Note: This is a slightly revised version of a talk I delivered at the recent CVCT Conference in Washington, DC. Why are we vulnerable to fake news and why is it so hard to get rid of it? This is a complex question, but one important factor is that fake news delivers clear and simple…
Right Wing Minority Rule
September 6, 2018 by 19 Comments
The US is not perfect but until recently it has always moved, inexorably, if slowly and fitfully, in the general direction of justice and greatness. The best and undeniable example of this in recent times is the election of Barack Obama, something which would have been unthinkable at any other time in our history. But…
No, A Big NIH Trial Did Not Show That Lowering Blood Pressure Will Prevent Dementia
July 26, 2018 by 4 Comments
It’s “breakthrough” time again. News reports out of the Alzheimer’s Association International Conference (AAIC) this week have been relentlessly upbeat and positive about findings from the NIH’s SPRINT MIND study. The message: aggressive blood pressure control can help protect the brain. But unless you look very carefully at the news reports and “expert” statements you won’t…
If You Look For Atrial Fibrillation You Will Find Atrial Fibrillation
July 10, 2018 by 3 Comments
If you look hard to find people who have atrial fibrillation (AF) you will in fact find people who have atrial fibrillation, a new paper published in JAMA shows. But the paper offers no evidence whatsoever that the new diagnosis improves outcomes in these people, though it does find that the diagnosis leads to increased use of…
American Heart Association Venture Capital Fund Sparks Criticism
May 17, 2018 by 3 Comments
(Updated) The American Heart Association has announced that it has launched a $30 million venture capital fund “designed to spur healthcare innovation in heart disease and stroke care.” The AHA said that the Cardeation Capital fund will be funded by the AHA and co-investors Philips and UPMC. The fund “will invest in emerging healthcare companies that can…
Cardiology World Erupts Into Controversy Over Change In Major Clinical Trial
March 18, 2018 by 4 Comments
As a major clinical trial in cardiology nears completion it has provoked a storm of criticism and controversy. The brouhaha erupted in response to a late change to one of the most important— and already controversial— trials in cardiovascular medicine. The NIH-funded ISCHEMIA trial was designed back in 2011 to provide a definitive answer to…
Nuance And The Healthcare Apocalypse
December 21, 2017 by 5 Comments
(Updated) If you actually have a life you may not be aware that there’s been a fierce debate on Twitter and the blogosphere over Lisa Rosenbaum’s NEJM article decrying the oversimplification and self-righteousness of the “less is more crusade.” In response to fierce criticism, from myself, the Lown Institute, and others, Saurabh Jha praised and defended Rosenbaum for embracing nuance…
Huge Diet Study Questions Conventional Wisdom About Carbs And Fats
August 29, 2017 by 7 Comments
–But PURE also challenges belief that more is better for fruits and vegetables. BARCELONA — An enormous prospective study of food intake in adults, reported here, challenges several staunchly held beliefs about dietary components and their association with health risks: finding, for example that diets rich in fats, including saturated fats, don’t increase mortality risk,…
Scott Gottlieb’s Sham Ideology Rejects Clinical Trials
March 14, 2017 by 3 Comments
Donald Trump has nominated Scott Gottlieb to be the next FDA Commissioner. To his credit, Gottlieb is not certifiably crazy like several of the other candidates who were reported to be under consideration for the job. But he is is a deeply conservative ideologue who is determined to reduce the government’s role in healthcare. On two occasions in…
Long Unsuccessful Heart Failure Drug Once Again At Center Of Controversy
January 23, 2017 by 9 Comments
–The long, strange 30-year journey of BiDil. It’s been buried in the avalanche of related news but there’s an interesting and somewhat bizarre cardiology angle to the debate over Trump’s nomination of Tom Price to be the next HHS Secretary. ProPublica reported on Friday that last summer Price went to bat for the makers of…
How The Internet Brought Us Donald Trump
November 20, 2016 by 4 Comments
Does the internet expand our world? Does it lead us to a broader and richer view of our world and ourselves? It seemed like a simple question. The year was 1994 and the internet was still new. I was sitting in a classroom full of MIT students as a guest during my year as a…
Is The American Heart Association Trying To Kill Health Reporters?
November 14, 2016 by 4 Comments
The answer is no. The AHA is not trying to kill us. But its dietary advice is consistently confusing and occasionally wrong, and health reporters in New Orleans may end up as collateral damage. Just take a look at what’s being served in the press room at the big American Heart Association meeting going on now…
Time For Cardiologists To Start Prescribing Diabetes Drugs?
June 22, 2016 by 2 Comments
There’s an emerging consensus that now may be the time for cardiologists to start thinking seriously about prescribing diabetes drugs. Until now most cardiologists have not considered this to be part of their job description. But now new data from large cardiovascular outcome trials (CVOTs) shows that these drugs may one day become, like statins and…
The American Heart Association’s Strong Stance Against Science
May 25, 2016 by 8 Comments
Once again the American Heart Association has taken a strong stance against science. Of course, that’s not how the AHA phrases it. In its own words the AHA says it “strongly refutes the findings” of a “flawed study” which “you shouldn’t use… to inform yourself about how you’re going to eat.” But in fact the…
Study Suggests Salt Restriction Only Beneficial In People With Hypertension
May 22, 2016 by 3 Comments
–More questions raised about broad efforts to restrict salt; AHA condemns study A large new analysis offers more evidence that broad salt restriction doesn’t benefit most people and may even harm some people. The study did find that salt restriction may be beneficial to the minority of people with high blood pressure who also consume…
On Road To Bankruptcy A Stent Company Invested in Marty Leon’s VC Fund
May 3, 2016 by 1 Comment
More questions are being raised about the research and financial activities of Palmaz Scientific, the bankrupt medical device company founded by Julio Palmaz, the co-inventor of the stent. In the middle of severe financial troubles that eventually brought the company to bankruptcy Palmaz Scientific found enough money to invest in a venture capital fund. The VC Fund,…
Experts Foresee Major Role For Generic Crestor
May 2, 2016 by Leave a Comment
— Finally there’s a challenger to the long reign of Lipitor The FDA approval on Friday of the first generic version of Crestor (rosuvastatin calcium) marks the end of an era and the beginning of a major shift in cardiovascular medicine. Over time, as the price of the drug drops with generic competition, it seems…
FDA Adds Heart Failure Warning To Saxagliptin and Alogliptin Labels
April 6, 2016 by Leave a Comment
The FDA said on Tuesday that it was adding new warning to the labels of diabetes drugs containing the saxagliptin and alogliptin. The FDA said the drugs “may increase the risk of heart failure, particularly in patients who already have heart or kidney disease.” The announcement comes two years after an FDA panel recommended that…
How Many People Really Have Familial Hypercholesterolemia– And Does It Matter?
March 14, 2016 by 1 Comment
A new study estimates that about 834,000 adults in the US have genetically high cholesterol levels, otherwise known as familial hypercholesterolemia (FH). The prevalence of FH, which the authors calculate as 1 in 250 American adults, is twice the size of earlier assumptions. But the authors acknowledge that the criteria for FH used in their…
Studies Spotlight Role Of Triglycerides, Put HDL In The Background
March 11, 2016 by Leave a Comment
Two new studies provide more evidence tilting the balance in favor of triglycerides rather than HDL playing a causative role in cardiovascular disease. But it is still too early to know whether the findings of any of the studies will point to useful new methods to prevent and treat disease. In the first study, published…
The Door Opens Wider For Drug Companies To Make Off-Label Claims
March 9, 2016 by Leave a Comment
The FDA has finally reached a settlement in its long dispute with Amarin Corporation, manufacturer of the prescription fish oil product Vascepa. Last year a US judge ruled against the FDA. The settlement brings an end to the litigation and will permit Amarin to promote off-label usage of Vascepa as long as its statements are…
Best Selling Smartphone Blood Pressure App Gave Wrong Results
March 2, 2016 by Leave a Comment
A best-selling smartphone app that purported to measure blood pressure actually delivered highly inaccurate results, according to a research letter in JAMA Internal Medicine. The finding could cause genuine medical harm for the large number of people who use the app. In addition, the study adds new fuel to the fiery debate about the reliability…
Slow Down. Don’t Sprint To More Aggressive BP Treatment
February 22, 2016 by 7 Comments
Two editorialists in Annals of Internal Medicine urge caution in interpreting and adopting the findings of the SPRINT (Systolic Blood Pressure Intervention Trial), which last year showed a benefit for a more aggressive approach to blood pressure therapy. The trial found improved outcomes in high risk patients treated to a target of of 120 mm…
Vampire Lab Turns To Old Trick To Grow Business: Physician Owned Labs
February 11, 2016 by 15 Comments
(Updated) True Health Diagnostics, the new laboratory that bought the assets and adopted the business model of the disgraced and bankrupt laboratory company Health Diagnostic Laboratory (HDL), is turning to some old, unethical, and illegal tricks to grow its business. As I’ve reported previously, one key to the spectacular growth of HDL laboratory involved surreptitious…
Slow Start For ‘Blockbuster’ Heart Failure Drug Entresto
January 28, 2016 by 2 Comments
Entresto, the new heart failure drug from Novartis that is widely expected to be a blockbuster, is off to an exceptionally slow start. Approved last July, the drug, formerly known as LCZ 696, had sales of only $21 million in 2015, only $5 million of which came in the fourth quarter. Despite low expectations in the early…
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