What are the benefits of combining ezetimibe and atorvastatin for lowering cholesterol?

Combining ezetimibe and atorvastatin can provide a more effective approach for lowering cholesterol in patients who have not achieved their target LDL cholesterol level on a statin alone. Statins are a commonly prescribed cholesterol-lowering medication that works by blocking a key enzyme in the liver that produces cholesterol. However, some patients may not respond well to statins or may not achieve their target LDL cholesterol level.

Ezetimibe, on the other hand, works by inhibiting cholesterol absorption in the small intestine, which can complement the cholesterol-lowering effects of statins. When used in combination with atorvastatin, ezetimibe can further reduce LDL cholesterol levels in patients who may not respond well to a statin alone.

Studies have shown that combining ezetimibe and atorvastatin can lead to a 15-20% reduction in LDL cholesterol levels beyond what can be achieved with atorvastatin alone. This combination therapy has also been shown to be safe and well-tolerated in clinical trials.

Furthermore, the combination of ezetimibe and atorvastatin may offer additional benefits to patients with cardiovascular disease. In a clinical trial, the combination therapy was associated with a reduced risk of major cardiovascular events, such as heart attack or stroke, compared to atorvastatin alone.

Overall, combining ezetimibe and atorvastatin can provide a more comprehensive approach for lowering LDL cholesterol levels and reducing cardiovascular risk in patients who may not achieve their goal on a statin alone. However, it is important to consult with a healthcare provider to determine the most appropriate cholesterol-lowering therapy for individual patients based on their medical history and risk factors.


Heart attack causes more deaths in women than men

Lisbon : A study has found that women have twice the rate of heart attack death than men.

In a study of 884 men and women in Portugal, researchers found that women’s chances of survival due to heart attack were reduced.

All of them were hospitalized for the most dangerous type of heart attack (in which the vein that supplies blood to the heart closes).

To open the closed vein, all the patients underwent angioplasty and a stent was inserted so that blood could circulate easily. Angioplasty was performed on these patients within 48 hours of the onset of symptoms and research was started to know the mortality rate in these patients.

The results of the study, presented at the European Society of Cardiology’s Scientific Congress Heart Failure 2023, showed that the number of women dying within 30 years after this medical condition occurred was 2.8 times higher.

On this occasion, 11.8 women died, while the death rate of men was 4.6 percent.

Women are at higher risk of dying from heart attacks because they have a heart attack when they are older than men and are generally in poor health.

Dr Mariana Martinho, lead author of the study, said that women of all ages who are affected by a heart attack are at a higher risk of deteriorating health.

He said that these women need to strictly control blood pressure, cholesterol and diabetes after suffering from this medical condition.

Heart disease increases in people with kidney disease

A recent long-term study has shown that people with various kidney diseases or complications are more likely to develop heart disease, which becomes very severe in some people.

Several previous studies have also shown that kidney diseases are closely related to heart diseases, while they also increase the chances of serious diseases such as stroke.

In this regard, experts from Boston, Massachusetts, studied 600 people with kidney disease and reviewed their health again after about six years.

According to the medical journal ‘JAMA’, experts took kidney samples of 600 people and studied them in the laboratory and detected their disease.

After five and a half years, experts reviewed the health of all the volunteers again, which showed that 126 people suffered from serious diseases like heart disease, stroke, heart attack and heart failure and some of them also lost their lives.

All of the people who were part of the study were middle-aged and none of them were minors.

According to experts, the people whose kidney samples were taken were specifically diagnosed with two kidney diseases.

Most of these people were found to have garbage collection in the kidneys, while others were found to have problems like blocking blood transmission due to swelling in the kidneys.

According to experts, the causes of kidney waste can be many, but the problem is usually common in people with diabetes, while the problem of swelling in the kidneys and not having proper delivery of con there is associated with blood pressure, but there may be other reasons.

Similarly, experts said that other kidney diseases or complications can also cause serious diseases like heart disease and stroke, but the chances of people suffering from these two diseases increase

Cardiac ablation is the most effective treatment for arrhythmias.

Ablation is an invasive procedure that is done on the heart to treat irregular heartbeats. This is a serious procedure, and sometimes, but not often, problems can happen after it. Ablation is the best way to treat arrhythmias because it works up to 80% of the time.

Cardiac arrhythmias, also called arrhythmias, are problems for patients and can be life-threatening in some cases. Arrhythmias cause problems for several hundred thousand people in Poland. Arrhythmias can be treated in a number of ways, but ablation is the most effective. What is ablation, who can get it, and what are the reasons it shouldn’t be done?

What is ablation, and what is the procedure?

Ablation is a percutaneous procedure that eliminates or isolates places in the heart that are responsible for heart disorders. It involves entering the heart through veins and arteries with a catheter, looking for places responsible for arrhythmia, and heating or freezing them. A qualified electrophysiologist can see the places that cause and sustain the arrhythmia and heat or freeze them, forming a scar to prevent electrical conduction. This prevents arrhythmias from occurring.

What are the indications for ablation?

The most common sustained arrhythmia is atrial fibrillation. Other arrhythmias that qualify for ablation include Wolff-Parkinson-White (WPW) syndrome, nodal tachycardia, atrial flutter, and ventricular arrhythmias. All of these arrhythmias should be treated with ablation according to European and Polish guidelines.

Not everyone can take advantage of this treatment option

For example, we can’t do ablation on a person with atrial fibrillation who weighs 150 kg, has sleep apnea, and has a blood pressure of 200/100. Then, it doesn’t make sense to do such a thing because the risks are worse than the benefits. There are also medical reasons why it shouldn’t be done, like if there is a thrombus in the heart. If we “scratch” it with an electrode, we will cause a stroke. There are a lot of patients whose underlying disease can be fixed, and they should work on that first. After that, we should do ablation.

How effective is ablation compared to other methods?

Treatment of atrial fibrillation with drugs is most often ineffective – 15, 20, 30% – this is assessed differently in studies. Either way, pharmacotherapy will not improve the patient’s situation as we would like. The effectiveness of ablation is much higher, reaching 70-80% .

Does the ablation procedure need to be repeated?

Each arrhythmia must be treated in a different way, because, in some cases, the treatment is nearly 100% effective and in others, it is only 60–70% effective. In one case, ablation only needs to be done once, but in another, it needs to be done more than once as the disease gets worse over time. It has its own style.

Ablation is considered a safe procedure. Can it cause complications?

Different things can go wrong. I always tell my patients that this is a problem that could lead to death. It is, after all, a surgery on the heart. How complicated a procedure is depends on what kind it is, when it is done, and who does it. It depends on how healthy the person is in general. Less than 1% of young, healthy people who have WPW ablation are at risk. If this is an 80-year-old man who was hurt in an electrical storm and is on a ventilator, sedated, limping, and in the ICU, the risk is very, very high. In general, only 4% of all complications are mentioned in large registries. It can cause death, a hole in the heart from an electrode, or a stroke, but these things don’t happen often because we know how to stop them.

Ablation is a major operation that reduces the risk of cardiac surgery by controlling the pressure of the electrode. Blood thinners are used to keep patients from having a stroke during surgery, which happens rarely.

Heart arrhythmias: how to recognize them?

The heart is a very important part of the body. His work makes it possible for the heart to pump blood all over the body. When the heart is healthy, it beats in a steady, calm way. When you sleep, your heart rate slows down, and when you work out, it speeds up. The heart never stops working, so over time and in response to a bad way of life, it may start to work less well.

Cardiac arrhythmias, also called arrhythmias, are one of the most common heart problems. The heart muscle contracts in a way that isn’t normal, and the heart rate is higher than the normal range of 60 to 100 beats per minute. A slow heart rate of less than 60 beats per minute is called bradycardia, and a fast heart rate of more than 100 beats per minute is called tachycardia.

Causes of arrhythmias

You should know that the nervous system controls the normal rhythm of the heart, and the sinus node is the “stimulator.” Normal heart rate values mean that it is working as it should. An abnormal heart rhythm may result from the node’s improper work or from other conduction pathways stimulating the heart. Arrhythmia can be caused by:

  • excessive stress (due to excess adrenaline)
  • hormonal disorders (thyroid)
  • the effects of drugs
  • alcohol consumption
  • taking drugs
  • excessive coffee consumption
  • steroids

Symptoms of bradycardia

  • weakness
  • dizziness
  • risk of fainting
  • loss of consciousness
  • risk of cardiac arrest

Symptoms of tachycardia

  • palpitation feeling
  • “anxiety” in the chest
  • “feel” the heartbeat
  • “heaviness” in the chest
  • possible dizziness and fainting

The doctor can tell if you have either of these conditions by listening to your heart with a stethoscope and looking at the results of an electrocardiogram (ECG). Other tests, like thyroid hormones, an exercise test, and Holter monitoring of the heart rhythm (24/7), are also done if they are needed. Both arrhythmias need very different kinds of care. When a person is awake and has bradycardia with less than 50 beats per minute, a pacemaker may be put in. But if you have tachycardia, you should treat what’s causing it and also take drugs that slow the heart’s work that a cardiologist gives you. In some cases, electrotherapy is also used, such as cardioversion or cardiostimulation, and sometimes ablation, which means destroying the spot where the heart muscle needs more stimulation.

Remember, each untreated arrhythmia increases the risk of cardiac arrest! Therefore, when we experience disturbing symptoms, we should consult a doctor as soon as possible!

Excessive consumption of red meat can lead to heart disease

If you enjoy eating red meat, you may get life-threatening heart disease.

A medical investigation conducted in the United States revealed this.

The Cleveland Clinic study discovered that red meat’s fat and cholesterol are bad for the arteries of the heart, but bacteria in the stomach also have a role.
The study found a link between bacteria in the stomach and a chemical called TMAO, which raises the risk of heart attack and stroke in persons who consume a lot of red meat.

Read more at Blogger’s Zone

Increase of sleep problems may increase chances of stroke, says study

Galway: A study has revealed that an increase in sleep problems can increase your chances of suffering from paralysis.

According to a new study, snoring, loud breathing from the nostrils, sleeping more during the day, waking up at night or getting less or too much sleep can worsen sleep quality and increase the risk of stroke.

According to Christine McCarthy, the author of the study from the University of Galway in Ireland, people who have more than five of these symptoms may have a five-fold increased risk of suffering from stroke than those who do not have sleep problems.

Kristen Natson, associate professor at Northwestern University’s Feinberg School of Medicine in Chicago, who was not part of the study, said the findings were consistent with past research that found a link between inadequate sleep and elevated blood pressure and blood vessel dysfunction, which are considered to be factors for stroke.

The study, published Wednesday in the journal Neurology, looked at data from more than 4,500 participants in the Interstroke study. The international study was based on people who have suffered from stroke.

About 1,800 people involved in the study had the most common type of stroke in which the veins going to the brain are closed. Another 439 people had a hemorrhage in which the veins or arteries of the brain burst and as a result, blood flowed to the brain tissues.

According to Dr. Phyllis Xie of Northwestern University’s Feinberg School of Medicine (who was also not part of the study), poor sleep can affect natural blood pressure (which occurs at night) and play a role in hypertension (which is a dangerous factor for stroke and cardiovascular disease).

ECG of the heart: indications and the course of the examination

Electrocardiography, also known as an ECG, is a test that measures the electrical activity of the heart muscle and is used to diagnose heart disease. Under the National Health Fund, heart ECGs are performed gratis. The patient won’t experience any pain from the test. Pregnant women can have them done.

Indications for ECG of the heart

Every two years, people over 40 should have a heart ECG. This makes it possible to identify potential circulatory system changes as soon as possible. 

  • palpitations ,
  • hypertension ,
  • pain in the chest,
  • fainting, 
  • weakness and feeling tired.

A heart ECG is also performed in patients who are at high risk of heart disease (family history, diseases accompanying heart problems) and in people: 

  • with a diagnosed disease of the circulatory and heart system, 
  • with suspected heart disease, 
  • having a pacemaker .

How to prepare for a heart ECG?

You don’t need to prepare for a heart ECG test because it is a safe procedure. The patient does not have to be on a fasting regimen. You must, however, keep in mind a few guidelines. You shouldn’t: the day of the exam and the day before it.

  • consume alcohol, cold drinks and coffee, 
  • engage in strong physical exertion, 
  • eat large meals. 

Additionally, refrain from smoking two hours before the heart’s ECG. Patients with thick chest hair should shave to make an examination easier.

Heart ECG – waveform

The patient should take off all jewellery and things made of metal. He is then instructed to partially undress. The patient is lying flat during the examination. Each limb has an electrode that resembles a paperclip. A heart ECG typically lasts 5 to 10 minutes. A cardiologist should interpret the ECG results and, if additional testing is required, will order it.

Symptoms of a heart attack in women

Women’s symptoms of a heart attack differ from men’s. Anxiety, fatigue, shortness of breath, and cold sweats are all possible side effects. Symptoms can be confused with the flu or acid reflux.

Acute myocardial infarction is the leading cause of death in women all over the world. It can affect not only older women, but also young women under the age of 55. Although it is stated that heart attack symptoms are less common in women than in men, many scientific sources indicate that chest pain is equally characteristic and common in both sexes. What distinguishes the female sex is that during a heart attack, women are more likely than men to develop atypical symptoms (and there are more of them) as well as prodromal symptoms.

What are the symptoms of a heart attack in women?

The symptoms of a heart attack may resemble those of other heart diseases, such as advanced coronary artery disease  or pre-infarction. Be vigilant if you notice even one of the following ailments:

  • burning or pressure in the so-calledin the well – may resemble heartburn, but does not improve with antacids, there may also be pain in the center of the chest ,
  • sudden muscle pain – may be accompanied by inertia of the hands, pain may be in one or both arms, back, neck or jaw,
  • shortness of breath – breathing is accelerated, shallow and it is not due to intense effort or severe stress (and even if it does, it does not subside under the influence of rest and relaxation),
  • extreme fatigue  – perceived as a sudden general weakness (which can lead to fainting ),
  • other symptoms such as: nausea and even vomiting, dizziness, cold sweats .

The most common symptom of a heart attack, regardless of gender, is chest pain or discomfort. Women, on the other hand, are more likely to report unusual heart attack symptoms such as jaw or back pain, shortness of breath, and nausea. So, they might get the wrong diagnosis or not connect their symptoms to a heart attack. 

Early warning signs of a heart attack in women

Symptoms that occur during a heart attack are one thing, but doctors also look for prodromal symptoms that appear before the disease. Dr. Jean C. McSweeney led a team of scientists from the University of Arkansas for Medical Sciences who looked into the significance of early warning signs. The following are the main warning signs that appear in women up to a month before the onset of a heart attack:

  • unusual, severe tiredness (the most common symptom)
  • sleep disorders,
  • dyspnoea,
  • chest discomfort.

Chest discomfort was present in almost 30% of women a few weeks before the infarction.

First aid for a heart attack in women

Even doctors have difficulty diagnosing a heart attack quickly. As a result, don’t try to diagnose yourself and don’t underestimate the problem. Call an ambulance if you are experiencing symptoms of a heart attack. If you suspect someone is having a heart attack, you should administer first aid before calling an ambulance:

  • when the patient is conscious, put him in a semi-sitting position,
  • loosen your clothes, open a window to let in some air,
  • when the patient is unconscious, put him in the lateral position,
  • control the patient’s pulse and breathing – if the heart stops working, start cardiopulmonary resuscitation.

In recent years, there has been an increase in cases of acute myocardial ischemia at a young age, which is caused by diseases such as diabetes or obesity, as well as excessive stress. That is why it is important to learn how to recognise a heart attack. The earlier it is diagnosed, the better the prognosis.

Coronary angiography can save your life. What is worth knowing about the procedure?

Coronary angiography is a test of the heart to see if the coronary arteries are open, which can cause a heart attack. It also allows for the widening of the artery with a special stent. The risk of problems after coronary angiography doesn’t go above 2%

Coronary angiography is a diagnostic test that gives a thorough look at the arteries that bring blood to the heart muscle. It involves the insertion of a catheter through the peripheral artery into the coronary arteries, contrast is given, and films are recorded using X-rays to show the condition of the vessels being examined.

Indications for coronary angiography

A doctor may order coronary angiography as a preventative measure or as a life-saving procedure. In the following circumstances, the doctor might recommend coronary angiography:

  • coronary artery disease (e.g. the appearance of angina pectoris , i.e. chest pain that worsens after exercise),
  • heart attack,
  • worsening of the symptoms of coronary artery disease, 
  • pre-infarction state ,
  • aortic aneurysm,
  • heart failure,
  • planned cardiac surgery,
  • inflammatory disease of the coronary vessels,
  • valve defects,
  • high cholesterol (check: cholesterol age norms ),
  • chest injury.

Coronary angiography after myocardial infarction

Coronary angiography is a life-saving procedure in the event of a heart attack due to coronary artery stenosis, and is done urgently when the patient’s life is in danger.

How is coronary angiography performed?

Coronary angiography is done in a hospital treatment room in the hemodynamics lab, which has an X-ray machine and devices that monitor the heart’s work. Coronary angiography can take anywhere from 30 minutes to 1.5 hours in more difficult cases.

The patient lies flat on the treatment table during the procedure. The doctor injects local anaesthesia into the artery on the wrist (or, less frequently, the femoral in the groyne), then inserts a cannula and gently inserts a catheter (a soft, hollow tube) into the artery, directing it towards the heart. The catheter is visible on the monitor screen at all times thanks to the x-ray. Then, a contrast agent is injected into one of the arteries, and the procedure is documented on film (angiogram). It depicts the flow of blood in the heart’s vessels as well as any narrowing or defects in the artery structure. The doctor gently removes the catheter after the examination. He applies a compression bandage. An ECG and blood pressure are used to monitor the heart’s function during the procedure.

Placement of stents during coronary angiography

When a coronary angiography shows that the artery is not completely open and may soon be completely blocked, the doctor does a procedure called angioplasty. He puts a stent in the blood vessel. A stent is a small “spring” made of a modern metal that is safe for the body. It is put in through the catheter. As it moves through the arteries to the site of stenosis, it is compressed as much as possible. Only at the site of stenosis is it properly unfolded, creating a tunnel that supports the vessel walls so that blood can flow freely. This framework keeps them from “sticking together.”

Coronary angiography: preparation for the procedure

If the procedure is done because someone’s life is in danger, no special preparations are made (medication is administered just before the procedure). When a coronary angiography is planned, the doctor suggests getting a hepatitis B shot (hepatitis B). Some medicines need to be stopped as well. There are also tests for creatinine, urinalysis, and a full blood count, as well as any other lab tests that are needed.

You should eat a light breakfast and drink a little more water than usual in the morning before your coronary angiography. If you drink enough water, it’s easier to get rid of the contrast in your urine after the procedure. Before the actual coronary angiography, the patient needs to be cleaned, given a venflon covering, and have the hair at the puncture site shaved.

Coronary angiography: recommendations after the procedure

After a coronary angiography, the doctor may tell you to drink 1.5 litres of still water to get the contrast out of your body faster. After the femoral artery exam, you should lie flat on your back for a few hours to let the artery that was punctured heal. Most of the time, the procedure needs a few days in the hospital. If a stent was put in during coronary angiography, the patient must take medicine for several months to prevent blood clots and stent rejection.

Complications of coronary angiography

Studies show that the risk of problems after coronary angiography doesn’t go above 2%. Coronary angiography is a risky procedure because it involves cutting into the body (any procedure during which tissue continuity is interrupted is an invasive procedure). During the procedure, a cardiologist or surgeon keeps an eye on the patient at all times. People who are older or have other diseases, like diabetes or kidney failure, are more likely to have problems after a coronary angiography.

Possible complications of coronary angiography:

  • harmless: external bleeding or hematoma (bruise) where the artery was punctured
  • life-threatening: temporary or permanent kidney disorders, stroke, sudden cardiac arrest, severe bleeding at the puncture site.
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