ErinPharm Gazette June 2007
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This month is notable for the trend toward realising that lower LDL-cholesterol targets as well as raising HDL-cholesterol levels can combine to promote plaque regression. The ASTEROID study by Dr. Steven Nissen and his co-investigators is the first rigorous evidence that plaque in coronary arteries can be placed into regression when LDL-cholesterol and HDL-cholesterol levels change to lower and higher levels, respectively, to a point where regression and mg/dL numbers can now be related. This is the beginning since future studies should aim at a greater rate of regression. However it is the promise that should give encouragement to all those at high risk and those with an atherosclerotic burden. In reading these pages I hope you appreciate that as more aggressive statin treatments emerge it is even more vitally necessary
to add co-enzyme Q10 and omega-3 fish oils to a statin regimen as well as adopting a healthy nutritious diet and exercise program.
Progress is being made on making sure that all Americans get rapid access to an accredited treatment center in the event of a heart attack or stroke while new treatment protocols for minor stroke should be immediately implemented.
The work of Sirtris in seeking methods of upregulating sirtuin genes and so extending healthy longevity is in a sobering contrast to what we look forward to in the world health situation as demonstrated by the World Health Organization and its broad programs to reach out to all humankind.
This web page is one of a number of ErinPharm web pages designed by me as a synopsis of topics that interest me. I have no affiliation of any kind to any pharmaceutical company or medical group. The opinions expressed are my own. I welcome communication and debate. I am an optimist. I look forward to the future with wonder.
The Life Extension Foundation
Keep up to date with advances in the prevention, diagnosis, and treatment of colorectal cancer.
Advances in lung cancer therapies are moving ahead. Keep up to date.
Are you trying to lose weight and have been misled by the multi-billion dollar industry selling pills, potions, and 'magic cures'? You are not alone. A survey backed by a commercial drug company reports that approximately 70% of American dieters have tried scientifically unproven methods to lose weight. That's an astounding number of people who have tried dietary supplements in the form of pills and powders. About half of survey respondents incorrectly think supplements are approved by the federal Food and Drug Administration, while about two-thirds believe such products must carry warning labels for side effects. All that happens is maybe temporary loss of weight and the emptying of your pocket. Resist the temptation to believe in those seductive commercials. The only way you can lose weight and keep it off is by a commitment to a change in lifestyle. I recommend lifestyle changes.
The American Cancer Society is your main source of information in the ongoing battle against cancer.
A stage in statin trials has now been reached in which serious medical discussion is directed toward the prospects of lowering LDL-cholesterol even further below present target ranges in order to get a greater decline in the incidence of cardiovascular disease. It is possible that almost all members of the population could benefit from LDL-cholesterol reduction therapy, that future target ranges could be for lower than 50 mg/dL of LDL-cholesterol, and that much lower target levels may become the focus of attention as more trial data accumulates. Discussion has begun on the variability and levels of particle sizes for the cholesterol transport proteins; beginning a more detailed and real look at the range of these proteins that we simplify into HDL, LDL, VLDL and triglycerides. This brings us to a new plateau in the elimination of heart attack, stroke, and peripheral artery disease. From Medscape
Although significant advances in the treatment of major stroke have reached the stage where now the focus is on a patient reaching an operating table within the 'three-hour' window after the event so that t-PA can be administered for effective treatment, there has not been a comparable attention to the management of minor stroke and TIA (transient ischemic attack). That now should change with the results of the EXPRESS study (Existing Preventive Strategies for Stroke). Principal investigator Dr. Peter Rothwell of the University of Oxford told attendees at the 16th European Stroke Conference In Glasgow, Scotland, that early aggressive treatment of patients with a first TIA resulted in a dramatic reduction of the incidence of a second stroke in the following 30 months even though a high proportion of patients were over 80 and even over 90 years of age. Dr. Rothwell described the study results as "astounding".to the point where all study data was carefully rechecked.
A meta-analysis of eight randomized controlled trials indicates that folic acid supplementation reduces the risk of a first stroke by 18%. This now adds to studies suggesting that folic acid supplementation can reduce the incidence of cerebrovascular disease while adding to the controversy over its utility in reducing cardiovascular disease.
Research teams headed by Dr. Shinya Yamanaka, Kyoto University, and Dr. Rudolf Jaenisch, from the Whitehead Institute of Biomedical Research in Cambridge, Massachusetts, have generated pluripotent stem cells from fibroblasts. They did so by introducing the genes for four transcription factors that are usually active only in embryonic cells. These cells closely resemble embryonic stem cells and their use to generate stem cell therapies would avoid the ethical issues surrounding stem cell research.
Dr. Melissa-Walton Shirley, co-director of the Kentucky Pilot Project for primary angioplasty, urges an urgent need to bring in programs to significantly decrease the time from event to angioplasty for patients with acute coronary syndrome. She points out that improved technologies make it possible for non-surgical hospitals to attain the ability to be within access to all patients with acute coronary syndrome and that such access should be a right, particularly since heart disease precipitates mortality more than any other diagnosis. (video editorial)
A research team headed by Dr. Katarina Kallio, University of Turku, Finland, report results of a study that children as young as 11 have developed endothelial dysfunction in response to secondhand smoke, in a dose-dependent manner, even when exposure is minimal. The effects were both striking and troubling, particularly because of the low levels of smoke to which the childeren were exposed.
An interesting video and slides explanation of the evidence that rApo-A1 Milano HDL begins to reduce plaque and associated inflammation within 24 hours of administration. The seminal discovery of this HDL variant in a family grouping in Italy was the beginning of research aimed at increasing HDL -cholesterol levels by therapeutic means as well as demonstrating that arterial plaque can be placed into regression and rapid regression is possible when an appropriate therapy is developed..
Men newly diagnosed with prostate cancer have a wide array of options and considerations when deciding whether they chose surgery, external beam radiation, or brachytherapy. The decision making process, taking into account cure rates and quality-of-life implications, should be thoroughly discussed with the patient's physician.
A recent description of the benefits and protective effects of Vitamin D3 was in a daily bulletin from the Life Extension Foundation (get your own free bulletins from LEF with the logo at the top of this page) in the June 29 issue. Researchers point out that many people do not get enough Vitamin D3 from diet and/or sunlight and thus are at greater risk from cancers of any cause as well as heart disease, diabetes, arthritis, Alzheimer's disease and other illnesses. Federal guidelines are for 200 to 600 units a day but studies are leading experts to conclude that 1,000 units of Vitamin D3 a day or even more would resolve deficiences found over a wide range of the population.
The FDA has approved the first drug to treat fibromyalgia. The drug Lyrica (pregabalin) was already approved for partial seizures, diabetic neuropathy and pain after shingles rash.
The most interesting work being done on healthy life extension is to be found at Sirtris, a company founded by Dr Christoph Westphal and Dr. David Sinclair, who discovered in 2003 that a compound found in red wine and other plant products, resveratrol, extends the lifespan of flies, fish, and mammals by very significant amounts. They are developing new molecules much more potent than resveratrol which act by the same mechanism, in activating a gene called SIRT-1 or the collection of genes called sirtuins.
For the first time, regression of plaque in coronary arteries has been shown to occur when LDL-cholesterol is taken to even lower levels than previously. In this study, the ASTEROID study, presented by. Dr. Steven Nissen and co-investigators, two thirds of the patients in this study had regression of plaque in their coronary arteries when LDL-cholesterol levels went below 70 mg/dL, with greater regression the lower the LDL-cholesterol level in the patient. HDL-cholesterol levels also rose by unexpected amounts. This work was presented at the American College of Cardiology 55th Annual Scientific Session and is one of a series of clinical trials exploring the safe parameters of plaque regression.