Oral anticoagulants…who needs ‘em?

Patients with atrial fibrillation do! According to a new study, hundreds of thousands of patients aren’t receiving them each year. Folks with AFib are at a very high risk for stroke, and guess what? Oral anticoagulants—a.k.a. blood thinners—can reduce the risk by two-thirds and direct oral anticoagulants (DOACs) are proven to be just as effective, if not more so. No, this isn’t a groundbreaking new therapy. Quite the opposite. DOACs have been available since 2010. 655,000 patients were evaluated in the study and the data show that over a seven-year period, only 6 out of 10 patients with high stroke risk were prescribed these potentially life-saving meds. This guy sums it up best.

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There’s no “good fat” when it comes to obesity

Is it possible to be simultaneously hefty and healthy? In a study presented at the European Congress of Obesity, researchers who scrutinized 20 years of electronic health records for 3.5 million people discovered that people who were overweight, but did not have any of the metabolic problems usually linked to excess weight, were more prone to develop metabolic problems. Compared to non-overweight individuals, “healthy obese people had a 50% higher risk of heart disease, a 7% higher risk of stroke, twice the risk of heart failure and a greater risk for peripheral artery disease.” The takeaway: physicians should encourage weight loss among obese patients irrespective of metabolic abnormalities.

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Diet…dementia?

Many say a healthy diet is the path to a healthy life, but one kind of diet might not be helping much. Diet sodas. While the consumption of their sugary counterparts does contribute to 184,000 deaths each year, using the diet alternatives to cut out sugar might not be the right call. The American Heart Association’s Journal published a study linking the artificially sweetened drinks to higher risks of stroke and dementia. Compared to never drinking diet sodas, those who had one a day were three times as likely to be diagnosed with dementia, and those who had one to six a week were 2.6 times as likely to experience an ischemic stroke. The lesson here… just stick to high quality H2O [Warning: stupid Adam Sandler GIF]

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5. Stop priming the proton pump

Which would be worse, your doctor demands you change your eating habits or prescribes a medication that increases your risk of stroke? For those still resisting lifestyle changes in favor of drugs, tune in to this: a popular category of heartburn medications called proton pump inhibitors (PPIs) has been linked to a 21% greater risk of stroke. A study of 245,000 patients who had an endoscopy showed that within 6 years of follow-up, 9,500 patients had their first ischemic stroke. Researchers controlled for other risk factors, investigated their medications and found patients on the highest dose of PPIs had a stroke risk from 30% for lansoprazole to 94% for pantoprazole. Add that to PPIs’ links to dementia and heart attacks and then reconsider fatty foods and large portion sizes.

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4. A stroke of technological genius

Otsuka and NEC are teaming up to create a medicine “bottle” to help increase medication compliance. Apparently the threat of a 2nd stroke isn’t incentive enough for many patients. About half wander off course from their medication regimen after about six months. The new bottle will flash an LED light when a dose is due and will alert a patient’s prescriber of non-compliance. Pletal, Otsuka’s clot-fighting drug that reduces the chance of a second stroke, is optimally effective when taken uninterrupted so there are potentially large health benefits from the technology. This is all well and good until some do-gooder applies the technology to beer bottles that tell your doctor how much you drink. We’re just sayin’ it’s a slippery slope. That’s all.

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