Bottom Line Health
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| THE STUDY
A team of researchers divided 17,991 patients into five groups based on the number and type of symptoms—no symptoms, two different forms of angina, chest pain not caused by angina, and dyspnea alone.
After an average follow-up of nearly three years, the researchers found that patients who had dyspnea but no other signs of heart problems were at more than twice the risk of death as those who had angina—chest pain that is the most recognized symptom of heart disease. |
Lester A. Mitscher and Victoria Toews
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 Another set of patients, seen at the First People's Hospital of Xiao Shan City in China, was treated with green tea polyphenols after being diagnosed with angina pectoris, a condition characterized by attacks of chest pain, usually brought on by physical exertion. angina is often a symptom of atherosclerosis and can be a warning sign of future heart attacks. Fourteen of the twenty-eight patients also had high fibrinogen levels. After a month's course of supplementation with green tea extract, the doctors reported that angina attacks were controlled in 71 percent of the patients. |
David Winston, RH(AHG), and Steven Maimes
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 Astragalus is useful for treating people with angina and mild congestive heart failure.
• Cordyceps benefits the vascular system and helps regulate blood pressure and strengthens the heart muscle.
• Dang shen is used to build the blood (xue). Studies indicate that this root not only enhances absorption of nutrients but it also increases the number of red blood cells and the hemoglobin content.
• Eleuthero, in clinical studies, has been shown to help relieve angina symptoms and lower LDL cholesterol and triglyceride levels. |
Melody Petersen
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 One was the blueprint for a drug that he believed could help patients with angina, the chest pain caused when the heart does not get enough blood.
In 1958 the thirty-four-year-old scientist took this idea to ICI, the giant British chemical company. Over the next six years, as an employee of ICI, he laid the groundwork for the discovery of a new type of lifesaving heart medicine called the beta-blocker. The drug would transform the treatment of angina and much more. |
Lester A. Mitscher and Victoria Toews
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| Although the evidence available today supports the likelihood that green tea polyphenols can help prevent or modulate the severity of developing angina, extracts of green tea polyphenols are not a substitute for medication when angina has developed.
THE SILENT EPIDEMIC OF HYPERTENSION
One out of every four people in the United States has hypertension (high blood pressure) and one out of every five American children already shows signs of the early stages of the condition. |
| After a month's course of supplementation with green tea extract, the doctors reported that angina attacks were controlled in 71 percent of the patients. In addition, fibrinogen levels were reduced in all but one patient and electrocardiogram results normalized in fifteen of the patients. angina patients are usually prescribed powerful medication for this condition, and they should continue taking that medication. |
| Although the evidence available today supports the likelihood that green tea polyphenols can help prevent or modulate the severity of developing angina, extracts of green tea polyphenols are not a substitute for medication when angina has developed.
THE SILENT EPIDEMIC OF HYPERTENSION
One out of every four people in the United States has hypertension (high blood pressure) and one out of every five American children already shows signs of the early stages of the condition. |
J. Douglas Bremner
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 The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study compared atorvastatin (Lipitor) treatment to placebo in 3,086 male and female patients with a recent heart attack or unstable angina.10 Although the study did show a 2.6% reduction in a combined measure of death and/or heart attack or related events (14.8% vs. 17.4%), it was of marginal statistical significance. There were no differences in mortality or nonfatal heart attack between the groups. Most of the benefits were from reduction of recurrent anginal chest pain. |
Shannon Brownlee
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 The combination of unstable angina and an abnormal stress test indicates she's at high risk for a heart attack.
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Standing at Crofton's right side, about even with her thigh, Altschuler palpates her groin to find the femoral artery, the pencil-thick blood vessel that runs right under the skin. "That's just my hand you're feeling. Now you're going to feel a big pinch and a sting," he says. Crofton groans loudly as Altschuler injects analgesic into her groin. He pauses for five seconds to let the drug take effect before slipping a needle fitted inside a plastic collar into her artery. |
Ray D. Strand
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 These patients have usually had symptoms of chest pain or what doctors call unstable angina. In situations like these doctors either open vessels via angioplasty (ballooning of the artery) or bypass these blockages with surgery.
If you were to spend a day following a cardiologist or cardiovascular surgeon around the hospital, you would soon realize he has to spend the majority of his time "putting out fires." He typically treats patients who are at the end of the inflammatory process, with his entire focus on attempting heroically to save a life. |
Brigitte Mars, A.H.G.
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 Cacao seed is used in the treatment of anemia, angina, appetite loss, asthma, and insufficient breast milk.
The cacao seed is certainly edible, as history has proven. The Aztecs were the first to prepare cacao as the delicous cocoa beverage enjoyed around the world today. Cocoa was the "love tonic" of Montezuma II, who is reputed to have drunk some fifty cups daily before visiting his harem of six hundred women. |
| The leaves are used topically as a poultice in treatments for angina, burns, fever, headache, heatstroke, and herpes.
Edible Uses
Anise hyssop has a wonderful aniselike flavor, with a hint of sassafras, and it is often used as a flavoring agent. Plains Indians used anise hyssop tea as a liquid sweetener. The plant's leaves are wonderful in small amounts in salads. It also can be made into a liqueur.
Other Uses
The essential oil is used in perfumery. The herb's leaf and flower can be used as breath fresheners. |
John E. Sarno, M.D.
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 He began to experience angina and was found to have significant narrowing of the coronary arteries. He had bypass surgery, and only a few months later experienced angina again and went through another cardiac procedure.
Mr. Jones denies that stress has anything to do with his recurrent cardiac trouble. His doctors are silent on the subject.
This is a common medical scenario in the United States. |
Thomson Healthcare, Inc.
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 Unproven Uses: Although research is ongoing, supplemental beta-carotene has also been used for the following: angina, asthma, cancer prevention, cardiovascular disease, cataract prevention, diabetes, free-radical reduction during bone marrow transplantation, immunostimulation, night vision, and oral leukoplakia. precautions and adverse reactions
Beta-carotene supplements are not recommended for patients with lung cancer or asbestosis (Albanes et al 1996; Chuwers et al 1997). |
Shannon Brownlee
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| They are elective procedures, which means they are performed on patients who have symptoms of heart disease—stable angina, for instance, and shortness of breath—but aren't in imminent danger of dying. Of those 1.2 million elective cardiac procedures, at least 160,000 are "inappropriate," meaning they should not have been done, according to cardiologists' own rules for when to put in a stent or do an angioplasty. When outside cardiologists looked at the patient records from Redding Medical Center, they found hundreds of such inappropriate cases. |
| This is the likely culprit in her angina, which occurs when tiny blood clots or bits of plaque get stuck in a narrow spot, temporarily blocking the flow of blood. Altschuler asks one of the technicians to bring him a stent, an expandable wire mesh tube no wider than a pine needle. In use since the late 1980s, stents have now nearly replaced balloon angioplasty as the preferred technique for opening a blocked section of artery. Altschuler takes a wire with the stent on one end and threads it up the catheter until it rests just inside the narrow spot in Crofton's artery. |
| They also knew that angioplasty and stents could relieve the pain of angina and in some instances could help patients breathe more easily (because it improves the heart's ability to pump blood to the lungs). It seemed like an obvious, entirely logical extension to imagine that angioplasty and stents could also prevent heart attacks in patients with symptoms of serious heart disease, by keeping all of their blood vessels open. But when this idea has been measured in clinical trials, it hasn't panned out. "We know we can prevent heart attacks with aspirin, and with drugs called beta-blockers. |
| Recently, Wennberg and his team recommended that Medicare should expand its P4P agenda to reward hospitals that establish a certified shared decision-making process for ten conditions that often result in elective surgery, such as chest pain due to angina; hip and knee arthritis; silent gallstones; prostate conditions; and breast cancer. The ten conditions account for about 40 percent of Medicare spending for surgery. Hospitals and surgery centers that provided high-quality patient decision aids would receive a small bonus. |
| Gray marbles are the patients with serious but not necessarily life-threatening ailments, like pneumonia or gallstones, or chronic conditions like hernias, congestive heart failure, and angina. It is the decisions about these kinds of cases, the gray middle ground, that get doctors into trouble.
It turns out there are very few rules to guide physicians about how to treat many serious and/or chronic conditions. Does this pneumonia case really need to be hospitalized, or will she do just as well taking antibiotics at home? |
Bottom Line Health
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| THE STUDY
In their study, Cannon and his team collected data on 1,825 patients who had experienced a heart attack or unstable angina and were taking 80 mg of Lipitor daily.
We can feel comfortable using high-dose statins even if LDL cholesterol ends up at 40 mg/dL. That's actually a good thing.
Christopher P. Cannon, MD
After four months of therapy, LDL cholesterol dropped below 100 mg/dL for 91% of the patients. Of these, 11% saw their LDL cholesterol drop below 40 mg/dL, according to the report. |
Thomson Healthcare, Inc.
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| As compared with those in the conventional group, the number of patients having angina pectoris attack and ST segment change in PTCA process was lessened in the puerarin injection group, with blood levels of vWEAg and ET-1 lower, and NO content higher than those in the conventional group (Xie et al, 2003).
Deafness
The effect of kudzu on sudden deafness was observed in 72 patients who were randomly assigned into a therapeutic group (n=40), who received intravenous infusion of puerarin injection, and a control group (n=32), who were given intravenous infusion of anisodamine. |
Tori Hudson, N.D.
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 Supplementation with arginine has been shown to increase artery dilation in normal people, people with hyperlipidemia, and in those with hypertension;245' 246 significantly improve blood flow and function in patients with congestive heart failure;247- 248 and in some, but not all trials, improve blood flow, vasodilation, exercise tolerance, and quality of life in those with angina.249-250 Therapeutic doses for cardiovascular effects seem to range from 6 to 12 grams per day. |
J. Douglas Bremner
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| This study did find a statistically significant reduction in a combined outcome of heart attacks, unstable angina (worsening and/or uncontrollable chest pain), and/or heart-related death. However, the absolute reduction was only 2% (5.5% rate in the placebo group vs. 3.5% in the treated group). There was no difference in deaths between the lovastatin (eighty) and placebo (seventy-seven) groups. |
| For instance, in the ACTION study (A Coronary disease Trial Investigating Outcome with Nifedipine) that I mentioned earlier, 7,665 patients with stable angina received the calcium channel blocker nifedipine or a placebo in a randomized trial. There was no difference in a combined measure of fatal and nonfatal heart attack or stroke, revascularization, or heart failure. Death from heart disease was equal in the groups, and there was a 16% increase in noncardiac deaths with nifedipine that was not statistically significant. |
| Like a lot of drugs, this one's journey to the pharmacist's shelf began in a quest to treat a different condition, in this case angina (heart disease). During trial studies researchers noticed that it had a positive effect on erection, which turned out to be stimulating news for Pfizer. The drug was patented in 1996, approved by the FDA on March 27, 1998, and became the first pill approved for the treatment of erectile dysfunction in the U.S. |
| In the DART-2 study 3,114 men with stable angina (chest pain) were randomly assigned to receive omega-3 supplements or placebo. Instead of being protected from heart disease, the omega-3 group had a statistically significant increase in sudden death and cardiac death.54 The increase in deaths occurred more often in those taking fish-oil capsules than in those eating oily fish. In another study two hundred patients with a history of a potentially lethal heart arrhythmia called ventricular tachycardia were given omega-3s or placebo. |
Tori Hudson, N.D.
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| The American Heart Association recommends aspirin for "patients who've had a myocardial infarction (heart attack), unstable angina, ischemic stroke (caused by blood clot) or transient ischemic attacks (TIAs or 'little strokes'), if not contraindicated." You should not start aspirin therapy without first consulting your practitioner. Also inform your practitioner if you are taking aspirin and must have a simple surgical procedure, even a dental extraction, as it increases the risk of excessive bleeding. |
Dr Ron Roberts
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 It has also successfully helped people suffering from asthma, allergies, angina, anxiety, bronchitis, colitis, digestive and gall-bladder problems, insomnia, stress, tiredness and ulcers.
Scepticism and fear of needles often deter people from the healing potential of acupuncture but any apprehension is soon dispelled during a first treatment. Perhaps surprisingly, most people look forward to further visits.
Auricular acupuncture—acupuncture in and around the ear?is a related healing technique. It is often more effective than body acupuncture. |
Ray D. Strand
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| Ordinary physical activity results in fatigue, heart palpitations, shortness of breath, or angina.
Class III: Marked limitation of physical activity; although patients are comfortable at rest, less than ordinary activity will lead to the symptoms noted above.
Glass IV: Inability to carry on any physical activity without discomfort; symptoms of congestive heart failure are present at rest. With any physical activity, increased discomfort and symptoms will occur. |
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