If you’re confused about standards for managing hypertension in older adults, you’re not alone. When the American Heart Association and American College of Cardiology updated the guidelines in November 2017, millions of adults suddenly faced a new diagnosis of high blood pressure. Adding to the confusion: some medical organizations disagreed with the revisions, opting instead to manage their older patients according to prior standards. Continue reading
Is it just me, or do medical journals seem to have a knack for publishing conflicting findings on the same topic within the very same week?
That’s what happened earlier this month when the journal Nature Medicine published a fascinating paper that linked a chemical plentiful in red meat, l-carnitine, to the acceleration of atherosclerosis in mice. Researchers also found convincing evidence that when l-carnitine is converted into another chemical, called TMAO, by gut bacteria it may also be linked to heart disease in people. (For an engrossing account of these experiments and the science behind them, check out Gina Kolata’s story for The New York Times.)
A few days later, I ran across this headline: “L-Carnitine Significantly Improves Patient Outcomes Following Heart Attack.” C’mon now. Really? First l-carnitine is bad for the heart, now it’s beneficial? Continue reading
This is the second of two posts about a study of whether chelation therapy might benefit some patients who have suffered a heart attack. In the first post, I gave health reporters high marks for their coverage.
Early in my career, I covered a story on chelation therapy. It was the first time I’d ever heard of the alternative treatment. I was a broadcast producer, and we needed video, so we visited a chelation clinic. Looking back, I can’t recall what our story was about, but I do remember what it was like to talk to the patients as they sat in recliners that lined the walls of the narrow storefront.
They were all hooked up to IV bags filled with a vivid yellow liquid that was a mixture of B-vitamins and the chemical EDTA that they believed was flushing heavy metals, minerals, and toxins from their bodies.
Many spoke of chelation with fervor. One man, a diabetic, credited the regular three-hour infusions with saving his legs, which were riddled with sores.
Chelation has been around for decades. It is accepted treatment for lead poisoning and other kinds of heavy metal toxicity. But alternative practitioners have greatly expanded its use, with claims that it can treat myriad ills, everything from autism to Alzheimer’s to problems caused by metal hip implants. There’s almost no scientific evidence to back up these claims.
It was against this backdrop – lots of claims, enthusiastic patients, evangelistic providers – that the NIH set out to test the practice.
The Trial to Assess Chelation Therapy, or TACT, has again ignited a heated debate among doctors.
Here’s another voice to add to the discussion. He is lead study author Gervasio A. Lamas, M.D., chairman of medicine at Mount Sinai Medical Center in Miami Beach, Fla., and professor of clinical medicine at Columbia University Division of Cardiology. I asked him to talk about the process of publishing TACT and asked him to respond to a few of the main criticisms of the trial. These are lightly edited questions and answers from our interview: Continue reading
In case you missed it, health reporters who cover medical studies had a shining moment recently. It centered around the heavily stage-managed publication of the Trial to Assess Chelation Therapy, or TACT.
TACT was a 10-year double-blind, randomized controlled study of 1,708 patients that was carried out at 134 sites in the U.S. and Canada. It cost the government and, by extension, taxpayers, $31 million. About 60 percent of the sites were traditional chelation centers – some of which had shaky legal histories, the rest were traditional cardiology practices and academic medical centers, including Johns Hopkins Bayview Medical Center and the Mayo Clinic. Continue reading
Peggy Peck of MedPage Today found that research presented as new at the European Society of Cardiology’s annual meeting this weekend was actually published in July, despite the society’s requirement that information submitted for presentation must be new, unpublished data.
When asked by MedPage Today to point out the “news” in the Hot Line presentation, STAR lead investigator Bodo-Eckehard Strauer, MD, of the Heinrich Heine University of Düsseldorf, Germany, said the news was that bone marrow cell therapy significantly improved survival in patients with chronic cardiomyopathy, which he illustrated with a slide showing a Kaplan-Meier curve – the same graph that was published in the July issue of the European Journal of Heart Failure. Moreover, every data slide in Strauer’s presentation matched the tables in the published paper.
Following questions from MedPage Today, the organization acknowledged its error and has announced the researcher will not be allowed to present at its meetings for two years. Roberto Ferrari, M.D., president of the society, said the research had been accepted for presentation because they thought it had new data but that “We were snookered.”