@ASPCardio Statement led by @DBelardoMD & myself w/ @ErinMichos @RonBlankstein @rblument1 @kcferdmd @KCKlatt @pnatarajanmd @DrOstfeld @KoushikReddyMD @deirdre_tobias @KevinH_PhD Practical Evidence-Based Approaches to Nutritional Modifications to ⬇️ #ASCVD
bit.ly/3tRD0XP Image
Recommendations to ⬇️ #ASCVD with Nutrition:
1. Primary and Secondary Prevention of ASCVD: A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein & fatty fish is optimal for the prevention of ASCVD
🥕🥬🥦🫑🥒🍅🧅🧄🥔🐟🍉🍒🍏🍊🍇🍋🍎🌶️🍈🍐🌿🌱
2. Hyperlipidemia: Replacing saturated fat with polyunsaturated and monounsaturated fat, reducing dietary cholesterol intake, and increasing intake of fiber rich foods, can all lead to a ⬇️ in LDL-C and apoB.
3. Hypertension: Eating a low sodium DASH dietary pattern, rich in dietary potassium from fruits and vegetables, is recommended for the prevention and treatment of hypertension.
@kcferdmd @BakrisGeorge @NHLBI_Translate @AnastasiaSMihai @jbrianbyrd @ASPCardio
4. Type 2 Diabetes: Preventing weight gain and obesity is pivotal for diabetes prevention. Thus, effective strategies for weight loss and management are likely beneficial for mitigating diabetes progression
bit.ly/3tRD0XP
5. Obesity: The importance of diet for prevention of weight gain and obesity is well demonstrated, with poor nutritional habits playing a role in gradual midlife weight gain.
@bjcohenmd @EugeniaGianos @DrEugeneYang @KTamirisaMD @DrNasrien @khurramn1 @AnumSaeedMD @netta_doc
6. Vitamin Supplementation: Vitamin supplementation is not routinely recommended for the prevention of ASCVD; supplementation should be individualized and recommended in those where it is necessary to meet nutrient requirements or as otherwise medically indicated.
7. Children: Primary prevention of ASCVD should begin as early as possible, emphasizing small changes in eating behaviors to promote nutrient-dense dietary patterns to establish nutrition-related goals that are focused, feasible, and measurable.
Dr. Renee Rodriguez-TY!
8. Older Adults: Nutrition therapy can have substantial benefits for individuals across the life span, including older adults with existing disease burden. Dietary recommendations to reduce cardiovascular risk should be counseled, tailored to the patient
9. Social Determinants of Health: Healthcare providers should evaluate patients for inequities in food access and socioeconomic resources, while providing culturally relevant nutrition resources when appropriate.
10. Multidisciplinary approach: Medical nutrition therapy, in collaboration with registered dietitians, results in greater improvements in cardiovascular disease risk factors and referral should be encouraged. @KCKlatt @deirdre_tobias @RonBlankstein
bit.ly/3tRD0XP

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦

Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @DrMarthaGulati

Sep 23
Dr. Steve Nissen #FHSummit24
#CvPrev #CardioTwitter
🚨🚨🚨We are failing patients🚨🚨🚨
🚨🚨🚨After 3 decades our practice pattern is the same

It started in the 1970’s with the Cholesterol Skeptics…& now just stronger despite all the evidence
#CVPrev #CardioTwitter


Image
Image
Image
Image
Despite trials that proved the effectiveness of statins, the next studies didn’t help convince people that lower LDL was better (commercial statin wars drove this!)

So patient remained under-treated… as they are now.
#FHSummit24
Image
Image
Then the REVERSAL trial shows no progression with intensive LDL ⤵️ and lower is better.

PROVE-IT showed also lower is better

And so did all these other trials…

And terms, we still don’t use intensive LDL lowering because our guidelines didn’t keep pace with the evidence


Image
Image
Image
Image
Read 7 tweets
Nov 16, 2022
@ASPCardio Statement: Defining Preventive Cardiology
🫀Noted ⤵️ in mortality from CVD over the past several decades driven by progress in prevention
🫀More recently CVD mortality ⬆️ w/ ⬆️ risk factors at younger ages
🫀Our goal was to define the field of preventive cardiology Image
@ASPCardio proposed a unifying definition of preventive cardiology: proactive, patient-centered approach in which clinician, or team of clinicians and non-clinicians, assesses CV risk & implements a comprehensive strategy of risk mitigation to prevent CVD & its clinical sequelae. Image
CVD Prevention goes far beyond LDL.
Lifestyle Approaches are key and we have had @ASPCardio statements on this, including the role of nutrition on heart health led by @DBelardoMD and myself, with the collaboration of many others

@KevinH_PhD @KCKlatt @kcferdmd @deirdre_tobias Image
Read 5 tweets
Mar 14, 2022
Our paper in @JACCJournals today:
Childbearing Among Women Cardiologists
The Interface of Experience, Impact, and the Law
with my coauthors @pamelasdouglas @drmalissawood @sarma_amy @DrToniyaSingh @Drroxmehran Dr. Bairey Merz & legal experts Joan Williams,Rachel Korn,Jessica Lee Image
👉Rate of ⬆️ of #WIC is just 0.3%/year
👉No Federal Mandate for Maternity Leave in🇺🇸
👉Issues related to childbearing affect practicing cardiologists
💃purpose of this study was to examine
the impact of pregnancy & maternity leave &
associated institutional policies/practices WIC ImageImageImageImage
📌323 Respondents: ~35% of #WIC so quite good for a survey
📌Practices: Academic🎓/Hospital🏥/🏠Private
📌37% report extra call/service prior to MatLeave
📌<8% have RVUs prorated for MatLeave
📌41% had salary⬇️ during pregnancy year
📌23%: no paid MatLeave Image
Read 5 tweets
Oct 28, 2021
The Chest Pain Guidelines are now released!
ahajournals.org/doi/10.1161/CI…
Top 10: CHEST PAINS
Thanks to the entire writing group and my co-cahirs: Deb Murkerjee & Phil Levy
💥First Chest Pain Guidelines @AHAScience @ACCinTouch
Top 10 messages:
#1: Chest Pain is MORE than Pain in the chest
➡️History Matters
➡️ Assess probability of chest pain symptoms being ischemic
#2:High sensitivity troponin are useful and preferred biomarker
💥No more CK/CM, no more myoglobin

@HighSTEACS @MaasAngela @mmamas1973 @KTamirisaMD @iamritu @mswami001 @cardiojaydoc02 @onco_cardiology @ShelleyZieroth @fitmslax @DrToniyaSingh
Read 12 tweets
Sep 1, 2021
Great discussion last night with the #EMPEROR in the room
Thanks @JavedButler1 @DrNasrien @hswapnil & Dr. Bayes
If you want to view the recording the link is here:
drive.google.com/file/d/10iTYIN…

We started with @hswapnil disclosing his #flozinator status & how we all need to be as well
@hswapnil showed that until now for CKD, every trial of other drugs has essentially failed.
Although renal function was not a 10 (or 2o or even 3o) endpoint of EMPA trials, the benefits were seen
Work by @ChristosArgyrop (🥬Lover & #Flozinator) showed Renal & CVD benefits #SGLT2i
@hswapnil @uOttawa mentioned that mechanism of how renal protection with #SGLT2i occurs unknown. But asked the proactive question: "Does it Matter?"...and now he is a cardiologists according to @JavedButler1

Group Hug Endo/Cards/Nehpro

@DBelardoMD @DLBHATTMD @ChristosArgyrop
Read 7 tweets
Aug 30, 2021
#ESCCongress #HOTLINE #cvPrev #STEPStudy
Can intensive tx ⬇️ CVD risk risk HTN, older 👴🧓
🫀Optimum BP remains uncertain in older pt: differing rec's worldwide
🫀🇨🇳 age 60-80y, 9624 pts RCT, >50% Home BP cuff provided
🫀Intensive 110-130 SBP vs 130-150: 26% benefit with int tx ImageImageImage
#ESCCongress #STEPStudy
🫀 No diff in afib, coronary revasc, Mortality but all other endpoints significant
🫀 Safe: Hypotension more common in Intensive arm but no great syncope
🫀 No subgroup diff
How low should we go? Lower!
@NEJM nejm.org/doi/full/10.10…
@Steph_Achenbach ImageImageImageImage
#ESCCongress #STEPStudy
➡️Mean age 66 (75% below age of 70)
➡️ Most with well controlled BP at entry
Context of patient heterogenity
🫀Signif impact on CV events
🫀 Tx well tolerated & achieved! (SBP 126 Intensive)
🫀Is this SPRINT? BP achieved similar to STEP ImageImageImageImage
Read 4 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(