Items in AFP with MESH term: Cardiovascular Diseases
ABSTRACT: The results of recent large clinical trials have led physicians and patients to question the safety of menopausal hormone therapy. In the past, physicians prescribed hormone therapy in an attempt to improve overall health and prevent cardiac disease. Hormone therapy appears to increase the risk of breast cancer when used for more than three to five years; therefore, regulatory agencies now advise that physicians prescribe it only to treat menopausal symptoms such as hot flashes and vaginal atrophy, with the smallest effective dosage and for the shortest possible duration. Although estrogen is the most effective treatment for hot flashes, alternatives such as venlafaxine and gabapentin are effective for some patients. Herbal formulations such as dong quai, ginseng, kava, and dietary soy, among others, do not appear to benefit patients more than placebo. In contrast to systemic estrogen therapy, topical estrogen therapy for vulvovaginal atrophy is more appealing for certain patients because it does not require the addition of a progestogen for endometrial protection. Some have advocated selective estrogen reuptake modulators as alternatives to hormone therapy for the prevention of menopausal osteoporosis. The decision to use either therapy depends on clinical presentation and a thorough evaluation of the risks and benefits, because both have potential detrimental health effects and both are linked to an increased risk of venous thromboembolism.
American Heart Association Releases Scientific Statement on Cardiovascular Disease in Women - Special Medical Reports
ACSM/AHA Release Recommendations for Fitness Facilities - Special Medical Reports
ABSTRACT: Certain modifiable risk factors for cardiovascular disease have their beginnings in childhood. Cigarette smoking, hypertension, physical inactivity, obesity, hypercholesterolemia, hyperinsulinemia, homocysteinemia and poor nutrition in childhood and adolescence may all contribute to the development of cardiovascular disease in adulthood. Identifying at-risk children and adolescents is the first step in modifying or preventing these risk factors. Intervention is most effectively accomplished with an integrated family-oriented approach. Involving the entire family in counseling about interventions to reduce the risk factors for coronary artery disease is important. The family should complete a questionnaire about the family's history and risk of cardiovascular disease. The child, along with other family members, should be given advice on dietary changes to reduce fat intake. Incorporating a cardiovascular health schedule into routine office visits is useful for monitoring the risk of cardiovascular disease and for reinforcing the need to maintain healthy habits.
ABSTRACT: Family physicians are often asked to advise patients who are preparing to travel. The Air Carrier Access Act of 1986 has enabled more passengers with medical disabilities to choose air travel. All domestic U.S. airlines are required to carry basic (but often limited) medical equipment, although several physiologic stresses associated with flight may predispose travelers with underlying medical conditions to require emergency care. Recommendations for passengers with respiratory, cardiac or postsurgical conditions must be individualized and should be based on objective testing measures. Specific advice for patients with diabetes, postsurgical or otolaryngologic conditions may make air travel less hazardous for these persons. Air travel should be delayed after scuba diving to minimize the chance of developing decompression sickness. Although no quick cure for jet lag exists, several simple suggestions may make travel across time zones more comfortable.
AHA and ACC Issue Scientific Statement on Preventive Cardiology for Women - Special Medical Reports
AHA Examines Cardiovascular Problems in Diabetes - Practice Guidelines