Cholesterol News, Again?

In November 2013, the American  Heart Association (AHA) and the American College of Cardiology (ACC) released new guidelines for cholesterol therapy in adults 20-79 years old. The guidelines were based on solid medical evidence but, nonetheless, generated a lot of controversy and even opposing opinions from experts in the field. On one hand, the guidelines argue for limiting some of the cholesterol testing we now use as a guide for therapy. On the other hand, the guidelines recommend therapy (the use of statin drugs) for certain groups of patients, regardless of their blood cholesterol levels. The controversy which evolved was covered in articles in the New York Times last November. The two titles convey the opposing messages: Experts Reshape Treatment Guide for Cholesterol and Don’t Give More Patients Statins.

Some of the best known statin drugs now in use include: Atorvastatin (Lipitor), Rosuvastatin (Crestor), Lovastatin and Simvastatin.

A study on the subject was published in the New England Journal of Medicine of  3/20/2014 by Michael J. Pencina, PhD, from the Duke Clinical Research Institute. It reports that the new guidelines would increase the number of U.S. adults eligible for statin therapy by almost 13 million, and that most adults between 60-75 years old would become candidates for treatment. I also refer to the guidelines in my blog of last November, Statins, To Take Or Not To Take.

The guidelines use a newly updated, computerized cardiac risk assessment tool, in deriving its recommendations. We use the same tool in our office.

Are You Walking Outdoors Yet?

Our citron is being acclimatized to the outdoors. Are you?

And The Cough Goes On...

Do you have an untreated cough that has lasted for several weeks? If so, you are not alone. Many patients in my practice have been complaining about a cough that does not seem to go away. I have seen more of it this year than in other years, and it started back in November of last year.

Typically, one would have an episode of bronchitis, sinusitis, or the common cold, which may have been treated with a course of antibiotics. The initial symptoms then partially or fully resolve. A few days or a week later, the nagging cough develops, and is commonly referred to as “post infectious cough.”

The cough may be “productive” (producing mucus), or it may be “dry.” It can occur during the day, when you’re lying down at night, or throughout the night. In more severe cases, the cough will come in “volleys” (paroxysms), and will awaken you, or even frighten you. It may be associated with a post nasal drip or gastric acid reflux. Some medications, particularly some of the medication used for the treatment of high blood pressure, can cause a persistent, dry cough.

The underlying reason for the cough is an inflammatory process which affects the linings of the bronchial tree leading to the lungs. It’s similar to the process responsible for bronchial asthma. It is thought by some authorities that, when left untreated, this condition can leave you predisposed to a recurrence, or even trigger the new onset of asthma.

When the cough lingers, you should be examined by a physician. This is especially important if you have a chronic condition such as asthma, chronic bronchitis or heart disease, and even more so if you have an impaired immunity, take immune suppressing medications, or are a smoker.

In treating the persistent cough, the physician must make sure that conditions other than post infectious cough are ruled out, such as pneumonia, asthmatic bronchitis and the whooping cough (pertussis).

Once other causes have been ruled out or treated, the post infectious cough will resolve on its own. But it may take weeks, and I have seen it last for months. Treating it will generally shorten the duration and severity of the post infectious cough, and should make you feel better much faster.

So, when you develop a lingering cough, don’t just tough it out, have it evaluated medically, and treated if necessary.

FREE Blood Pressure Check and Analysis

Come in all Month Long for a FREE Check!

No appointment necessary, just call 203-853-1919

2000 Post Road, Fairfield, CT

If you have a home monitor in need of calibration, bring that in too, we'll make sure it's working correctly, for FREE too!

Heart Month is All Year Round

Did you know that February was National Heart Month? Did you do anything to make sure your heart was in tip-top shape? If you're like most people, you didn't! High blood pressure is a major risk factor for heart attacks, stroke, diabetes, and almost every major life threatening condition. Come in for a FREE Blood Pressure check! During the month of March, come into the office, at no charge, to get a FREE Blood Pressure check. If you've got an issue, we'll make a plan to solve it, and solve it fast. In March, if you have a home blood pressure machine, we'll check it for accuracy, and ensure you're using the machine correctly, also for free. Just give us a call at 203-853-1919, and let us know you're coming in, appointments for this service are not necessary. Please share this important free service with your friends. You never know when you can save a life. See you at the office.