study found that the use of a cerebral protection device, which captures debris dislodged from blood vessels during the TAVI procedure, reduced the number and volume of brain lesions seen on MRI.
Researchers from the University of Leipzig Heart Center, Germany studied 100 patients with an average age of 80 who underwent TAVI. Half of the patients received the cerebral protection device and the other half did not. Patients underwent brain MRIs before the implantation and again at 2 and at 7 days after the procedure. The results found that using the filter device helped to decrease the number of brain lesions seen in the brain by about half.
Aug 09 2016
Rank #13: Shared Financial Incentives for Both Physicians and Patients Improved Cholesterol Levels
Financial incentives for physicians or patients are one way healthcare organizations are trying to improve health outcomes. A new study examined whether providing these financial incentives would help improve low-density lipoprotein cholesterol (LDL-C) in patients with a high-risk for cardiovascular disease.
Researchers from the University of Pennsylvania, Philadelphia studied 1,500 patients and 340 primary care physicians. Physicians were randomly assigned to one of four groups. One group solely focused on providing physicians with financial incentives, while another group focused on financially rewarding patients when they showed improvements in their cholesterol levels. A third group consisted of shared incentives for both physicians and patients, while the last group (a control group) did not receive any financial incentives.
Overall, shared financial incentives for both physicians and patients, but not incentives to physicians or patients alone, resulted in a significant reduction of LCL-C levels at 12 months.
Nov 10 2015
Rank #14: Bridging The Cardiology Gap: Care Priorities for Adults With Congenital Heart Disease
Guest: Yuli Kim, MD
Advancements in cardiac surgery and medical care for pediatric patients over the past decades have produced a sizeable population of adults living with congenital heart disease. These adults and their unique health care needs expose an emerging gap in expertise for the cardiology community, where training in congenital heart disease management has traditionally been the provence of pediatric subspecialists. How can these adult patients find cardiologists familiar with their particular anatomy and problems, and what special care strategies must cardiologists be familiar with to provide optimal care?
Dr. Jennifer Caudle will discuss the selective health care needs and personalized management strategies for adults with congenital heart disease with Dr. Yuli Kim, Medical Director of the Philadelphia Adult Congenital Heart Disease Center and Assistant Professor of Medicine & Pediatrics at the University of Pennsylvania and the Children's Hospital of Philadelphia.
Apr 25 2016
Rank #15: Cardiovascular Risk Reduction in the Elderly: Best Lipid Strategies
Guest: Joyce Ross, MSN, CRNP, CS, CLS, FNLA, FPCNA
Host Dr. Alan Brown welcomes Joyce Ross, MSN, CRNP, FNLA, President-Elect of the National Lipid Association. Joyce serves as a consultative education specialist in cardiovascular risk intervention with the University of Pennsylvania Health System. Their discussion focuses on lipid management to reduce atherosclerotic cardiovascular disease (ASCVD) risk in elderly patient populations. Thhis interview was recorded live at the National Lipid Association in San Diego, California for the 2016 Spring Clinical Lipid Update.
May 09 2016
Rank #16: Pharmacometabolomics to Predict Statin Response: Ready for Prime Time?
Live from the Clinical Lipid Update of the National Lipid Association in Amelia Island, FL, host Dr. Alan Brown welcomes Dr. Rhoda Cooper-DeHoff. Dr. Cooper-DeHoff is an Associate Professor in the Department of Pharmacotherapy and Translational Research and Division of Cardiovascular Medicine of the Colleges of Pharmacy and Medicine at the University of Florida. She is also Associate Director of the Center for Pharmacogenomics at this institution.
Dr. Cooper-DeHoff discusses the rise of pharmacometabolomics, genomic testing, and pharmacogenetic testing in lipidology, with particular emphasis on predictive mapping for statin responses.
Oct 03 2016
Rank #17: Pediatric Heart Transplantation: Ethical Questions
Host: Maurice Pickard, MD
Donation of the heart after asystole leads to questions about the point at which death is irreversible. Dr. Armand Antommaria, assistant professor in the division of pediatric inpatient medicine and an adjunct assistant professor in the division of medical ethics and humanities at the University of Utah School of Medicine, discusses the ways that pediatric cardiac transplant surgery may be pushing controversial organ-retrieval strategy beyond acceptable legal, moral, and ethical boundaries. Hosted by Dr. Maurice Pickard.
Sep 16 2008
Rank #18: Unclog the Arteries: Treatment Options for Arterial Disease
Guest: Grace Wang, MD, FACS
Unclogging patient arteries is a key step to preventing stroke in patients with arterial disease. Whether it be preventing the operative stage, or surgery itself, advances in treatment at Penn Medicine are seeking to lessen the effects of arterial disease.
Host Dr. Barry Mennen welcomes Dr. Grace Wang, vascular surgeon and Director of the Vascular Laboratory at the Hospital of the University of Pennsylvania. Dr. Wang highlights the importance of early detection in arterial disease, as well as the symptoms and risk factors of the disease. She will also discuss the current and upcoming surgical intervention options at Penn Medicine.
Jun 07 2017
Rank #19: Protective Hypothermia: Medical Ice Slurry Technology
Host: Larry Kaskel, MD
Dr. Ken Kasza, a senior mechanical engineer at Argonne National Laboratory, discusses with host Dr. Larry Kaskel how doctors can use medical ice slurry to reduce the brain and other organs' demand for oxygen, thus giving doctors additional time to diagnose and treat critical patients in emergencies. Dr. Kasza outlines the mechanisms underlying the ice slurry coolant and the developments for delivery technology, and reviews the amazing surgical applications completed with surgeons from the University of Chicago. Tune in to hear how the protective hypothermia effect of medical ice slurry is the future of medicine.
Dec 04 2008
Rank #20: Consciousness During Cardiac Death: A Window to Improving Brain Resuscitation?
Guest: Sam Parnia, MD, PhD
We are beginning to understand what happens when a patient in cardiac arrest, with no brain activity, later reports detailed perceptions, suggesting a high level of consciousness. What can we learn from the study of this phenomenon to help us improve resuscitation of the brain during cardiac arrest? What can it tell us about the experience of dying, and at what point consciousness ceases? Dr. Sam Parnia, a fellow in pulmonary and critical care medicine at Weill Cornell Medical Center in New York, and one of the world's leading experts on the scientific study of death, joins host Dr. Maurice Pickard to talk about his research project, AWARE (AWAreness during REsuscitation) at the University of Southampton School of Medicine in the United Kingdom, where Dr. Parnia is an honorary senior research fellow.
Nov 26 2008