cheap Canada Goose New data fuels doctors’ demands to rewrite U
(Repeats with no changes to text)
canada goose black friday sale By Julie Steenhuysen and Bill Berkrot
buy canada goose jacket cheap CHICAGO, Nov 21 (Reuters) Controversial heart disease prevention guidelines that abandoned specific targets for reducing LDL cholesterol are buy canada goose jacket under fresh assault after a major study highlighted the benefits of canada goose uk shop taking LDL to very low levels.
Guidelines issued last year by the American Heart Association and the American College of Cardiology asked doctors to assess individual patients risk for heart disease over 10 years based on a complex calculation of risks posed by lifestyle, family history and other health conditions. Those deemed at sufficient risk would be prescribed cholesterol lowering statins.
Canada Goose Outlet The recommendation overturned canada goose clearance sale decades of practice in which doctors screened patients for high cholesterol, canada goose then sought to reduce LDL Canada Goose sale to a specific level. Many cardiologists uk canada goose criticized the guidelines, saying they were confusing, and that patients and physicians were comfortable with measurable goals canada goose coats on sale to reduce the risk of heart disease, the world No. 1 killer.
canadian goose jacket Those opponents got a boost from data released on Monday showing high risk patients fared better when their LDL was brought to very low levels by adding Merck Co Zetia to treatment with a statin.
canada goose store Several prominent heart specialists told Reuters the guidelines should be changed, with some advocating LDL targets even lower than previous ones. Many have ignored the year old recommendations.
never really bought the new guidelines, said Dr. Andrew Klaus of Mount Carmel Health System in Columbus, Ohio. The Zetia trial showed that lower is better, he said. would predict the guidelines are going to be rewritten very soon.
canada goose coats on sale The so called Improve It trial of Merck Zetia, canada goose black friday sale unveiled cheap canada goose uk at the AHA annual meeting in Chicago, studied more than 18,000 high risk patients. It showed they could further cut heart attacks and strokes by taking LDL cholesterol from about 70 canada goose uk black friday to around 53.
canada goose clearance sale Dr. Steven Nissen, cardiology chief at the Cleveland Clinic, said the result up the prevention guidelines.
canada goose coats matters how low you go (with LDL). which is why many of us were so upset about the guidelines, Nissen told Reuters. At a recent meeting of cardiologists and primary care doctors, Nissen asked how many had adopted the guidelines.
canada goose out of those 300 raised their hand, he said. is using them.
Canada Goose online TOMES Millions of Americans at risk of Canada Goose Jackets heart disease could be affected by the outcome of the debate. Some 83.6 million live with some form or cardiovascular disease or the effects of stroke, according to the buy canada goose jacket cheap AHA.
Canada Goose Parka By some estimates, the new guidelines would boost the use canada goose coats of high potency statins such canadian goose jacket as AstraZeneca Crestor and Pfizer Inc Lipitor, now available as cheaper generic atorvastatin.
buy canada goose jacket The debate could also affect the future of new medicines from Amgen Inc and Regeneron Pharmaceuticals Inc that reduce LDL even more aggressively.
In Reuters interviews with more than a dozen cardiologists attending the AHA meeting, most said they were wrestling with the guidelines.
AHA and ACC officials have heard the Canada Goose Coats On Sale complaints and said the guidelines are subject to revision based on new scientific data.
canada goose deals don want guidelines that serve as scientific tomes that nobody finds useful, said Dr. Robert Harrington, an AHA https://www.radondenvercolorado.com board member. need our guidelines to really help guide practice.
When a major trial like Improve It comes out, absolutely responds to that, he said.
Dr. Patrick O president of the ACC, said the new guidelines were based on the fact that uk canada goose outlet clinical trials of cholesterol lowering Canada Goose Online statin drugs were not designed to test the effectiveness of specific cholesterol targets canada goose uk outlet only the drugs themselves. canada goose store Doctors following the guidelines tend to test cholesterol levels far Canada Goose Outlet less frequently, and that has some in the field worried.
Canada Goose Jackets still having this back and forth, which seems to represent a gap between the manner in which trials were designed and the practical implications, O said. Canada Goose online hope we will be able to strike the right balance in the cheap Canada Goose process.
CLARIFYING THE MESSAGE Dr. Lori Mosca of New York Presbyterian Hospital, who helps train residents, said she is frequently asked how to interpret the guidelines.
is sufficient confusion out there that it worthy of clarifying what the message is, she said.
Dr. Matthew Sorrentino, a preventive cardiologist at University of Chicago Medicine, uses the guidelines. But he said the older targets an LDL of 70 for high risk patients were easier for canada goose factory sale doctors and patients to grasp.
everybody knew what the LDL target was, he said. can see making the guidelines easier to follow. Donald Lloyd Jones of Northwestern Medicine in Chicago, defended the scientific rigor behind them. He said focusing on a cholesterol goal may have led to canada goose sale undertreatment, perhaps failing to take into account the added risks from diabetes, obesity or smoking.
A new class of drugs, known as PCSK9 inhibitors, that can lower LDL by more than 50 percent may increase the pressure for new, even lower, LDL targets, some doctors said. One from Amgen and another developed by Regeneron and Sanofi are expected to reach the market next year and initially be used in patients with extremely high cholesterol Canada Goose Parka or those who cannot tolerate statins.
Canada Goose sale can really canada goose clearance get away from paying attention to what the LDL is, said Dr. Daniel Rader, director of the preventive cardiology program at the University of Pennsylvania. (Reporting by Julie Steenhuysen and Bill Berkrot; Editing by Michele Gershberg and Douglas Royalty).