Labor Union Targets American Heart Association For Financial Conflicts

Unite Here, a labor union with 270,000 members, is attacking a surprising target, the American Heart Association. A report released by the group— entitled “Is the American Heart Association for sale?”– cites multiple examples of financial conflicts of interest involving prominent leaders of the organization. Among the major accusations in the report: Robert Eckel, a former AHA president…

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American Heart Association Cancels Baltimore Conference

The American Heart Association announced last night the cancellation of a medical conference in Baltimore due to the unrest in the city. QCOR 2015, the Quality of Care and Outcomes Research Scientific Sessions, was scheduled to be held at the Hilton Baltimore from Wednesday to Friday this week. Here is part of what the AHA said: … Click here to…

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Doctors Halt Squabbling And Agree How To Manage Hypertension In People With Blocked Arteries

There’s been a lot of drama in the hypertension field over the past few years. Initially sparked by the decision of the National Institutes of Health to end its sponsorship of national guidelines, the subsequent appearance of multiple guidelines with divergent recommendations led to even more controversy and discussion. Now, however, the appearance of a new scientific statement…

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More Guideline Controversy: The Tricky Business Of Calculating Cardiovascular Risk

Calculating cardiovascular risk has become a central and highly controversial component of cardiovascular guidelines. Now a study in the Annals of Internal Medicine finds that most of the commonly employed tools seriously overestimate the risk of people today. … Click here to read the full post on Forbes….

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Very Simple High-Fiber Diet Stands Up To American Heart Association Diet

Diets notoriously fail to help people lose a lot of weight. One problem is that most diets include a broad range of restrictions and guidelines that many people find difficult to follow. Another problem is that negative recommendations may have unintended consequences, such as low-fat recommendations leading to increased consumption of refined carbohydrates. Now a new…

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Salt, Science, And The American Heart Association’s Double Standard

Once again the American Heart Association is sticking by its recommendation that pretty much everyone should consume no more than 1,500 milligrams of sodium each day. This is dramatically lower than the 3,500 mg/d the average American now consumes. In a blog post reprinted on MedPage Today the president of the American Heart Association,  Elliott Antman, assails a study published earlier this week which found no…

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An Expert’s Perspective: Why Salt Is Not Like Tobacco And Why Guidelines Are Tricky

At the center of this week’s renewed debate on salt was Salim Yusuf, the long influential and often controversial cardiology researcher and clinical trialist based at McMaster University in Hamilton, Ontario. I spoke with Yusuf before the publication of the New England Journal of Medicine papers, which include his own two papers from the PURE study. Yusuf was troubled…

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More Guideline Controversy: Blood Pressure Expert Decries ‘Political Correctness’

Now add “political correctness” to the long list of criticisms directed against the recent publication of new and updated cardiovascular guidelines. One leading hypertension expert writes that the authors of the recent AHA/ACC/CDC Science Advisory on blood pressure control were chosen not for their expertise but for political expediency. … Click here to read the full post on Forbes. Confusion…

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Missing High Blood Pressure Guideline Turns Up In JAMA

After  years of delay and many twists and turns, the hypertension guideline originally commissioned by the NIH has now finally been published in JAMA. The evidence-based document contains a major revision of hypertension treatment targets and includes new and somewhat simplified recommendations for drug treatment. The previous US hypertension guideline was published more than a decade ago….

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Slouching Toward Phase 3: Progress Report On New Cholesterol Drugs At The AHA

The American Heart Association meeting in Dallas this year brought new phase 2 data about several promising new cholesterol drugs. But before jumping on any bandwagons it would be good to remember that even for the drugs most far along in development we still haven’t seen any phase 3 data. In addition, it bears repeating that the…

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TACT Substudy Suggests Possible Strong Benefit for Chelation in Diabetics

One year ago the results of the TACT trial were published in JAMA, sparking an enormous controversy over the propriety of publishing a trial suggesting that chelation therapy might be beneficial in people with cardiovascular disease. Chelation therapy has long been a staple of alternative medicine, but until the publication of TACT it had received no credit whatsoever in…

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No Value For Renal-Artery Stenting In CORAL

Previous small studies have failed to find any benefit associated with renal-artery stenting, but the trials have been small and were not powered for clinical outcomes. Now, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) trial, presented at the American Heart Association meeting and published simultaneously in the New England Journal of Medicine, offers strong and persuasive evidence that renal-artery…

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Controversy Erupts Over Accuracy Of Cardiovascular Risk Calculator For Guidelines

In the face of a highly critical story in the New York Times by Gina Kolata about the new cardiovascular guidelines, authors of the guidelines and leaders of the American Heart Association and the American College of Cardiology defended the value and integrity of the guidelines. The Times story claims that the cardiovascular risk calculator used to assess individual risk in the new guidelines is deeply flawed. “In…

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The Fate Of New Cholesterol Drugs Depends On IMPROVE-IT

Prospects for the highly anticipated new class of cholesterol-lowering drugs, the PCSK9 inhibitors, took a wild roller coaster ride this week. The publication of new lipid guidelines by the American Heart Association and the American College of Cardiology led many observers to think that the promising new drugs under development by Regeneron (in partnership with Sanofi),…

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After Long Wait, Updated US Cardiovascular Guidelines Now Emphasize Risk Instead Of Targets

Original illustration by Max Husten

Updated cardiovascular health guidelines were released today by  the American Heart Association (AHA) and the American College of Cardiology (ACC). The guidelines are designed to provide primary care physicians with evidence-based expert guidance on cholesterol, obesity, risk assessment, and healthy lifestyle. The new guidelines reinforce many of the same messages from previous guidelines, but also…

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American Heart Association Announces Late-Breaking Clinical Trials

AHA 2013 logo

There are still a few days left in August and the European Society of Cardiology meeting doesn’t start until this weekend in Amsterdam. Nevertheless, the American Heart Association has released the list of late-breaking clinical trials for the annual meeting in November. Late-Breaking Clinical Trials 1: Acute Cardiovascular and Cerebrovascular Care Sunday, Nov 17, 2013, 4:00 PM –…

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Observational Study Lends Support to CRT Guidelines

A large observational study published in JAMA suggests that patients with left bundle-branch block (LBBB) and longer QRS duration derive the most benefit from a cardiac resynchronization therapy defibrillator (CRT-D). The findings appear to support current, but often criticized, guidelines from the American College of Cardiology, American Heart Association, and the Heart Rhythm Society, in which a class I recommendation…

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The Guidelines Are Dead. Long Live The Guidelines.

Following last month’s surprising announcement that the National Heart, Lung, and Blood Institute would no longer issue guidelines, leaders of the American Heart Association and the American College of Cardiology have now announced that are “officially assuming the joint governance, management and public distribution” of the enormously influential cardiovascular prevention guidelines, including the much-delayed and much-anticipated hypertension and cholesterol guidelines (formerly…

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Sex And The Cardiac Patient Should Not Be A Taboo Subject

It’s not an easy conversation to have. After a heart attack or other major cardiac event, talking about sex is awkward, and often avoided by patients, their partners, and physicians. But a new consensus statement from several major cardiology organizations urges physicians to get over their reluctance or embarrassment and counsel their cardiac patients about…

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Cardiology Goes Better With Coke

At the bottom of this post I’ve reprinted an email cardiologists are receiving from the American College of Cardiology. See the bottom of the message for the disclosure that Coca Cola is paying for this educational program. I don’t have much to say about this though I wonder what the faculty of this program will…

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Hypertension And Cholesterol Guidelines Delayed Again As NHLBI Gets Out Of The Guidelines Business

NHLBI Director Dr. Gary Gibbons

The National Heart, Lung, and Blood Institute (NHLBI) will no longer issue guidelines, including the much-delayed and much-anticipated hypertension (JNC 8) and cholesterol (ATP IV) guidelines. Instead, the NHLBI will perform systematic evidence reviews that other organizations, including the American Heart Association and the American College of Cardiology, will use as a resource for their own guidelines….

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Dramatic Increase in Use of Radial Artery Access for PCI in the U.S.

In the last six years interventional cardiologists have dramatically increased their use of radial access for PCI, according to a retrospective study published in Circulation. Using data from the CathPCI registry on more than 2.8 million procedures between January 2007 and September 2012, Dmitriy Feldman and colleagues found that radial access PCI increased 13-fold, from a negligible 1.2% at the beginning of the study…

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Salt Report From IOM Sparks Much Heat, Only A Little Light

An Institute of Medicine report on salt earlier this week sparked a lot of controversy. The report concludes that there’s no evidence to support current efforts to lower salt consumption to less than 2,300 mg/day. Unfortunately, the press coverage offered little insight into the science behind the issue. On the Knight Science Journalism Tracker blog,…

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The Mediterranean Diet: The New Gold Standard?

Earlier today I summarized the important new PREDIMED study published in the New England Journal of Medicine showing the cardiovascular benefits of the Mediterranean diet. This study– a rare and much welcome instance of a large randomized controlled study of a diet powered to reach conclusions about important cardiovascular endpoints– has been widely praised and will undoubtedly have a…

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Back To The Future: Resurrected Data From 1960s Trial Might Impact Contemporary Dietary Fat Debate

In an exceedingly strange turn of events, data from a clinical trial dating from the 1960s, long thought to be lost, has now been resurrected and may contribute important new information to the very contemporary controversy over recommendations about dietary fat composition. The American Heart Association has long urged people to increase their consumption of…

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