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  • Red Yeast Rice: Nature's Medicine

    by Dr. Aimee Warren

    Cholesterol is a substance that is required for the body to make and maintain healthy cells. It is also used to make hormones such as estrogen and testosterone and bile acids which help digest food. Too much cholesterol in the body, however, can be damaging to the body leading to heart disease, heart attacks and strokes. High cholesterol can be hereditary but many times it is caused by lifestyle choices such as poor diet and lack of exercise. That being said, we can and should incorporate better habits to decrease high cholesterol and keep the prescription medications from taking over the medicine cabinet.

    Getting your bodies moving every day (yes, every day), decreasing saturated and trans fats in your diet (drop that frozen pizza!), and increasing the amounts of whole grains, whole fruits, veggies and fiber are just a few of the changes that can lower cholesterol and keep your heart healthy. Although lifestyle changes are the foundation in keeping your cholesterol in a healthy range, other alternative therapies can be utilized to lower your cholesterol naturally and may help keep you out of the pharmacy line.

    Omega 3 Fatty Acids: Considered essential fatty acids because they are required for our bodies to function normally and they are only available from dietary sources. Omega 3 fatty acids come in the form of ALA, DHA, and EPA. Most experts agree that DHA and EPA are the forms that are most beneficial to our health. Omega 3 fatty acids have been shown to decrease cardiovascular disease by reducing inflammation and also greatly lower triglycerides. Source: 2 Grams per day of fish oil or flax seed oil. Dietary sources include cold water fish/oily fish such as salmon, walnuts, ground flax seeds, broccoli, and spinach.

    Red Yeast Rice: Used for centuries in China as both a food and medicine, red yeast rice is made by fermenting a type of yeast called Monascus purpureus over red rice. It contains chemicals similar to those found in statin medications and works by inhibiting an enzyme in the body that makes cholesterol. In one study performed by the American Heart Association, red yeast rice decreased total cholesterol by 16%, “bad” cholesterol LDL by 21% and lowered triglycerides by 24%. Source: 1200-2400 Milligrams of red yeast rice powder in capsule form daily. Take with food.

    Niacin (Vitamin B3): Niacin has been a well-studied supplement shown to decrease cholesterol. Specifically, it has been shown to lower LDL (the “bad” cholesterol) and raise HDL (the “good” cholesterol). Flushing of the skin is a common and potentially unpleasant side effect of niacin; however taking the slow release form and taking a baby aspirin along with it may help decrease this effect.
    Source: Men 16 milligrams daily; women 14 milligrams daily

    Phytosterols: Also referred to as plant sterol and stanol esters, these are a group of naturally occurring compounds found in plant cell membranes. They are structurally similar to our body’s cholesterol so when they are consumed, they compete with cholesterol for absorption in the digestive system. As a result, cholesterol absorption is blocked and blood cholesterol levels are lowered. Total cholesterol can be lowered by 10%, LDL cholesterol can be lowered by as much as 14%! Source: Recommended amount daily: 1.3 – 2 grams twice per day with meals. Phytosterols are naturally present in small quantities in nuts, vegetable oils, legumes, whole grains, fruits and vegetables. You can also get the recommended amount through supplements and fortified foods.

    Always ask your doctor before starting any new medication or supplement. Be well, Aimee Warren D.O.


  • Having Your Eyes Checked? Why Not Get Screened For Hypertension

    Blood pressure screenings outside traditional healthcare settings contribute to better hypertension control and management, according to a study published in The Journal of Clinical Hypertension.

    Researchers from Kaiser Permanente examined 1,076,000 electronic health records of its Southern California patients seen over a two-year period in primary care settings as well as other health-related settings including optometry, orthopedics, dermatology, neurology, and urology offices.

    Of the patients studied, 112,000 were found to have high blood pressure. Of these, 17% were diagnosed in non-primary care settings. Ophthalmology/optometry offices diagnosed 25% of the cases, neurology 19%, and dermatology 13%.

    “Patients who do not see their primary care providers on a regular basis may have hypertension that goes unrecognized," said study lead author Joel Handler, MD, Southern California Kaiser Permanente hypertension lead. "For this reason, expanding hypertension screening to non-primary care settings may be an opportunity to improve early hypertension recognition and control."

    Patients identified with hypertension during non-primary care visits were more likely to be older, male and non-Hispanic white. These patients were also more likely to smoke and to have chronic kidney disease.

    Researchers also found that patients with an initial high blood pressure identified during non-primary care were less likely to be obese compared to those with an initial high blood pressure identified during a primary care visit.

    "The differences in the patient characteristics observed in our study suggest that expanding hypertension screening to non-primary care settings may also help identify patients who would have been missed otherwise," said study co-author Corinna Koebnick, PhD, Kaiser Permanente Southern California Department of Research & Evaluation. "However, this approach requires an effective system, such as the one in place at Kaiser Permanente, to assure appropriate follow-up if a patient with high blood pressure is detected."

    The research was part of Kaiser Permanente's continuing efforts to address the impacts of hypertension and improve the cardiovascular health of its members and the community. Only about half of people with hypertension have their condition under control. High blood pressure, which often has no warning signs or symptoms, increases the risk for heart disease and stroke, two of the leading causes of death for Americans..

  • Nearly 3 out of 4 Americans Don’t Know Their LDL-C Number

    A recent online Harris Poll survey of 2,033 people found that 71% did not know, or were unsure of, their LDL-C level. Moreover, 44% were unsure if LDL-C was good or bad cholesterol.

    “It is concerning that the majority of Americans in our poll are not sure of or do not recall their LDL-C, or bad cholesterol, levels," said Ralph M. Vicari, MD, and vice president of Foundation of the National Lipid Association (FNLA), which partnered with the Preventive Cardiovascular Nurses Association, Mended Hearts, Sanofi US and Regeneron on the Cholesterol Counts poll.

    “As a cardiologist, I make it a point to write down and give my patients their numbers, and explain what they mean,” said Vicari. “We want every American to get 'counted' by taking the poll, go to their healthcare provider to get their cholesterol checked, learn their numbers, and encourage friends and family to do the same.”

    The initial results from the Cholesterol Counts Poll also found:

    - 29% those surveyed were told that they have high LDL-C (bad cholesterol)
    - 52% of people ages 55 and older were personally concerned about their cholesterol compared
    with 37% of those ages 35-54
    - 27% of those surveyed who were told that they have high LDL-C levels had not taken a
    prescription medication to manage it
    - New Mexico, South Carolina, Tennessee and West Virginia each had the highest percentage of
    people surveyed (37 percent) with high LDL-C
    - Massachusetts had the lowest percentage of people surveyed (21 percent) who reported being
    told they have high LDL-C (bad cholesterol)

    "The results of the Cholesterol Counts Poll uncover a concerning situation. About a third of Americans surveyed self-reported high levels of LDL-C, but many of those surveyed are not sure that LDL-C is bad cholesterol," said Michele Packard-Milam, CAE, executive director of Mended Hearts. "There seems to be a gap in knowledge about LDL-C – we need to rally Americans to become educated about their LDL-C numbers and what they mean to their heart health.”.

  • Survey Finds Only 62% Of Women Comply With Cholesterol Meds

    When it comes to compliance, only 62% of women take their prescription cholesterol medications as directed, according to a survey of 795 women conducted by WomenHeart: The National Coalition for Women with Heart Disease.

    The research also uncovered that only 31% eat five fruit or vegetable servings per day, and that few doctors screen their patients for familial hypercholesterolemia (FH). What’s more, less than two percent of participants were enrolled in clinical research trials, but 40% said they were interested in participating in and learning more about clinical trials. 

    "The survey and focus group findings indicate a real need to reduce barriers to detection and treatment of cholesterol and/or FH in women, which are both major risk factors for heart disease," according to Mary E. McGowan, Chief Executive Officer, WomenHeart. 

    Womenheart logo

    The main reasons why women stop taking cholesterol medications were poor doctor-patient communication, high medication costs, and insurance company resistance to approve preferred medications and specialist visits. 

    The results were released during a Capitol Hill briefing which included Congresswomen Joyce Beatty (D-OH) and Lois Capps (D-CA), as well as Martha Gulati, Associate Professor of Medicine and Clinical Public Health, The Ohio State University, Stephanie Hammar, patient and WomenHeart Champion, Catherine Davis Ahmed, Director of Outreach and FH Patient Advocate, The FH Foundation and Mary McGowan. 

    "We look forward to working with Congress and the medical community to increase awareness of high LDL, FH and other major risk factors for heart disease – the leading cause of death in women - and to implement programs to improve early and accurate diagnosis and proper treatment of heart disease risk factors to improve women's heart health," says McGowan.  

    WomenHeart: The National Coalition for Women with Heart Disease, is a patient- centered organization serving the 43 million American women living with or at risk for heart disease – the leading cause of death for women. The organization is devoted to advancing women's heart health through advocacy and community education, and is a community of thousands of members nationwide, including women heart patients and their families, healthcare professionals, and health advocates..

  • Stanford U Launches MyHeart Counts Smartphone App

    Cardiologists and researchers at the Stanford University School of Medicine have launched an iPhone app that tracks physical activities and allows the user to participate in heart research. 

    The free MyHeart Counts app collects data about physical activity such as walking or running, and also provides cardiac risk factors for Stanford scientists studying the prevention and treatment of heart disease. 

    “We are looking for everyone who is curious as to how healthy their heart is to download this app,” said Alan Yeung, MD, the Li Ka Shing Professor of Cardiovascular Medicine at Stanford. “Users will be able to see their activity and fitness levels, and their ‘heart age.’ We’ll also be able to study what motivates people to improve their heart health.” 

    The MyHeart Counts app delivers a comprehensive assessment of each user’s heart health and provide information on how to improve it. In the future, it will also be used to study various methods — designed to be both easy and fun — for using smartphones and other wearable devices to enhance heart-healthy habits. 

    MyHeart Counts may be downloaded from the App Store 

    The app takes advantage of the iPhone’s built-in motion sensors to track physical activity and to collect data during a six-minute walk test. People with a wearable activity device that connects with the Health app on their iPhone are encouraged to use that as well. Activity data from Apple Watch will feed directly into the Health app on the iPhone when it becomes available in early 2015. Participants will also enter data about their risk factors for heart disease and their readings from basic lab tests to get feedback on their chances of developing heart disease and their “heart age.” 

    Stanford Medicine’s MyHeart Counts is one of the first five apps to use the ResearchKit framework, which makes it easier for scientists to study health and disease by allowing them to gather more frequent, real-world participant data through the iPhone. 

    Data from the MyHeart Counts study are strictly for research and will not be used for any for-profit venture. The app is not for clinical care and does not provide personal access to a Stanford physician.

    Participants are encouraged to use the app to monitor their activity. Once every three months, over the course of a year or longer, they’re asked to report on one week’s worth of activity and update their risk-factor information. 

    “There are two major elements to the study,” says Michael McConnell, MD, professor of cardiovascular medicine and principal investigator for the MyHeart Counts study. “One is collecting data as broadly as possible on physical activity, fitness and cardiovascular risk factors, which provides important feedback to the participants and helpful research data for our study. The second is studying ways to help people enhance activity and fitness, and decrease their chances of heart disease.” 

    Researchs hope to leverage the explosion in wearable devices as a means to better record and report information about behaviors, such as physical activity or sleep patterns, to improve health. “Preventive medicine hasn’t worked by having doctors make to-do lists for their patient, then seeing them six months later and hoping they did everything on the list,” McConnell says. “The future needs a much more ongoing engagement with people’s health. We need to understand how to reach out to modify behavior long before we end up having to see someone for a heart attack or stroke.”.

  • Housework, Light Chores, Help Seniors Avoid Heart Disease

    Light activities such as dairy chores or walking around the house reduces the risk of heart disease for those 70-85 years old, according to a report in the online version of the Journal of the American Heart Association.

    Researchers from several universities used real-life movement data from 1,170 seniors and found that the 10-year risk of heart disease increased one percent for every 25-30 minutes of inactivity. What’s more, they found that, contrary to popular belief, moderate or high-intensity movement wasn't the only way to decrease the risk of risk of heart disease.

    The study was the first to use actual movement data. Participants in the Lifestyle Interventions and Independence for Elders (LIFE) study were recruited to wear an accelerometer on their hips during the day. The average age of the participants was 79 ±5 years. Data from the devices showed that, on average, the participants spent 77% of the time, or 642 ±111 min/day, in sedentary behavior, 138 ±43 min/day engaged in low-level activities, and 54 ±37 min/day engaged low to moderate activities. Each sedentary minute per day was associated with increased heart disease risk among both those with cardiovascular disease (0.04%, 95% CI 0.02% to 0.05%) and those without CVD (0.03%, 95% CI 0.02% to 0.03%).

    The study is significant because older adults account for nearly 70% of CVD‐related deaths and for nearly 75% of CV health care expenditures, according to the researchers.

    The results are good news for mobility-impaired seniors, according to Dr. David Frid, a cardiologist with the Cleveland Clinic. “I think the study kind of confirms what we’ve always believed,” says Dr. Frid in a Reuters Health report. “As everybody gets older, we know their cardiovascular risk goes up and the more active they remain it’s going to reduce their overall cardiovascular risk. In general though, older people can try to be a bit more active, but they should check with their doctor before starting an exercise program that involves things like running on a treadmill or pedaling a bike.”.

  • Blueberries Help Postmenopausal Women Decrease BP

    Can a blueberry – or a cup of blueberries – a day keep the cardiologist away? Yes, according to a study of postmenopausal women performed at Florida State University and published in the Journal of the Academy of Nutrition and Dietetics.

    For the study, 48 healthy, postmenopausal women ages 45 to 65 with pre- and stage 1-hypertension took part in a randomized, double-blind, placebo-controlled, eight-week clinical trial. The women were divided into two groups. One took 11 grams of freeze-dried blueberry powder twice a day (morning and night) while the other group took 22 grams of a placebo powder. Twenty-two grams of the blueberry powder equates to one cup of fresh blueberries.

    After eight weeks, the blueberry group experienced a 5.1% (range=0% to –9.9%) decrease in mean systolic blood pressure along with a 6.3% (range=–1.3% to –11.0%) reduction in mean diastolic blood pressure. No reductions in mean SBP or DBP were observed in the control group.

    The researchers theorized that blueberry consumption may influence nitric oxide production. This theory is supported by studies showing that flavonoids such as blueberries improve vasodilation through endothelial production of nitric oxide..

  • Cholesterol Poised To Lose 'Nutrient of Concern' Status


    The Dietary Guidelines Advisory Committee (DGAG), a group of top nutrition experts who meet every five years to assess and recommend health-enhancing changes to American dietary habits, will soon stop referring to cholesterol as a “nutrient of concern.”


    Sometime in 2015, the DGAG will release its revised Dietary Guidelines under the auspices of the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA). The new Dietary Guidelines are a powerful influence on the nation's nutritional programs, including how school lunch menus are developed, how foods and beverages are labeled and marketed, and how dietitians dispense dietary advice.



    Some experts believe that taking cholesterol off the nutrients of concern list may lead consumers to interpret the new guidelines as a license to put cholesterol-laden foods back on their tables. Others think that the case against cholesterol was overblown in the last Dietary Guidelines.


    "Looking back at the literature, we just couldn't see the kind of science that would support dietary restrictions," says Robert Eckel, the co-chair of the task force and a medical professor at the University of Colorado, in a Washington Post report about the meeting. The recommended figure of 300 milligrams of cholesterol per day is "just one of those things that gets carried forward and carried forward even though the evidence is minimal," he says.


    The idea that cholesterol may not be the dietary villain it was portrayed to be was announced at a December 2014 DGAG meeting. According to the Committee, current research supports the hypothesis that a healthy adult cholesterol intake does not boost the amount of cholesterol in the blood, nor does normal intake increase the risk of heart disease.


    The new thinking poses a challenge in that LDL-C, saturated fats, and trans-fats still are consider health risks. Just because cholesterol no longer is a nutrient of concern doesn’t mean people can consume as many trans-fats or saturated fats as they desire. What’s more, people must still be concerned about high LDL-C levels.


    Communicating these nuances will be vital for the DGAG as it fine-tunes its report. "It's turned out to be more complicated than anyone could have known," says Lawrence Rudel, a professor at the Wake Forest University School of Medicine in the same Washington Post article.  “Eggs are a nearly perfect food, but cholesterol is a potential bad guy. Eating too much a day won't harm everyone, but it will harm some people."



  • Multivitamin Controversy Rages On: Study Points to Heart Benefits for Women

    Should healthy people eating reasonably healthy diets take multivitamins?

    In February 2014, the U.S. Preventative Services Task Force, a group of 16 healthcare volunteers supported by the Agency for Healthcare Research and Quality (AHRQ), said no, there was insufficient evidence to recommend multivitamin products as a means to prevent cardiovascular disease or cancer. The conclusion didn’t sit well with a group of National Institutes of Health researchers. Using data from the extensive National Health and Nutrition Examination Survey III, the team discovered that women who took multivitamin-mineral supplements for  at least three years were significantly less likely to die.

    The authors cautioned that multivitamins did not benefit men, women taking them for less than three years, or anyone taking just multivitamins without minerals.

    “It’s way too early to really know if use of multivitamin-minerals over time reduces the risk of cardiovascular mortality (or any other health problem or cause of death) in women,” Regan Bailey, who led the study, told Reuters Health in an email.

    “Our study suggests the possibility that there is such a connection for women, which is an interesting finding but to know for sure would require a clinical trial,” said Bailey, a registered dietitian and researcher at the NIH Office of Dietary Supplements.

    More than one-third of Americans take MVMs, spending about $ 5.5 billion each year.

    Bailey said many health behaviors, such as eating nutritiously, exercising regularly and not smoking clearly reduce the risk of developing heart disease and dying from it.

    “Taking a multivitamin-mineral should not be a replacement for any of these behaviors,” she says. “And it’s not clear whether taking a multivitamin-mineral added to a healthy lifestyle is going to provide an additional health advantage.”

    For their study, published online in The Journal of Nutrition, Bailey’s team analyzed data for 8,678 healthy adults. About 21% of those participants who took dietary supplements used MVMs - defined as three or more vitamins plus one or more minerals – and 14% used multivitamins without minerals.

    The researchers followed the participants for an average of 18 years to find out how many died of cardiovascular disease.

    Women who had been taking multivitamin-mineral dietary supplements for at least three years when they answered the survey had a 35% lower risk of dying from heart disease over the following decades when compared to women who did not use the supplements.

    Dr. Benjamin Baechler, a physician at the University of Minnesota in Minneapolis who practices integrative medicine, called the new study’s results thought provoking.

    “When it comes to a daily supplement, this study suggests making a distinction between a product that only has vitamins and those that also have minerals,” he says..

  • Be Red On February 6th To Support The AHA’s National Wear Red Day


    The American Heart Association has designated February 6th, 2015, as National Wear Red Day to raise awareness about women and heart disease.

    According to the AHA’s site, heart disease remains the leading killer of women in spite of widespread knowledge of the risks. About 43 million women are affected by cardiovascular disease. Since 1984, more women than men had died each year from heart disease and stroke, and about 55,000 more women than men have a stroke each year. 

    About 80% of heart disease and stroke events among women are preventable, according to the AHA. The association recommends that all women visit their healthcare provider to check their numbers, i.e., blood pressure, cholesterol and glucose. Lifestyle changes are important, including not smoking, losing weight, being physically active, and eating healthy.  

    For more information, visit or connect via Facebook at

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