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All Giddy about Cholesterol
Three studies presented at the recent American Heart Association annual meeting deserve our attention. The first studied Vytorin (10mg Zetia and 40mg Simvastatin) vs 40mg Simvastatin alone in patients with known coronary artery disease. States the study website: “Vytorin significantly reduced CV outcomes more than Simvastatin alone” in this group. Over 7 years there was a 6% reduction in CV endpoints compared to statins, which is approximately (by our calculations) 3-4 ad


Medicare's Quality Indicators and the reduction of quality geriatric care
What are quality indicators? Essentially Medicare and the ACA are attempting to assure that we doctors practice quality medicine, and they have established means to monitor us through quality indicators. On the surface, that sounds like a very noble cause. But unfortunately, the quest to enforce quality is leading us to just the opposite pole. We have talked about the quest for numerical perfection and how much of a folly that is for older patients. Yet, many quality in


The enduring curse of Ancel Keys
Who is Ancel Keys? If you ever wondered why we think eggs and shell fish are harmful, why low-fat foods sell so well, why we have become a society obsessed with cholesterol levels, why statins are among the most profitable drugs peddled by our pharmaceutical companies, you just have to look at the work of Ancel Keys. In 1953, after examining data on dietary intake in 22 countries, he published the Seven Countries Study that linked high fat/high cholesterol diets to increase
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