Month: January 2021

In 2020, the terrible toll of the COVID-19 pandemic largely overshadowed the affliction that remains the leading cause of death in this country: heart disease. In the United States last year, at least twice as many people died from cardiovascular causes as those who died from complications from SARS-CoV-2, the novel coronavirus.

While the challenges from the virus are new, experts have been studying heart disease for decades — and everyone can benefit from that knowledge. “The lifestyle habits that keep your heart healthy may also leave you less vulnerable to serious complications from infections such as COVID-19 and influenza,” says cardiologist Dr. Deepak L. Bhatt, professor of medicine at Harvard Medical School and editor in chief of the Harvard Heart Letter.

So what exactly are those heart-healthy habits? The American Heart Association refers to them as “Life’s Simple 7.” Put simply, they are:

1) Stop smoking

2) Eat … Read the rest

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. There is compelling evidence that screening to detect CRC early to find and remove precancerous polyps can reduce CRC mortality. However, screening has associated harms, including procedural complications, and inherent limitations. For example, colonoscopy, the most common screening tool in the US, is less effective in preventing cancers of the right, or ascending side, of the colon compared with cancers of the left, or descending, side of the colon.

Moreover, only 60% of US adults recommended for screening actually follow through. Even under the best circumstances, screening is resource-intensive, requiring time, equipment, and a trained doctor to perform the procedure, and cannot be widely implemented in many parts of the world. Thus, alternatives to screening to effectively prevent CRC are a high unmet need.

What are alternatives to screening for prevention of colorectal cancer?

Adherence … Read the rest

Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.

Doubling up on side effects

While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC … Read the rest

Early in the pandemic, epidemiologists made a striking observation. Compared to the general population, people with cardiovascular disease (CVD) were more than twice as likely to contract severe forms of COVID-19. In the last six months, death rates from COVID-19 have dropped significantly, but CVD remains a major predictor of poor outcome. What have we learned about heart disease and COVID-19 in that time?

Pre-existing heart conditions and poor metabolic health increase risk of severe COVID-19

As I described in a blog post back in April, some health conditions, like diabetes, increase risk of severe COVID-19 by suppressing the immune system; others, like asthma, increase risk by weakening the lungs. However, in the early months of the pandemic it was not entirely clear how CVD increased the risk of severe COVID-19. We now have two explanations.

The first is that pre-existing heart conditions, such as damaged heart muscle or blocked … Read the rest

Falls rank among the top causes of death and injuries among the elderly, and the risk increases significantly in older people being treated for cancer. Now, investigators are reporting that a newer class of drugs for advanced prostate cancer is associated with a significant increase in fall risk.

Called androgen receptor inhibitors, or ARIs, these drugs target testosterone, a hormone that accelerates the growth of prostate tumors. Unlike traditional hormonal treatments that interfere with the body’s ability to make testosterone (known as androgen deprivation therapy, or ADT), ARIs work by preventing testosterone from binding to its receptor on cancer cells. Three ARIs were evaluated in the study — apalutamide, enzalutamide, and darolutamide — and each can limit prostate cancer progression and extend survival. The investigators emphasized that the benefits of using ARIs outweigh the risk of falls and fractures, which are rare even in treated patients.

What the investigators did

Now that COVID-19 vaccines are rolling out, pregnant and breastfeeding people have many questions around risks and benefits. At first, many of those receiving vaccines in US will be healthcare workers, although the circles for vaccine eligibility are widening.

The Centers for Disease Control and Prevention (CDC), the American College of Obstetrics and Gynecology (ACOG), and the Society for Maternal-Fetal Medicine agree that the new mRNA COVID-19 vaccines should be offered to pregnant and breastfeeding individuals who are eligible for vaccination.

Here are answers to some basic questions you may have about getting a COVID-19 vaccine if you’re pregnant or breastfeeding — or are considering a pregnancy. Keep in mind that information is evolving rapidly. Your obstetric provider or medical team can advise you more fully, based on your personal health risks, exposures to the virus that causes COVID-19, and preferences.

What do we know about how COVID-19 affects people

To many people, gout seems like a disease of the past. Cartoons from 200 years ago depicted it as a condition afflicting the wealthy (“the disease of kings”), whose gluttonous consumption of food and drink was thought to bring on the attacks of debilitating arthritis.

All these years later, much about gout is still misunderstood. Shame, derision, and the belief that the gout sufferer deserves the condition linger. And rather than being a disease of the past, gout is quite common — and rates are rising. Estimates suggest gout affects nearly 4% of the adult population in the US, an increase from prior decades. And it’s not a disease limited to the well-to-do; it affects people of all economic classes.

The most likely explanations for the rising rates of gout are an aging population and excess weight. Both are major risk factors for the disease. The expanding waistline of the … Read the rest