Cardio Buzz

Top 7 Cardiology Breakthroughs from ESC Amsterdam 2023

Welcome to ESC this year from Amsterdam, the city known of charming canals, cycling, and attractive architecture. There were 5 new guidelines, tens of session and 30 late-breaking clinical trials. In this episode, I've handpicked just seven trials. The choice was made based on the importance of the topics, the ability of the results to shake up the practice and challenge some cardiology dogmas.
Some of the trials were positive, others were negative, but we learn in both cases. I'll be presenting the trials in ascending order of importance, saving the most impactful one for last. Here we go...

الأسبرين بعد الأربعين

هل يجب أن نتناول الأسبرين بعد سن الأربعين لمنع النوبات القلبية والسكتات الدماغية أم لا؟
هل هو مفيد أم مضر؟

القلب وهُرمون الذكورة

تستوستيرون هو هرمون الذكورة الذي يمنح الرجال القوة والدافع والعزيمة لتحقيق الأهداف. انخفاض مستويات التستوستيرون يؤدي الى فتور الرغبة الجنسية وضعف الانتصاب والإرهاق وضعف العضلات والاكتئاب والدوار وانخفاض كثافة العظام.  هل يؤثر ذلك على صحة القلب؟ ماذا يحدث إذا قمنا بتصحيح نقص التستوستيرون باستخدام التستوستيرون الخارجي؟ هل سيؤذي القلب أم يشفيه؟ ماذا تخبرنا أحدث الأبحاث عن تعويض التستوستيرون وتأثيره على القلب؟

A Breakthrough Treatment for High Blood Pressure

Hypertension affects one third of humans. Untreated hypertension, shortens life expectancy by five years because it's a major cause of heart failure, renal failure, strokes, and coronary disease. The mortality due to hypertension has increased  more than 30% in the last three decades. And the sad fact is that hypertension is uncontrolled in the majority of hypertensive patients, but it seems there's a breakthrough treatment.
Angiotensinogen is a protein, it's mainly produced by the liver. If we stop the production of Angiotensinogen in the liver, then the whole. Renin angiotensin system will be silenced. And we have the results of the study on DNA silencing available. 

Testosterone! Mens’ health and Hearts’ Health...

Testosterone is the primal essence of manhood. Testosterone is the gift that gives men the strength, the drive, and the resolve to achieve goals. It's part of what makes man a man. 
 But what happens when testosterone levels drop? Does that affect the heart's health? What happens if we correct testosterone deficiency with exogenous testosterone? Will it damage the heart or heal it?  What does the latest research on testosterone replacement tell us? 

Is cholesterol really the devil?

What is the difference between cholesterol and LDL cholesterol? 
What evidence do we have that link cholesterol and heart disease?
How convincing is that evidence?
Is it a myth created by the drug industry or is it a fact backed by science?
Let's answer all of these questions in this episode

The Science Behind… How do we know the cause of a disease

 I've got several questions and comments all related to the cause of atherosclerosis. Most of the questions and comments were skeptical and  doubting the causal effect of cholesterol atherosclerosis. In this episode we elaborate more on how modern science arrives at conclusions on the cause of diseases, especially chronic degenerative diseases like atherosclerosis.

Is vaping safe for the heart?

Vaping, or electronic cigarette use, is becoming increasingly popular, especially among youth and young adults. While it is perceived as safer than tobacco cigarettes, the exact composition of the liquids used in e-cigarettes is not publicly known, making it difficult to predict the health effects. E-cigarette contents include nicotine, flavors, chemical additives, and a solvent. Studies have shown that vaping can have negative effects on cardiovascular health, such as higher arterial stiffness, impaired endothelial function, and increased blood pressure. However, clinical studies were inconclusive, and long-term trials were not available. It is also unclear if e-cigarettes can be effectively used for smoking cessation. We reviewed the contents of the vape, the latest literature, and the statement from the American heart association on electronic cigarettes, and here are the facts.

Lipoprotein a

Lipoprotein a is a molecule produced by the liver, similar to LDL in structure, with a peculiar protein that gives it wide variability.Elevated lipoprotein little (a) is causal of atherosclerotic disease, recurrent strokes, and aortic calcification. Smaller forms of LPa are riskier. LPa is not a risk factor for venous thromboembolismThe levels are determined genetically with minimal impact from lifestyle.Normal values are 125 nmol/L)Levels should not be converted from mg to mmol or vice versaLevels should be measured once in the lifetimeThe excess risk of LPa elevation can be mitigated by additional LDL lowering and tighter CV risk factor control.PCSK9i(s) reduces the levels by 25%, but they are not approved for this indication.Aspirin may be beneficial as primary prevention in individuals with genetic variants that elevate LPa.Specific therapies are being developed to lower LPA by >70% and may be released three years from now.

Sleep For Your Heart

Sleep is the single most effective way to reset our brain and body health each day. Sleep is a foundational element of human biology and is a requirement for life. We spend roughly one-third of our lives asleep. A famous quote is, “Happiness is nothing more than getting enough sleep”. Sleep disturbance is a common condition in modern society, with evidence showing that people sleep on average 1.5 hr less than a century ago. one-third of the general population suffers from sleep-related problemsAnd now, we better understand the relationship between poor sleep and poor health, especially cardiovascular health. Just a couple of months ago, the American heart association added Sleep to the essential pillars of cardiovascular health.And in this episode, we will discuss sleep and heart health, what is good sleep, what is bad sleep, what’s the risk of poor sleep, and we will end up with some advice on how to improve your sleep for a stronger heart. First, is there a relationship between the number of hours slept and CV health?Yes, we have clear data on this relationshipSleeping for less than six hours is associated with a 70% increase in mortality Sleeping 5 hr or less per night had a 2.3-fold greater risk of AMISleeping for less than four hours is associated with a 2.8 times increase in mortality Sleeping for nine hours or more was also associated with a 70% increase in mortality The ideal duration of sleep is between seven hours and eight hours because this has been associated with the best survival.During normal, healthy sleep, blood pressure drops by around 10-20%. This is known as nocturnal dipping, and research highlights its role in cardiovascular health. When we sleep, the blood pressure comes down, and the heart rate also goes down. This helps to unload the circulatory system and give rest to the heart. Poor sleep, whether from a lack of sleep or sleep disruptions, is associated with non-dipping, meaning that a person’s blood pressure doesn’t go down at night. Studies have found that elevated nighttime blood pressure is related to overall hypertension (high blood pressure). Not only hypertension but sleep disruption is also associated with an increased risk of diabetes, coronary atherosclerosis, and myocardial infarction. Add to that obesity risk; we can remember that we are more likely to feel hungry when we don’t get enough sleep. All these conditions are increased with sleeping less than six hours or with sleeping more than nine hours. It is a U-shaped relation.We've understood the impact of sleep quantity on health, but what is the impact of poor sleep quality on health?We also know that difficulty falling asleep, nightmares, easily awakening from sleep, use of sleeping pills, and walking up tired are markers of poor sleep.Poor sleep quality was associated with subclinical cardiovascular disease and increased risk of cardiovascular disease. Sleep apnea, where there is airway obstruction resulting in loud snoring and apnea, is a well-established risk for resistant hypertension, heart failure, coronary disease, and atrial fibrillation.What’s the mechanism linking sleep and poor cardiometabolic health?There are several potential mechanisms. Data show that a lack of sleep may increase sympathetic nervous system activity the next day; sleep deprivation also results in an inflammatory state and in increased salt intake, elevated cortisol levels, and insulin resistance. These changes all culminate in poor cardiometabolic health resulting in a cascade or a package of cardiovascular diseases. How to improve your sleep?First: Identify your ideal sleep durationThe general rule is 7-8 hours of daily sleep. But because this may vary, you can measure your own needed sleep hours this way… Try to get into bed at the time where you fall asleep within about 15 minutes, and wake up without an alarm clock, feeling rested, and having enough energy to carry you through the day. On average, the amount of sleep you get this way is probably the right amount of sleep for you. The American heart association elected to add sleep duration as an eighth metric to the formal definition of CVH. Metric: Average hours of sleep per night Scoring:
Points Level 100 7–