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.
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
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
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👉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
📌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
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
@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
#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
#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! @NEJMnejm.org/doi/full/10.10… @Steph_Achenbach
#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
#ESCCongress#HOTLINE#IAMI
Does influenza vaccination improves outcomes in patients with recent MI?
💉 Flu assoc 🫀 death
💉 Vaccine=Class 1 ESC/AHA/ACC
💉8 countries, 4 Flu seasons RCT- double blind of AMI pt, 2571 pts: mostly male (>80%)
💉28% ⬇️ events with vaccine 🆚placebo
#ESCCongress#HOTLINE#IAMI
💉Safe, well tolerated
💉In patients with MI/high risk CAD benefit from influenza vaccination
💉Flu & CVD: 2 of the most common causes of 🏥
Vaccine ⬇️ risk of flu, all cause death and CV events now
High risk pt benefit from flu vaccine #CVprev
#ESCCongress#IAMI
💉Flu vaccine does ⬇️CV deaths but does not seem to ⬇️ acute CV events in post-AMI patients
💉Data clearly shows influenza vaccine is useful in high risk patients with CVD. Mechanism isn't clear but does that matter?
💉Vaccinate people after #AMI in 🏥!
#ESCCongress#HOTLINE#CardioTwitter#CVPrev #SSaSS Salt Substitute and Stroke Study @georgeinstitute
🫀Included w/ prior stroke or poorly controlled BP
🫀Interventional: Salt subs
🫀 65y 50%💃 73% hx stroke
🫀3.3 SPB⬇️
🫀⬇️ stroke&CV events
🫀Salt subs is effective to ⬇️ stroke
💥Very Important study
💥High risk group- mean age 65, 3/4 with stroke, high salt intake (but typical in the world for many)
💥5000 MACE: Power enormous
💥3mmHg SBP ⬇️
⬇️ in stroke & mortality HUGE! Simple intervention #ESCCongress@Steph_Achenbach #CVPrev#cardiotwitter