Dr Ford Brewer - PrevMed

Stents did not improve survival long-term for patients. This was a long-term follow-up for the original COURAGE trial, also in the New England Journal.

Red yeast rice has been used for centuries in Chinese medicine. It has been shown to decrease cholesterol. It includes HMG-CoA reductase materials. In fact, statins were originally developed from Monacolins, the fungus used to make red yeast rice.

The FDA declared Monacolin products as a drug and tried to stop the sale of supplements containing them. This decision went to court and was overturned by the US Court of Appeals. They actually typically contain 10-20 mg of monacolins. Mevacor, made by Merck from red yeast rice, contains 20-80 mg of monacolins. So you're taking the same thing but usually at a lower dose. Side effects are the same: liver function problems, muscle breakdown.

I prefer to use better statins at far lower doses. And I don't appreciate the patent formula product salesmen all over the web saying, "my product, XXX, is safer, more effective, and contains the exact right combination

Bacopa monnieri is an ancient Ayurvedic treatment for improved cognition, decreased depression, and anxiety. It is also called Brahmi ( along with its companion Gotu kola). Dale Bredesen, at The End of Alzheimer's, says it improves cholinergic function. Others say it is an antioxidant that passes the blood/brain barrier.

Standard use is 300 mg of the active ingredient bacosides.

The science is not incredibly strong. But there are a few well-designed, but underpowered (too few subjects).

If you investigate the science, you will likely see the Portland study. It was, like the others, underpowered, with 54 total participants. They did see decreased depression and anxiety and improved cognition using objective studies. P values were low, as would be expected with such small numbers.

About John Lorscheider - John is a frequent contributor. He’s also a PrevMed patient. Like most of us, John’s family and personal history includes significant cardiovascular risk.

John came from a technical background and spent his entire career in providing engineered fluid process systems and equipment to industry, as well as performing root cause failure analyses for his customers.

His own study and research made it clear he wasn’t getting the whole story about prevention from his docs. They just didn’t know. So he’s been in several roles of running prevention medical groups to help further the science.

I've debated and struggled for months about doing a series on mindfulness. I will start with book reviews on Untethered Soul by Micheal Singer, and The Power of Now, by Eckhart Tolle. Both were introduced to the larger public by Oprah Winfrey - Singer in 2012 and Tolle in 2007.

Here's why I've debated this series; this channel has been all about scientific evidence. Stress management through mindfulness tends to be the antithesis of science. It changes the focus from problem-solving to experience.

There is a group known as a "marriage of western and eastern thought". It's called Palouse Mindfulness. To me, they're not so much a marriage of the two. They're using western science to document the effect of eastern thought patterns and techniques.

Untethered Soul starts with a typical yogi's technique of reductionism of self; asking the question, "who am I"? It strips away the assumptions that we are our externals: physical attributes, roles, and relationships. We are, instead, an internal entity experiencing the external world.

The Power of Now starts off focusing on the mind's construct of time. Problem-solving focuses on the past and future. These are, again constructs of a problem-solving mind. Now is the experience of that internal part of us that is mindful, the Watcher ( as opposed to the Thinker).

In 2004, 1 million stents were placed in the hearts of Americans. 85% appear to have not helped. This is according to the most respected medical journal in the world - the New England Journal of Medicine.

On my first day with the FreeStyle Libre, I awoke in the middle of the night. I spent a good deal of time in the 70s, 60s, and even some time in the 50s.

The device works great in terms of seeing a pattern over the past few hours. And it's easy, quick, and simple. Just press the button and hold the reader next to the device.

The connection to the computer - and to my iPhone - are not so simple or intuitive.

ARBs are not ACE Inhibitors. ACE Inhibitors were the original drug in the renin-angiotensin antagonists. They have a big long-term impact in terms of preventing heart attacks. But they also cause cough in up to 20% of patients. ARBs were developed to accomplish the same thing but without the cough. ARBs do decrease blood pressure. And they decrease long term risk for stroke. But they DO NOT decrease the risk of a heart attack. ACE Inhibitors do decrease the risk of heart attacks. There are reasons for this. It is likely due to the fact that ACE Inhibitors cause increased bradykinin by slowing the breakdown of bradykinin). Bradykinin does many things to decrease cv inflammation, include increased Nitric Oxide and decreased monocyte function.

Stents are incredibly prevalent. All of us know many people that have had stents. Usually, the reason the patient understands is the following, "I had a ___ % blockage in the artery of my heart."

There have been multiple studies showing that many ( maybe most) stents don't help. The most recent was the ORBITA study, published in the LANCET in January 2018.

The ORBITA trial was a randomized comparison of stents to lifestyle and medication therapy of 200 individuals. They even did a sham procedure. Here's how that worked. All 200 patients were admitted and prepped for the stent procedure. So all 200 had no clue whether they'd actually had a stent placed or not.

The result? There was no difference in the treadmill exercise test. The stents did not help.