Don’t miss a beat! Get involved with October’s National Cholesterol Month

As a long-term provider of popular high-cholesterol treatments such as Lipitor and Crestor, Medical Specialists® Pharmacy are proudly supporting October’s National Cholesterol Month 2015, organised by the charity HEART UK to raise more awareness about what cholesterol is, the often underestimated serious health risks associated with high cholesterol, and what can be done to lower the low-density lipoprotein (LDL) – also known as ‘bad cholesterol’.

What is cholesterol?

For those unaware of what cholesterol actually is, it is a fatty, waxy substance known as a ‘lipid’, located in all of the body’s cells. The body requires some cholesterol to produce hormones, vitamin D, and substances to aid food digestion, and will produce what it needs, but some of the food we eat also contains cholesterol.

Cholesterol travels through the bloodstream in small packages that go by the name of lipoproteins. The two main types of lipoprotein are:

. High-density lipoprotein (HDL) – HDL carries cholesterol away from the cells and back to the liver, where it’s either broken down or passed out of the body as a waste product. For this reason, HDL is referred to as ‘good cholesterol’ and higher levels are better.

. Low-density lipoprotein (LDL) – LDL carries cholesterol to the cells that need it. If there’s too much cholesterol for the cells to use, it can build up in the artery walls, leading to disease of the arteries. For this reason, LDL is known as ‘bad cholesterol’.

High cholesterol – i.e. high levels of the bad LDL cholesterol – itself will not usually cause any symptoms, but it increases a person’s risk of serious health problems.

For example, plenty of evidence shows that high cholesterol can raise the risk of suffering with heart attack, heart disease, stroke, narrowing of the arteries (atherosclerosis), transient ischaemic attack (known as a ‘mini-stroke’) and peripheral arterial disease.

These risks are due to the fact cholesterol accumulate within the artery wall, reducing blood flow to the heart, brain and other areas of the body. In addition, the risk of a blood clot is also increased with high cholesterol.

What causes high cholesterol?
There are a number of contributing factors to a person having high blood cholesterol, some lifestyle choices, others being related to underlying conditions and there is also a risk if there has been a family history of such problems.

Lifestyle choices that can cause high cholesterol include a lack of exercise or physical activity, drinking too much alcohol, having a diet high in saturated fat and being a smoker. People with diabetes or high blood pressure usually also have high cholesterol.

Highlighting the risks of ‘The Silent Killer’ high cholesterol is imperative for HEART UK during National Cholesterol Month for many reasons, but one of those is to educate people about a condition many will not be aware of, but can be deadly – Familial hypercholesterolaemia (often shortened to FH).

FH is inherited, passed on by one of your parents and can cause incredibly high levels of cholesterol. Those with FH have high cholesterol levels from birth, whereas most people’s cholesterol increases with age and could be 50, 60 or 70 years of age before their cholesterol is deemed to be at a level linked to an increased risk of major heart problems.

Some people may never display any symptoms, but the common signs of FH are lumps and bumps around the knuckles or Achilles tendon (due to cholesterol deposits), yellow cholesterol build-up around the eyes and eyelids, or a pale ring around the iris.

If, after going to the doctor for a cholesterol check and it is found to be significantly high, the doctor may refer the patient to a specialist for an assessment if he or she believes that patient has FH, which could include gene tests. The specialist will then explain which family members need to be assessed too and medication will likely be required, as healthy lifestyle choices alone are not enough to reduce cholesterol for anyone with FH.

Treating high cholesterol

Adhering to a healthy diet that is low in saturated fat and engaging in regular exercise to maintain a healthy weight/BMI can lower the level of cholesterol in the blood, or prevent cholesterol levels being too high to begin with. The higher the cholesterol level, the higher the risk of stroke or heart disease and therefore the overall risk of having a heart attack.

Statin medication available today from Medical Specialists®, such as Atorvastatin, Pravastatin or Rosuvastatin, work to lower the LDL (‘bad’) cholesterol and raise the HDL (‘good’) cholesterol. Statins may be prescribed to certain people with risk factors for heart conditions, such as those with high cholesterol or high blood pressure, older patients, smokers, or those with family history of early heart disease. Between eight and ten million Britons take statins, making them the most widely prescribed drugs across the UK.

Get involved with National Cholesterol Month

HEART UK are providing expert, independent advice on statins and other cholesterol treatments, in addition to campaigning for improved detection of those at risk of high cholesterol and offering training for health professionals.

National Cholesterol Month 2014 was a roaring success, with more than £25,000 raised, but HEART UK are hoping to smash this amount for 2015, continuing with the theme the ‘Great Cholesterol Challenge’.

HEART UK state on their website how people can get involved and acquire a fundraising pack, saying: “Treat your heart by pledging to adopt a new healthy habit and raise funds for HEART UK at the same time! For this year’s campaign we have developed some really exciting ‘virtual challenges’ which we know you will love – see how you can get involved!

“Great Cholesterol Challenge packs are available now! If you would like a pack or need any further information about this year’s campaign, please email us and we will get one sent to you.”
Moreover, HEART UK offer advice on who should have cholesterol tests and how frequently to get one done:

•     Every 5 years if you are between the ages of 40 and 75.
•     Every 12 months if you are on cholesterol lowering medication.
•     Any child of a parent with inherited high cholesterol (FH) – by the age of 10.
•     First degree relatives of a person with FH – on being told of the risk.

“The NHS will provide you with a free cholesterol test if you fall into any of the above groups, speak to your Doctor or Practice Nurse about arranging your cholesterol test.”

Could diet soft drinks cause heart attacks and strokes?

The diet sugar-free soft drink…often seen as a beneficial tool in the quest for weight loss and a staple in the diet of many people trying to lose weight that may have a sweet tooth. With almost zero calories and apparently none of the spoonfuls of sugar that has been lumped into their full-sugared counterparts, diet drinks are almost too good to be true.

However, this too good to be true mantra, may actually be fitting after the alarming findings of a new study into artificially sweetened fizzy drinks and the impact they can have on our body.

Worryingly, those people who are drinking two or more diet soft drinks each day may be a staggering 50% more likely to die because heart disease. This conclusion was arrived at after health experts looked at the diet drink consumption of nearly 60,000 people taking part in the women’s health initiative, a long-term US study into the cardiovascular health of post-menopausal women.

The average age of the women was calculated at 62.8 and all women must have had no prior history of cardiovascular problems to be involved in the study.

Through a questionnaire, women were asked to document how many diet drinks they drank over a duration of three months, with a drink being taken as a 12oz (355ml) sized beverage including diet soft and fruit drinks.

The researchers tracked the women for an average follow-up time of about 9 years, variety of negative outcomes occurred in 8.5% of those who drank at least two diet drinks each day. These negative outcomes included: coronary heart disease, congestive heart failure, heart attack, ischemic stroke, peripheral arterial disease and cardiovascular death.

In contrast, negative outcomes occurred in 6.9% of the women who drank between five and seven drinks each week, within 6.8% that had drank one to four drinks per week, and 7.2% drinking between zero and three diet drinks each month.

“Our findings are in line with and extend data from previous studies showing an association between diet drinks and metabolic syndrome,” commented Dr Ankur Vyas, of the University of Iowa Hospitals and Clinics, lead investigator of the study. The syndrome has been linked to a number of risk factors for heart disease, such as high blood pressure, high cholesterol and obesity.

“We only found an association, so we can’t say that diet drinks cause these problems,” Dr Vyas added, highlighting there may be other reasons for the link between diet drinks and a risk of heart attack and stroke.

Dr Vyas stressed that the women who had drink two or more diet drinks each day were typically younger in age, more likely to smoke, with a higher prevalence of diabetes, high blood pressure and of being overweight, adding that further research should be conducted to see if there is an actual definite link between diet drinks and cardiovascular risk.

Breast milk no better than bottled milk and may increase asthma risk, says new study

Almost from the moment they have given birth it seems new mothers are under heavy pressure to breastfeed their baby, with health experts long championing the health benefits of breastfeeding.

In fact, breast-fed babies have been said to be at a lower risk of suffering with sudden infant death syndrome, have less infections in their early years. Moreover, there are said to be health benefits in the long-term, with breast-fed babies growing up to be less likely to develop asthma, be obese, have high blood pressure or high cholesterol and type 2 diabetes.

However, all this could be thrown onto its head with the findings of a new study published in the Social Science & Medicine, which may finally help to shed the stigma of bottle-feeding a new-born baby and raises questions about previous studies that have supported and pushed for mother mothers to breastfeed, sometimes putting unfair pressure on mums to do this.

Lead author of the study Dr Cynthia Colen, from Ohio State University, and fellow researchers analysed 665 families in which there were siblings fed differently during their early years.  In total, there was 8,237 children made up of 7,319 siblings and 1,773 ‘discordant’ sibling pairs; one was breastfed with the other was fed with bottled milk.

In all of the families looked at, breastfeeding showed better outcomes for BMI, hyperactivity, maths, reading recognition, vocabulary word identification, digit recollection, scholastic competence and obesity.

However, when the analysis was focused purely on siblings fed differently within the same families, researchers discovered that the scores demonstrating breast-feeding’s positive benefits on 10 of the indicators were close to zero and therefore not deemed statistically significant. This means any health variances in those families may have happened by chance.

The only health condition that was found to have a significant difference in regards to breast-fed and bottle-fed siblings was asthma. Dr Colen actually claims that breast-fed babies were actually at a higher risk for developing asthma later in their life.

She said: “Many previous studies suffer from selection bias. They either do not or cannot statistically control for factors such as race, age, family income, mother’s employment – things we know that can affect both breast-feeding and health outcomes. Mums with more resources – with higher levels of education and higher levels of income – and more flexibility in their daily schedules are more likely to breastfeed their children and do so for longer periods of time.”

NHS guidance recommends new mothers to breastfeed for the initial six months (26 weeks) of a new-born’s life. Following this, breast milk alongside other food will “help them continue to grow and develop”, according to the NHS.

Dr Colen added: “I’m not saying breastfeeding is not beneficial, especially for boosting nutrition and immunity in new-borns. But if we really want to improve maternal and child health, let’s also focus on things that can really do that in the long term – like subsidised day care, better maternity leave policies and more employment opportunities for low-income mothers that pay a living wage, for example.”

New guidance recommends millions more to take statins

There could soon be millions more British patients being prescribed cholesterol-lowering statins such as atorvastatin or pravastatin to safeguard against heart attack and stroke, following the publication of new guidelines in the United States of who would benefit from taking statins; the first such guidance to be released in the US in a decade.

The updated guidelines are based upon the findings of a new study conducted over four years by the American Heart Association and American College of Cardiology, who decided to ‘think outside the box’ so to speak, as to what constitutes putting someone at a risk of heart attack and/ or stroke.

The researchers, unlike many of their peers who conduct similar studies, shifted their interests away from high cholesterol and instead utilised a formula to calculate risk and looked at a person’s age, gender, race, together with certain health factors like smoking.

“This guideline represents a departure from previous guidelines because it doesn’t focus on specific target levels of LDL, or bad cholesterol, although the definition of optimal LDL cholesterol has not changed,” Dr Neil Stone, author of the report, said in a statement.

Dr Stone added: “The likely impact of the recommendations is that more people who would benefit from statins are going to be on them.”

Dr Donald Lloyd-Jones, one of the experts who help to draft the new guidelines, said: “We’ve been undertreating people who need statin therapy. Statins lower cholesterol levels, but what they really target is overall cardiovascular risk.”

More African-Americans – a demographic usually at a higher risk of stroke – could be prescribed statins in accordance to the new guidelines.

Under the guidance, there would now be approximately 44% of men and 22% of women who would be deemed suitable for taking statins – or 33 million Americans.

This is in stark contrast to previous US guidelines that meant only 15% of adults in America were recommended for statin treatment, whereby patients had to have a target set to lower their cholesterol to. These numerical targets have now seemingly been abandoned.

In creating the guidelines, the panel analysed four particular groups who they believed to need statins more than most: patients currently with heart disease, people with LDL levels of 190 or higher due to genetic risk, adults aged between 40 and 75 with type 2 diabetes and older adults with a 10-year risk of heart disease in excess of 7.5%.

Those in the panel also stressed the importance of a “diet pattern” which includes fruit, vegetables and whole grains, with all adults engaging in moderate to vigorous exercise three to four times per week.

Many of the patents on statins have expired, with significantly cheaper generic statins now available. Crestor (rosuvastatin), a statin manufactured by AstraZeneca, still remains under patent however and in 2012 alone the drug had impressive sales of $8.3bn (£5.2bn).

Statins are actually the most commonly prescribed drugs in the UK, used by almost a tenth of the population. As cholesterol is still the primary factor in the process of prescribing statins, it is worth noting that NHS guidelines state that LDL cholesterol should not be higher than 3.0 and overall cholesterol no higher than 5.0.

South London stroke rates drop by 40% since 1995, statins credited

A new study has found that the incidence of strokes in a large area of South London has declined by more than a third during the 15 years between 1995 and 2010.

Researchers from King’s College in London say that the number of people suffering from strokes has fell by 39.5% in that time period in the area. Incidence of strokes was calculated at 247 per 100,000 people in 1995, however it was only 149.5 per 100,000 in 2010.

Approximately 152,000 people each year in the United Kingdom suffer from a stroke. There are two main types of stroke – ischaemic and haemorrhagic. The former accounts for a staggering 80% of all cases of stroke. An ischaemic stroke occurs when blood flow to the brain is prevented by either a blood clot or clump of fat. There is a high risk of a blood clot if your arteries have narrowed and clogged with fatty deposits; known as atherosclerosis. Major risk factors for atherosclerosis include smoking, high blood pressure, high cholesterol, obesity, diabetes and a family history of heart disease or stroke.

A haemorrhagic type of stroke is brought on due a weakened blood vessel supplying the brain rupturing and resulting in bleeding into the surrounding brain and brain damage. Two types of weakened blood vessels will typically cause a haemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs).

The researchers involved in the new study say the decline may be attributed to more people adopting a healthier lifestyle and the positive effects of cholesterol-lowering medications (statins), such as Lipitor (Atorvastatin) and Crestor (Rosuvastatin). Both drugs work to lower LDL, or “bad” cholesterol, and raise patients’ good HDL levels. It is estimated that statins are currently prescribed to an incredible 7 million in the United Kingdom – around a tenth of the population.

The team from King’s College looked at data extracted from the South London Stroke register, a database that covers an area with over 350,000 people in.

They found that rates of stroke incidence generally had fallen in men, women, white patients and those over the age of 45. However, similar declines in rates were not evident in those aged 15 to 44, or black patients, according to the researchers.

“We observed a higher prevalence of hypertension and diabetes mellitus in black patients compared with white patients in each of the four time periods in all age groups,” they commented.

“Other possible explanations for ethnic disparities include cultural differences in perceptions of health and the health care system, environmental exposures, genetic factors, socioeconomic status, and educational attainment.”

Professsor Graham MacGregor, chairman of charity Blood Pressure UK, said advances in medical knowledge had resulted in much more effective treatments being available for patients.

“We’ve got better blood pressure drugs and they are used more effectively. In the past GPs would prescribe one drug. We now know they work more effectively in combination, and they are often more acceptable to patients, with fewer side effects, so they take them and don’t leave them in the medicines cupboard. Statins cut the risk of stroke by 30 to 40 per cent so they have also played a part, but we need to do more.”

Dr Madina Kara, researcher at the Stroke Association, was clearly delighted with the findings from the study. She said: “It’s encouraging to see such a striking reduction in the number of people having a stroke in the past 16 years. Public health campaigns around the risk factors for stroke, such as high blood pressure and smoking are helping people to take control of their health and reduce their risk of stroke. This reduction, however, is not being mirrored in those under 45 years old, and the black population, where the incidence of stroke remains high.”

She also explained why certain sectors of the population could be more at risk compared to others. “We know that the African-Caribbean community are at greater risk of sickle cell disease, diabetes and high blood pressure – conditions that can lead to stroke. This means they are twice as likely to have a stroke compared to the white population. In addition, haemorrhagic stroke, caused by bleeding within or around the brain, is more common in younger adults,” she said.

Dr Kara added: “Stroke changes lives in an instant and can have a devastating physical and emotional impact on not only the stroke survivor, but their family and carers as well. To help reduce stroke across the whole population, we all need to take steps to reduce our risk.”

Chemical contained red meat may cause heart damage

A study carried out by researchers from Cleveland Clinic in Ohio, US, has found that the chemical L-carnitine can increase the risk of suffering from heart problems. Saturated fat and the manufacturing process involved with how meat is preserved are widely believed to be related to heart problems, but many health experts think there is more to it. 

Lead researcher of the new study, Dr Stanley Hazen, commented: “The cholesterol and saturated fat content of lean red meat is not that high, there’s something else contributing to increases in cardiovascular risk.”

L-carnitine is a nutrient which is contained in red meat, dairy products and some dietary supplements.  The study, published in the journal Nature Medicine, showed that the carnitine contained red meat was broken down by naturally occurring bacteria in the gut. 

However, this later resulted in higher levels of cholesterol and an increased risk of heart disease as the resulting broken down product - trimethylamine-N-oxide (TMAO), is known to speed up the build-up of plaque in arteries and cause them to harden (atherosclerosis) – a main cause of heart disease.

Part of the researchers’ investigations was conducted in humans, whilst other testing was carried out with mice. Studies involving animals can be sometimes difficult to interpret, and some degree of caution should be shown when generalising the findings to humans.

For the study, 77 healthy volunteers were administered a supplement of L-carnitine. Of this total, 26 were classified as vegans or vegetarians. Some of the meat-eaters in the group were told to eat an eight-ounce sirloin steak - this works out at around 180mg of L-carnitine.

Researchers then gave antibiotics to the participants for a one week period. These prevented bacteria in their gut from converting L-carnitine into TMAO. After this, the 77 people again were given L-carnitine. Tests were conducted on blood and urine at the beginning of the study and up to three weeks following L-carnitine being given. Some of the people also had their faeces analysed.

In addition, L-carnitine levels were checked in the blood of 2,595 other people, all of whom had attended a heart check-up. The researchers thought this would be an effective measure of assessing a potential link with L-carnitine levels and known cardiovascular disease, or risk of a cardiovascular event (i.e. a heart attack or stroke).

Finally, plaque levels were studied in the arteries of mice and this was done by comparing mice fed normally against a group of mice fed L-carnitine, for a 10 week period. Some of these mice were given antibiotics beforehand. 

The main findings were:

. Meat-eaters produced more TMAO compared to vegans or vegetarians following L-carnitine ingestion.

. A ‘significant’ link was found between L-carnitine concentrations and risk of cardiovascular event in those having heart check-ups. However this was only for those with a high TMAO concentration. Researchers state they believe this shows that TMAO, rather than L-carnitine, is the main factor of this link.

. A study of the faeces showed L-carnitine affected how much TMAO was in the blood.

. Mice given L-carnitine, were at a double risk of developing a plaque build-up in their arterial walls, - but only when they had their normal gut bacteria. When the animals were given antibiotics to clear the gut, L-carnitine did not cause the same arterial wall build-up.

Dr Hazen says that TMAO can be underestimated, and said: “It may be a waste product but it is significantly influencing cholesterol metabolism and the net effect leads to an accumulation of cholesterol. The findings support the idea that less red meat is better. I used to have red meat five days out of seven, now I have cut it way back to less than once every two weeks or so.”

A Mediterranean diet can decrease heart attack risk

Researchers claim that by adhering to a healthy Mediterranean diet, this is almost as good for your heart as statins in reducing the risk of suffering from a heart attack or stroke. The news emerges coincidentally as we approach the end of the ‘Rock up in Red’ campaign for National Heart Month, of which Medical Specialists Pharmacy are proud supporters of.

Cholesterol-busting statins such as Crestor (Rosuvastatin) and Lipitor (Atorvastatin) are currently prescribed to nearly a tenth (7 million) of the UK population and function by raising good/protective cholesterol (HDL) and lowering bad cholesterol (LDL) and triglycerides. The higher your cholesterol level, the bigger risk there is of suffering from a heart attack and stroke due to your arteries being clogged up with the fat-like substance known as cholesterol.

However, Spanish researchers led by Prof Ramon Estruch, a professor of medicine at Barcelona University, believe that consuming a Mediterranean diet comprising of plenty lot of fruit, vegetables, fish and wine, and only small amounts of red meat or dairy products, can provide some degree of defence against heart problems.

Many have previously acknowledged the fact that people from Mediterranean countries are more inclined to have lower levels of heart disease though there has been uncertainty if this was due to hereditary factors, or linked to diet and lifestyle.

For the study, the Spanish academics tracked 7,447 people during the years of 2003 and 2009 – consisting of men aged 55 to 88 and women aged 60 to 80. None of the participants had any kind of cardiovascular disease at the beginning of the study. However, they were all at risk due to having type 2 diabetes or were at risk due to having three things from a list of health problems. These were: smoking, high blood pressure, high levels of bad cholesterol, low levels of healthy cholesterol, overweight or there being family history of coronary heart disease.

The participants were assigned into one of three groups; two of which were instructed to eat a Mediterranean diet – one supplemented with four table spoons of extra-virgin olive oil and the other with about one ounce of nuts (walnuts, almonds or hazelnuts). The third group were instead told to stick to a diet that included low-fat dairy products, grains and fruits and vegetables.

Following an average of 4.8 years assessment, 228 had either suffered a heart attack or stroke or died of heart-related problems. Of this total, 96 were in the olive oil group (3.4% of participants), 83 in the group eating plenty of nuts (3.4%) and 109 in the low-fat group (4.4%). This equates to a 30% decline in risk for those on the Mediterranean diets compared with the low fat diet.

Researchers say that important elements from the diets that boosted health included moderate consumption of ethanol – derived from the wine, low consumption of meat, and high intake of vegetables, fruit, nuts, legumes, fish and olive oil. In fact they were so impressed with their study findings that they began adopting a Mediterranean diet themselves.

The authors conclude: “The results of our trial might explain, in part, the lower cardiovascular mortality in Mediterranean countries than in northern Europe or the United States.”

Although not involved with the study, Dr Mike Knapton, associate medical director of the British Heart Foundation, commented on its findings, and advised against anybody deciding to forsake their prescribed statins in favour of merely a change in diet. He said: “This large long-term study shows that eating a Mediterranean diet is associated with heart health benefits, including reductions in heart attack, stroke and deaths from cardiovascular disease. While these findings aren’t new they add to our knowledge and confidence that a Mediterranean diet can help cut down your cardiovascular risk. A well-balanced diet low in salt, saturated fat and sugar is a vital part of a healthy lifestyle. That said, a Mediterranean diet should not replace your prescribed medication.”

Small salt reduction could save thousands of lives

UK Health experts say that thousands of deaths could be prevented every year if consumers were more aware of exactly how much salt is in the food they are eating in comparison against their daily recommended limits.

British health professionals voiced their concerns about the UK’s ignorance to the dangers of too much salt after the publication of a damning U.S.-based study that linked the high salt content in processed foods to the obesity crisis in America.

British GP Ian Campbell, medical director of charity Weight Concern, said: “The same problems exist in the UK, with heart disease a well-recognised consequence of excessive salt. Greater awareness of the harm salt can do might help people choose to reduce their intake. Processed food is high in fat, sugar and salt. Food manufacturers have significantly reduced salt content, but it’s still too high. The average person has no idea of the quantities of salt in their diet – simply because they’re not adding it, the manufacturers are. People need to be aware the food we eat does affect our health directly. If you don’t know what’s in the food you are about to eat, ask.”

High levels of salt in a person’s diet can raise your blood pressure and hypertension (high blood pressure) means you are at an increased risk of health problems such as heart disease and stroke. Doctors are adamant that if consumers paid more attention to food labels, an incredible 25,000 lives could be saved each year.

Unfortunately though, many Brits are still unaware of theirs or their children’s daily recommended maximum intake, or even any rough idea of how much salt they are currently taking in.

According to health officials, if the average salt intake was reduced by merely a single gram, this could save 6,000 lives and £1.5billion annually. If the average consumption however dropped by four grams, approximately 25,000 deaths could be averted each year. British Heart Foundation statistics say that on average, men consume around 9.7g of salt a day and women fare a little better and average 7.7g – but still way above the recommended limit.

Dr. Campbell added: “Salt is a big problem in the UK too. It’s a silent killer. Over time consuming too much of it increases the risk of high blood pressure, which can lead to heart attacks and strokes. About 80 per cent of our salt intake comes from processed foods, so it can be difficult to avoid. Many people are unaware of where salt is hidden, such as bread, soups, ready meals, even breakfast cereals and mayonnaise. The Government approach has been to encourage food manufacturers to modify the amount of salt in their products. There has been a reduction but it is taking too long. The Food Standards Agency should consider setting mandatory maximum levels for salt.”

The recommended daily salt intake for adults has been 6g for many years, (around one full teaspoon), although the World Health Organization have spoken many times in recent years stating that at the very most, 5g should be the maximum intake each day.  However, current NHS guidance still sets the current daily limits to:

. 1 to 3 years: 2g salt a day (0.8g sodium).
. 4 to 6 years: 3g salt a day (1.2g sodium).
. 7 to 10 years: 5g salt a day (2g sodium).
. 11 years and over: 6g salt a day (2.4g sodium).

One of the biggest factors why people suffer with heart disease or stroke is because of high cholesterol. Salt itself does not contribute to high cholesterol levels, but consuming too much salt can cause high blood pressure that in turn is attributed to heart disease and stroke. Therefore, it is worth paying attention to the salt levels in your food.

To maintain healthy cholesterol levels you can also make other positive lifestyle changes to reduce risk factors, including: quitting smoking, lose weight if you are overweight, and limit the fat in your diet. All these will benefit blood pressure as well as cholesterol. Medication such as statins may be required if dietary alterations alone are not enough to have an effect, and for suitable patients they are obtainable from Medical Specialists Pharmacy at low prices. For more information about Crestor (rosuvastatin), Lipitor (atorvastatin), and Generic Atorvastatin, visit the Health and Lifestyle area of the Medical Specialists website.

A vegetarian diet can boost blood pressure and cholesterol

A Cancer Research UK and the UK Medical Research Council-funded study featured in American Journal of Clinical Nutrition suggests that those who adhere to a vegetarian diet and ditch meat and fish will see major health benefits over their meat-eating peers.

The findings of what is the largest study of its kind, could persuade some people to give-up meat in favour of veg and comes ironically only weeks after the Tesco horse meat scandal where some of their own-branded beef burgers were found to contain as much as 29% horse meat.

Scientists at the University of Oxford analysed 44,561 people in England and Scotland, recruiting participants over the age of 20 during 1993 to 1997. They specifically wanted vegetarians and vegans in the study to look at associations between nutrition and general health in contrast to the general UK population.

All participants were required to fill out a food-frequency questionnaire that quizzed them on what food they ate over the previous year, in addition to asking them about exercise, smoking habits and alcohol consumption. The researchers classified people as either non-vegetarian if they said they had eaten any meat or fish, or as vegetarian if they reported eating no meat or fish. For study purposes, vegetarians and vegans were categorised together (about 15,100 in total).

Over the course of an average 11.6 years of follow-ups, there were 1,235 cases of ischaemic heart disease (IHD). From this number, 169 people in the study had died as a result of heart disease and there were 1,066 recorded hospital admissions.

After taking into account factors such as age, gender, physical activity, smoking, alcohol intake, education and social background, it was calculated that being a vegetarian can decrease the risk of death or hospital admission from heart disease by a staggering 32%. Amazingly, a reduced risk was evident in both continuous vegetarians and in those who had begun eating meat at the five year follow-up.

If that wasn’t enough of a persuader to ditch the meat, vegetarians were also found to have lower levels of ‘bad’ cholesterol in their blood and a lower systolic blood pressure reading. Moreover, they were typically more slender with a lower body mass index (BMI) than the meat eaters, and had a reduced risk of developing diabetes.

Dr Francesca Crowe, author of the study at the Cancer Epidemiology Unit at the University of Oxford, said: “Most of the difference in risk is probably caused by effects on cholesterol and blood pressure, and shows the important role of diet in the prevention of heart disease.”
Co-author Professor Tim Key, deputy director of the Cancer Epidemiology Unit at the University of Oxford, added: “The results clearly show the risk of heart disease in vegetarians is about a third lower than in non-vegetarians.”

Red meat – particularly processed meat – comprises of numerous ingredients that have been regular attributed to increased risk of chronic diseases including bowel cancer. Such ingredients include heme iron, saturated fat, sodium, nitrites and certain carcinogens that are formed during the cooking process. At least by hitting the daily recommended intake of five portions of fruit and veg means that people can benefit from their antioxidant properties that work at reducing cholesterol, control blood glucose levels and reduce the risk of many types of cancer.

Cardiovascular disease is responsible for the largest number of deaths in the developed world. According to World Health Organisation statistics, it claimed 17.3 million lives in 2008 worldwide, with 6.2 million of these from strokes. A famous figure who almost succumbed to heart disease was former U.S. President Bill Clinton, once notorious for his strong penchant for hamburgers; he was required to have a coronary bypass operation in 2004 and is now leads a much better lifestyle.

As highlighted earlier, high cholesterol is a primary contributor for heart disease. However, Medical Specialists Pharmacy provides online consultations for patients with high cholesterol and with our help you can reduce the risk of developing heart problems. For suitable patients our in-house doctors can prescribe statin medication (Lipitor and Crestor), and our in house pharmacists can dispense to patients within 24 hours. We also dispense statins for patients who can provide a private prescription, and in 2012 we introduced the legally available generic Atorvastatin at much lower prices for suitable patients.

Stroke victims are getting younger compared to previous years

Health experts have warned that the age of people suffering from a stroke is worryingly low, and that the number of young adults being struck down with them is increasing. In fact, one in five victims is under the age of 55 according to research in the American Academy of Neurology Journal. In the same report, it was stated that the average age of someone suffering a stroke has dropped from 71 years in 1993 to 69 years in 2005.

The study centred on 5,900 Ohio and Kentucky adults who had suffered a first-time stroke between the years 1993 and 2005. It was found that over this time period, 20 to 54-year-olds accounted for an increasing proportion of strokes. In what had started at 13% in 1993 had risen to almost 19% in 2005.
To delve a little deeper – during the twelve years, whites aged 20 to 54 saw a rate increase from 26 strokes for every 100,000 people, to 48 per 100,000. A similar trend was noted among African Americans. In the same time period, the rate had gone up from 83 to 128 per 100,000 people.

Study author Dr Brett Kissela, of the University of Cincinnati College of Medicine in Ohio, offered his thoughts on what could be causing the increases. He said, “The reasons for this trend could be a rise in risk factors such as diabetes, obesity and high cholesterol. Other factors, such as improved diagnosis through the increased use of MRI imaging may also be contributing. Regardless, the rising trend found in our study is of great concern for public health because strokes in younger people translate to greater lifetime disability.”

Dr Kissela did suggest things that could be done to reverse the findings from the study though. He continued, “The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise. However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease.”

A spokesman for the Stroke Association, linked the results from the U.S study to stroke patterns in the UK, saying, “Although this research was carried out in the US, western cultures lead very similar lifestyles and in other research parallels have often been drawn between the US and the UK. For these reasons it’s likely that the UK could face similar outcomes. However, a UK specific study hasn’t been carried out yet.”

Strokes are the single biggest reason for adult disability within the UK due to the brain damage that is inflicted, with over 150,000 occurring every year in England alone. In addition, strokes are the third largest cause of death after heart disease and cancer. However, what are they and who is at risk?
A stroke happens when the blood supply to a certain area of the brain is suddenly stopped. Brain cells always require a constant source of oxygen inside the blood so therefore after the supply is cut off, the cells in the affected area either die or become damaged.

There are two main types of stroke – ischaemic and haemorrhagic. The former kind of stroke accounts for a staggering 80% of all cases of stroke. It happens when the flow of blood to your brain is stopped by a blood clot or clump of fat. You are at risk of developing a blood clot if your arteries have narrowed and clogged with fatty deposits; known as atherosclerosis. Major risk factors for atherosclerosis include smoking, high blood pressure, high cholesterol, obesity, diabetes and a family history of heart disease or stroke.

A haemorrhagic type of stroke is brought on due a weakened blood vessel supplying the brain rupturing and resulting in bleeding into the surrounding brain and brain damage. Two types of weakened blood vessels will typically cause a haemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs).

So what can you do to limit your chances of suffering from a stroke? As Mentioned earlier, smoking is a major cause so therefore quitting smoking immediately would be advisable through the help of smoking cessation medication such as Champix. Following an online consultation and the approval from one of our GMC registered in-house Doctors; you can obtain the effective smoking cessation medication Champix from Medical Specialists Pharmacy, costing just £75.00 per pack.

Medical Specialists also provides online consultations for patients with high cholesterol, a major contributor for strokes. For suitable patients our house doctors can prescribe statin medication (Lipitor and Crestor), and our in house pharmacists can dispense to patients within 24 hours. We also dispense statins for patients who can provide a private prescription, and have recently introduced the legally available generic Atorvastatin at much lower prices for suitable patients. The World Health Organisation has estimated that nearly 20% of all strokes and over 50% of all heart attacks can be attributed to high cholesterol so clearly the dangers of this are quite apparent.

Brits are still oblivious to the dangers of high cholesterol

Are you clued up about cholesterol? If not, you are part of potentially a third of the population who are still ignorant when it comes to knowing about what cholesterol is, the dangers of high cholesterol and what factors can put you at high risk of raised cholesterol. It is estimated that every four minutes somebody in the UK suffers a heart attack. Often high cholesterol is a major cause of this, and it seems the UK needs to be more aware of the dangers associated with having raised cholesterol levels.

Therefore as part of ‘National Cholesterol Week’ which is running this week until Friday, The Charity ‘Heart UK’ recently randomly quizzed 455 members of the public during August and September. Almost a third of those who took part were unaware that high cholesterol can be brought on by a bad diet as well as by being inherited through conditions such as familial hypercholesterolaemia (FH).


This is a genetic defect that affects roughly 1 in every 500 of the population and causes them immediately from birth to be lacking in low-density lipoprotein (LDL) receptors, which get rid of cholesterol from our blood. Because these people have high cholesterol from the moment they are born, they are at great risk from vascular diseases and hardening of the arteries, much earlier than normal. For anybody unfortunately who has FH, usually the most effective treatment is through statin therapy (e.g. Lipitor or Crestor). These medications decrease the production of LDL cholesterol by the liver, which in turn decreases LDL cholesterol blood levels by around 50%.

Heart UK says that there are approximately 120,000 people in Britain alone who have familial hypercholesterolaemia and are ‘ticking time bombs’  because they don’t know they actually have the condition that can cause premature death in some people who are just 30 years of age. In fact Heart UK claim that only 15% of these 120,000 sufferers are even aware they have FH .

Another worrying find from the study of the 455 people was the fact that only 38% of participants knew that two-thirds of people have cholesterol above the recommended level of 5mmol/L.  The results from the survey caused Jules Payne, chief executive of Heart UK, to voice his concerns and he said, “More must be done to ensure that everyone in the UK is aware of the risks associated with raised cholesterol. Heart disease is still the biggest killer in the UK and unhealthy cholesterol the greatest modifiable contributor to heart disease.”

The study results have emerged in the same week that scientists based at the University of Rochester Medical Center in America, linked statins to the protection against developing cancer and even in the treatment of tumours.

Cholesterol-busting statins such as the previously mentioned Crestor and Lipitor do not break the bank for patients and are used by roughly seven million Brits.  Statins have been used in countless experiments this year alone as scientists explore their wonderful capabilities in the fight against many different health problems besides high cholesterol.  Their emerging potential has led to calls from doctors for at least everybody over the age of 50 to be prescribed them as a matter of course, due to their abilities to massively reduce to risk of developing a whole range of life-threatening diseases and health conditions.

The researchers at Rochester Medical Center identified a genetic connection between cancer and raised cholesterol levels. The gene they analysed is the ‘ABCA1’ gene, which acts as a barrier preventing tumours from developing or getting bigger, whilst also maintaining cholesterol levels at a low level. The link was established after a defect was noted in a particular ABCA1 gene, which was first known to help regulate cancer-causing genes, and the defect led to the build-up of cholesterol.

Lead researcher Dr Hartmut Land commented on the study findings and said, “Scientifically it is very satisfying to have data that support longstanding ideas about cholesterol in the context of cancer. Our paper provides a rationale for cholesterol targeting as a potentially fruitful approach to cancer intervention or prevention strategies.”

If you want to improve your cholesterol levels, Medical Specialists Pharmacy can help. For suitable patients, we can provide both cholesterol-lowering statin medications Crestor (Rosuvastatin) and Lipitor (Atorvastatin). Along with diet, they lower ‘bad’ cholesterol (LDL-C), increase ‘good’ cholesterol (HDL-C), and also slow the progression of atherosclerosis in adults with high cholesterol, as part of a treatment plan to lower cholesterol to goal. We are pleased to inform our patients that we now also offer legal generic Atorvastatin, with prices from as little as just £11.25 per pack.

Men with a bulging waist risk impotence and ejaculation problems

For all you men out there – Next time you hit the town with your friends and drink pint after pint of beer, followed by that customary kebab on the way home, think about what the extra calories and weight could be doing to your sex life. By that, we do not mean the common ‘brewer’s droop’ that many intoxicated men experience, which is a temporary form of alcohol-induced impotence.

An American study that has been published in the August edition of the British Journal of Urology International claims that men with a larger waistline have a much higher chance of experiencing sexual dysfunction and symptoms of urinary tract infection.

Senior study author Dr Steven Kaplan of the Weill Cornell Medical College at Cornell University, worked with colleagues to examine 400 males who were all suffering with lower urinary tract symptoms, which include varying things such as difficulty urinating, incontinence and frequent urination during both the day and night.

Age ranges of the subjects spanned from 40 to 91 years. It was documented that 37.5% of the men had a waistline measuring less than 36 inches, roughly a third were measured between 36 and 40 inches and finally 29% of the men had a waist circumference of more than 40 inches.

A link was established between having a bigger waistline and frequency of urination. For example, it was noted that 39% of men with the largest waists needed to urinate more than eight times in a 24 hour time period. In contrast, statistics showed it was 27% for men in the middle category and just 16% for males with waists less than 36 inches.

As well as being more at risk of urination problems, researchers found that erectile dysfunction (ED) was present in 74.5% of the men with the biggest waists, whereas it was prominent in 50% of men in the middle group and 32% with the smallest waists.  Ejaculatory problems showed a similar pattern to the two issues already mentioned as 65% of men with the larger waists had ejaculation problems, followed by 40% and 21% respectively.

Moreover, the study also found men with the biggest waist circumference were more likely to have the common health conditions that have long been linked to obesity, such as high cholesterol, high blood pressure, coronary artery disease and type 2 diabetes.

Dr Kaplan spoke on the study results and said, “The findings demonstrate that obesity in men – part of a growing global epidemic, affects their well-being in profound ways. We have to think of the body in a much more holistic way. What we eat can have devastating consequences on more than just our hearts. Quality-of-life issues…can be affected as well in drastic ways.”

Certainly the problems encountered in this study paint a worrying picture for men. Indeed if current trends continue then it is expected that by the year 2030, half of UK men could be obese. Also in 2008 it was estimated that an incredible 502 million people around the globe were obese.

However, if you are a male who is suffering from ED, Medical Specialists Pharmacy offers a wide range of treatment options to help you and kick-start your sex life. The medications we provide for male impotence can be ordered with or without a private prescription, and pending approval from one of our registered doctors, can arrive to you within just 24 hours. We have Viagra, Cialis and Levitra, all obtainable at fantastic prices.

In addition, if you are suffering from the common ejaculation problem, premature ejaculation (PE), our doctors can prescribe Priligy for this condition, following a consultation. This is an oral tablet for suitable males suffering from premature ejaculation. These tablets are taken prior to the sexual activity. It acts quickly within 60 minutes and is only taken when you need it. In addition, we offer Stud 100 spray, obtainable from our chemist shop. Stud 100 delays ejaculation by reducing the sensitivity of the penis, significantly prolonging intercourse and providing greater satisfaction for both partners.

Many older people could have undetected heart conditions

New evidence has emerged in the last few weeks that show the older generation could be missing out on very basic healthcare that could help to prolong their lifespan.

A study that has been published in the journal ‘Heart’ was conducted by researchers at Newcastle University. The researchers underwent various medical tests on 300 elderly people aged between 87 and 89 years of age. After examinations were complete it was discovered that staggeringly, roughly a quarter of these people had a previously undiagnosed heart condition.

The authors behind the study say that if there was medication more accessible to older people, then money would be saved that is currently being spent by the NHS for costly hospital trips. They have further advised routine heart scans for anybody over the age of 85 who is complaining of breathlessness, which could be a sign of heart trouble.

The problem could escalate with the number of elderly people expected to increase. The Department of Health say that although a 40% decrease in cardiovascular disease has been seen in the last 10 years, more could be done. A spokesperson said, “We are currently developing a cardiovascular disease strategy which will consider how we better identify and treat heart diseases for people of all ages, including older people.”

However lead researcher Prof Bernard Keavney says, “We were surprised to discover just how many older people have heart problems. Many of these people could be treated with drugs that we know work, if their condition were recognised. This would improve their quality of life and it’s likely to slow their progression to heart failure.”

This study comes less than two weeks after scientists claim that older people could benefit from statins, with statistics showing that prescribing rates begin to drop for those over the age of 75.
Indeed, like their counterparts at Newcastle, researchers from both Oxford and Birmingham Universities claim that older people are being somewhat overlooked in regards to healthcare, and should be given cholesterol-lowering statins such as Crestor and Lipitor to help cut their risk of cardiovascular disease. The study authors from the two Universities published their findings in the British Medical Journal.

They analysed almost 37,000 subjects who were aged 40 and above, with no cardiovascular disease at the beginning of their study. They found for every extra 5 years of age, the chance of them being prescribed blood pressure medication increased up until age 85, when it then started to decrease. In comparison, statin prescription rates fell from just age 75.

When commenting on these findings, the authors said there is no evidence that statins are harmful for older patients and that the guidelines for the prescribing of the drugs need to be reviewed. They have also stated there should now be a ‘simple trial of use of statins in people over the age of 80’. Backing up those comments was the British Heart Foundation’s senior cardiac nurse June Davison, who says, “Available evidence would suggest that older people can benefit from heart protective drugs, but more research is needed.”

Even healthy adults could benefit from cholesterol-busting statins

Current guidelines recommend the prescribing of the cholesterol-lowering medication statins such as Crestor and Lipitor to those people who have a 20% or more chance of developing cardiovascular disease within a decade.  This risk is determined by studying factors including age, blood pressure, if they smoke and also if they suffer from diabetes.

As the benefits of statins become more apparent, we have seen in recent months some doctors have considered the possibility of a ‘statins for all’ approach. The argument for the taking of statins on a more widespread basis has been backed up by a recent study that was carried out by researchers at Oxford University, working with counterparts at the University of Sydney. Funded by organisations such as Cancer Research UK and the British Heart Foundation, it entailed a meta-analysis of patient data spanning across 27 separate studies. All trials had analysed the process of lowering ‘bad’ cholesterol (low-density lipoprotein or LDL) within 175,000 people in total and through the use of statin therapy.

The primary basis for this thorough analysis appeared to be the consideration if everybody over the age of 50-years old should be given statins, irrespective of if they have any known vascular disease. An editorial that accompanied the review argued that the present guidelines need to be re-evaluated as it may be more cost-effective to prescribe those over 50 with statins, instead of the current method of using costly screening examinations.

In their conclusions the researchers said, “The present report shows that statins are indeed both effective and safe for people with a five-year risk of major vascular events lower than 10% who would typically not be judged suitable for statin treatment … and, therefore, suggests that treatment guidelines might need to be reconsidered.”

This huge review that further evaluated past research would seem to suggest that statins could indeed benefit those without existing cardiovascular disease and those who are not considered at high risk of developing it.  However, the individual benefit for those at low risk may be limited. In addition, the risk of any possible side effects when giving statins to those over of 50 would have to be taken into account when deducing the overall advantage. However, statins are widely acknowledged to be safe medications by most health professionals and it seems a future where many ‘healthy’ individuals are prescribed statins may be a real possibility.

Fat firemen shatter the typical athletic and muscular image we have of them

It appears that our emergency services may be lagging behind in the battle to fight the flab. Less than four months after we reported that overweight police officers could face meaty fines and suspension, firemen have now come under scrutiny.

Regulations in place demand that all staff must have a formidable level of fitness in order to deal with a multitude of serious and critical situations. Just some of the tasks they need to cope with include carrying hefty equipment, erecting heavy ladders and carry potential victims of fire to safety. Indeed, when one imagines a firefighter, the stereotypical image is that of a hunky male with a rippling six-pack and bulging biceps – however the reality looks far from this.

Analysts have declared that over half of firemen could be too fat to effectively carry out their duties. Given that past U.S. studies made the shocking discovery that 80% of firefighters were deemed overweight or obese, it was surely only a matter of time before UK firefighters faced similar scrutinisation.

Therefore, experts at Loughborough University studied 735 firemen and came back with some alarming results. They found 53% were actually classed as overweight and a further 13% were obese. The situation looks to be a long-term issue as the University first assessed the firefighters in 2008 and found almost identical results. The previous research found 54% to be overweight and 11% were obese.

If the possible inhalation of smoke fumes was not damaging enough, their extra weight immediately puts them at an elevated risk of numerous health problems such as high cholesterol, heart disease and stroke, high blood pressure, diabetes, and breathing problems such as sleep apnea and asthma.

The Loughborough researchers have published a detailed analysis of their results in the journal Occupational Medicine and spoke of their concerns, saying, “Obesity among firefighters can present a hindrance to operational effectiveness. The proportion of firefighters who are either overweight or obese is lower in this UK sample than that found in US studies. But it was higher than that found in the general population. Given the negative implications of obesity for performance, there is a need for further investment in health promotion research and practice.”

It seems even the risk of cancer cannot persuade Brits to drop their excess baggage

Brits do not seem to possess enough motivation to shift those extra pounds it seems according to findings published this week by Cancer Research UK. At Medical Specialists Pharmacy we have already looked into many serious health issues that are directly linked to obesity such as lumbar disc degeneration of the back, and how having a poor diet is linked to high blood pressure and erectile dysfunction.

Cancer Research UK say there is an increasing number of kidney and womb cancer cases being diagnosed, and that more and more of these can be linked to obesity. Smoking is still the main culprit for causing cancer, but being overweight or obese comes in second in terms of cancer risks that you can actually do something about to avoid.  In fact recent data compiled by Cancer Research UK, showed that more than four in 10 cancers could be prevented by people making positive changes to their lifestyle.

Amongst those who answered questions for Cancer Research UK’s latest study, 68% of the overweight women claimed that they lacked the required willpower to lose weight. This was 8% more than the men who admitted the same thing. Overall, 87% of those surveyed did say they wanted to lose weight, but then problems such as ‘having too many other things to worry about’ and ‘ trying it before and not being successful’ were listed as reasons that eventually prevented them for losing weight.

In the midst of a recession, it can be understandable that a lack of money could be one of the main things people are ‘worrying’ about these days. But surely your short and long-term health is just as important? Overweight and obese individuals may regret the decision to decide to give up the admittedly tasking chore of losing those love handles, but bear in mind just some of the many health risks that are associated with obesity:

. High blood pressure (hypertension).
. Type 2 diabetes.
. High cholesterol.
. Joint and back pains.
. Severe tiredness or the inability to exert energy into physical activity.
. Poor circulation, ultimately leading to erectile dysfunction, as explained in great detail here.
. Psychological problems such as low self-esteem, confidence and feeling isolated.

Dr Harpal Kumar is chief executive for Cancer Research UK and he gave his views on the obesity crisis, “Unless we tackle the obesity epidemic in the UK, we risk cancer cases soaring. We understand that it can be extremely hard for people to maintain a healthy weight but keeping those extra pounds at bay could ultimately save your life.”

Dr Susan Jebb, head of diet and population health at the Medical Research Council, added to Dr Kumar’s comments and said, “It’s encouraging that most people recognise a poor diet and lack of physical activity significantly increase their risk of developing cancer. But it’s also clear that most people find it hard to turn their good intentions – to eat better and move more – into sustained changes in their lifestyle.  This gap between knowledge and behaviour helps to explain why the number of people who are obese is continuing to increase. Research shows that to make sustained changes in diet and physical activity people need tangible support from family, friends or health professionals. In the longer term, it’s important that the places we live and work make the healthier choice the easier choice, so healthy living becomes a way of life, not a matter of personal willpower.”