CONTROVERSIES & ADVANCES IN CARDIOVASCULAR DISEASE - DECEMBER 2021

Attending my first “live” medical conference since COVID-19, I must say that this annual symposium, sponsored by Cedars-Sinai Medical Center, certainly met my expectations for the most part.

Reviewing the role of inflammation and its various triggers as it relates to heart disease was certainly time-honored. Also covered were the controversies of using fish oil, and the highly acclaimed ISCHEMIA trial; should we stent the artery or exhaust medical therapy? After all, the desired result should always be patient outcomes, and not the procedure.

We were updated on the latest in cardiac imaging techniques including echocardiography, CT scanning and CMR (Cardiac Magnetic Resonance), which is MRI with the heart being the targeted image.

If you think women are from Venus and men from Mars, you are correct. It’s not only about the difference in a woman’s presentation that matters but appreciating the role of various risk factors that we don’t generally consider: risks experienced in pregnancy, such as gestational diabetes or pregnancy-induced hypertension, autoimmunity, and depression to name a few. Furthermore, pregnancy totally challenges the cardiovascular system in ways many of us fail to realize.

Being an integrative cardiologist, I like to focus on lifestyle. As expected, this symposium was totally based on the traditional model. Despite this being a full 2-day conference, there was a mere one lecture on nutrition: What Diet is Best for Cardiovascular Health? The speaker recommended a plant-based diet. He outwardly admitted that most nutritional studies are limited in scope, because they tend to be observational in design. He quicky projected slides on a few of these studies, before concluding that the best diet for heart health and longevity was clearly vegan.

My response: Really? Such unequivocal evidence does not exist. There was no mention of the Mediterranean Diet which made headlines years ago with the PREDIMED study. I was majorly disappointed.

My other point of contention was the never-ending argument touting the benefits of statins and new drugs to get the LDL (lousy) cholesterol to levels lower than ever. The concluding recommendation: any patient with any level of coronary disease, as noted on a coronary artery calcium scan, should have LDL cholesterol no higher than 70. Even if the score is a one!  Obviously, drugs would be needed to achieve values this low.

A bit short-sighted, but again this is traditional cardiology.

In summary, I rank this symposium quite favorably despite a few disappointments. I endeavor to take in what I can while appreciating the limitations of traditional cardiology/medicine

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this site. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2021