Posts Tagged Cardiology

Maybe Salt’s OK For You

Posted by on Friday, 22 January, 2010

EVIL

Cardiology: Seasoning.

Well.

Here’s the thing. About 25% of you are “salt sensitive”. Which means, if you eat too much salt, you could be at risk for high blood pressure (like you always heard), as well as heart failure, kidney disease, diabetes, cataracts, strokes.. on and on.

As if you didn’t have enough to worry about.

How can you tell if you’re salt sensitive?

Not that easy. A clue: low birth weight kids are prone to it.

If you’re in that group (salt sensitive, that is), you really SHOULD steer clear. Keep it off the table and out of reach. Learn other ways to enjoy food.

Or try exercise.

I’m sure you remember from your running days that you can get sick if you don’t have ENOUGH salt. Good hard exercise (done often enough) chews up the salt and may very well ALLOW you to indulge a bit.

Not such a terrible compromise, is it?

SALT AND HIGH BLOOD PRESSURE

I knew you would ask.

See, keeping extra salt out of your diet is such a standard part of government guidelines, that it is now the orthodoxy. EVERYBODY knows it’s true.

“But,” you may ask, “if one in four of us is salt sensitive, don’t we bias the results of the studies that all this stuff is based on?”

You would think.

What about those of us who aren’t sensitive – the majority?

Dr. Richard Fogoros, from the University of Pittsburgh, talks about the “Salt Wars” and concludes, conservatively, that you should “sell your salt shaker”.

Just in case.

MISTER ScienceAintSoBad, doesn’t want to lead you astray, but, given that most of us AREN’T salt sensitive, maybe a little common sense, based on your own medical history, your known inherited risk factors, and the advice of your Doc might give you license to “shake it”.

Just a little.

Anyway, all this stuff is a reminder that science is great ‘n all. But it doesn’t always lead us to clear answers.

The salt and pepper shaker image is from:


A Lifeline For Heart Failure

Posted by on Wednesday, 2 December, 2009
Heart Failure. Not The End Of The World

Heart Failure Isn't The End Of The World

Image based on a model from Google 3D Warehouse by www.pradodesign.com

Cardiology: Breakthrough Getting Noticed. Slowly.

This is a big deal. A big, big deal. But it’s early days.

Congestive heart failure’s ANOTHER disease you don’t want.

There are many.

You REALLY don’t want to struggle, weak and breathless all your days, till, eventually, nauseous, and coughing, you expire.

I’m right, aren’t I?

About half of CHF patients are gone within 5 years,

So I was VERY happy to run across a snippet of information about an obscure instrument that’s giving cardiologists the information that they need to change things.

Maybe.

Ah science. Always a maybe.

Still. This is the kind of thing a blogger like me LOVES to find. It’s so important and so little known that it’s practically a scoop!

Listen to this.

“In a previous study of 43 patients with the BVA-100, heart failure patients who were treated to a normal blood volume showed a 100% survival rate over a two-year period, in contrast to patients who remained volume overloaded – who showed only a 45% survival rate.” That’s from a statement by Daxor, the maker of the instrument.

GradnpaGeorge

Heart Failure Patient

In other words, you use this piece of equipment, figure out what the patient’s blood volume is,  if it isn’t normal, you do stuff to the patient till it’s OK again and, instead of most patients dying, everybody lives.

Does this make sense? Is the company spinning?

I talked to Stephen Feldschuh, the Chief Operating Officer (and a cousin of the actress Tova Feldschuh ).

I asked him about this “previous study” and how all this ties together. (If you’re following closely, the “study” is a paper published in the American Journal of Cardiology .  That link won’t do you much good unless you’re a medical pro. Here’s one by one of the authors that’s a LITTLE more accessible.)

According to Feldschuh, When the Docs “used their traditional measures to guess the volume status of the patient vs. using the BVA-100 to measure the volume status…the Dr’s were correct only 51% of the time.”

He said that “The most important part of the paper was to look at the mortality rates for these patients.  They were split into two groups (group one was patients who were hyper-volumic and the second group were patients who were normal or hypo-volemic).  They followed these patients for two years and extrapolated the third year…and what they found was that the normal/hypo group had 100% survival…while the Hyper group had a 39% death rate at year one and a 55% cumulative death rate by year two.”

The conclusion? The way you can sort out if a patient’s developing heart failure should be based on blood volume. Docs who think they’re going to pick it up on the physical exam by looking at swollen tissues (peripheral edema), venous pressure, or fluid around organs (ascites) are kidding themselves; a physical exam isn’t reliable for this stuff and may lead to the wrong people being treated.

And how do you get the blood volume?

Not easily. Which is probably why physicians have tended to shy away from doing so. It’s a long, tedious test which is considered inappropriate for many patients.

Which is where Daxor’s instrument comes in. It automates the test and shortens it to a tolerable one and half hours.

Which makes it practical. Which makes those near-perfect survival numbers within reach.

So why is MISTER ScienceAintSoBad still twitchy? Cause this IS science. And a single study, no mater how provocative, needs to be replicated by others.

I asked Mister Feldschuh when we would see more data.

“The follow up to this study is starting now (It is called TEAM HF) and the goal for this study is to do blood volume on these patients, determine who is in the hyper group and treat them down to normal status and see how they respond…this will be contrasted against a control group who will be measured to determine that they are hyper but their physician will not have the benefit of the knowledge of a measured blood volume to guide their therapy…the doctor will just have to use his current traditional guidelines to treat the patient.”

And the future for this technology?

“As the existence of the test becomes more wide spread I think it will reach critical mass and make ‘standard of care’.”

ScienceAintSoBadRating = 9

FULL DISCLOSURE: By the time you read this, MISTER ScienceAintSoBad may have bought a few shares in this publicly traded company.
Think what you will! :)

(attribution for photo of patient: http://www.flickr.com/photos/flickerbulb/ / CC BY-SA 2.0 )