EKG Card # 7 -Conduction system Components of the heart (Made Easy )

Reduced risk of dementia by Statin use ( Statins halved dementia risk in AF patients)

 Two new studies from Taiwan may have somewhat allayed concerns about cognitive dysfunction being a possible side effect of statins.These new data suggest that high-potency statins may reduce the incidence of dementia in patients with atrial fibrillation and in elderly patients. Nevertheless, before we can know for sure that statins may prevent dementia, a clinical trial confirming these findings is mandatory. Results showed an inverse relationship between statin use and dementia, with the risk of dementia reducing with increasing statin dose. This trend remained in different age, gender, and cardiovascular risk subgroups.The adjusted risks for dementia were significantly inversely associated with increased total or daily equivalent statin dosage. Patients who received the highest doses of statins had a threefold decrease in the risk of developing dementia. High-potency statins such as atorvastatin and rosuvastatin [Crestor, AstraZeneca] showed a significant inverse association with developing dementia in a dose-response manner. Higher doses of high-potency statins gave the strongest protective effects against dementia.All the statins except lovastatin were associated with a decreased risk for new-onset dementia when taken at higher daily doses. Lin suggested lovastatin may have shown different results as it has less cholesterol-lowering effect than other statins.Statins halved dementia risk in AF patientsuring a six-year follow-up, 2.1% of the patients taking statins developed dementia compared with 3.5% of the nonstatin group, a statistically significant difference (p=0.002).Other factors that were associated with a reduced risk of dementia included male sex and lower CHADS₂ score. History of MI, peripheral artery disease, coronary artery disease, chronic kidney disease, and valvular heart disease were not associated with new-onset dementia
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Systolic BP changes associated with 1-g increases in sodium intake

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Pushing for lower BPs in the elderly

A significant twofold increased risk of cardiovascular disease in elderly patients with systolic blood pressures >150 mm Hg as well as a significantly increased risk of coronary heart disease incidence.While stroke rates were not significantly increased in elderly patients with higher blood pressures, there was an increased risk of all-cause mortality among individuals 55 to 74 years of age with systolic blood pressures >140 mm Hg. The results, presented here today at the European Society of Cardiology (ESC) 2013 Congress, are considered hypothesis-generating at this point, say investigators, but do suggest a new standard for treating older patients.
Currently, the American College of Cardiology Foundation/American Heart Association guidelines recommend a treatment target of <140 mm Hg in individuals 65 to 79 years old, with older patients, those 80 years and older, treated to a target of 140 to 145 mm Hg, if tolerated. The European Society of Hypertension (ESH)/ESC recommend all elderly patients with a baseline systolic blood pressure greater than 160 mm Hg be treated to a target of 140 to 150 mm Hg. For fitter elderly individuals, treating to less than 140 mm Hg can be considered, according to the ESH/ESC.
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Difference between ECG patterns of Early repolarization and ARVC/D

What murmurs require further work-up and referral?

Losartan Looks Promising in Marfan Syndrome

AMSTERDAM-Hopes that angiotensin-receptor blockers (ARBs) could help reduce aortic dissections in Marfan syndrome got another boost today in the form of a small randomized trial from the Netherlands. Dr Maarteen Groenink (Academic Medical Center, Amsterdam, the Netherlands) presented the COMPARE trial results here at the European Society of Cardiology (ESC) 2013 Congressthis morning.

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