Possible Paradigm Shift in Heart Disease Treatment
By: Richard Lewis
A new understanding of obesity may have a significant impact on
the treatment of cardiovascular risk factors and heart disease.
Research into the endocannabinoid system may lead to new ways to
combat obesity, a major risk factor for heart disease. Researchers
believe the EC system acts as a coordinator of a variety of
processes in the body that regulate body weight, energy balance and
blood sugar levels.
"It seems as though the EC system receptors are overactivated when
'fattening foods' are consumed and weight is gained," said Dr.
Louis Aronne, director of the Comprehensive Weight Control Program
at the New York-Presbyterian Hospital/Weill Cornell Medical
Center.
"This overactivation leads to ... more fat production in the liver.
Eventually, what starts out as just eating the wrong foods will
lead to the development of obesity, cardiometabolic risks and heart
disease."
Blocking these receptors may help patients lose weight, thereby
reducing obesity and other risk factors for heart disease.
Clinical trials on receptor-blocking drugs are under way.
"In the future, we'll see a paradigm shift, or a change in the
treatment of cardiometabolic risk," Aronne said. "Instead of
waiting for risk factors and disease to emerge, we'll be treating
those who are obese earlier and earlier to prevent disease and
offset complications."
Meanwhile, the best advice to patients is to manage all their risk
factors for cardiovascular disease.
"The more risk factors someone has, the more likely he or she is to
have cardiovascular disease," explained Dr. Antonio Gotto Jr., dean
and professor of medicine at the Weill Medical College of Cornell
University in New York. "In cases where patients have two or more
risk factors, the heart disease risk caused by the whole package is
much worse than the risk associated with each individual risk
factor."
In essence, this theory can also apply to prevention and management
of risk factors; the more risk factors managed, the greater chance
a patient can prevent heart disease.
"Research into risk has been extremely beneficial in giving
physicians a better understanding of how they can help their
patients," said Gotto. "We've learned that without management of
all the issues related to one's cardiovascular health, it is very
unlikely patients will reduce risk substantially and prevent
disease."
Aronne and Gotto spoke at a recent American Medical Association media briefing on cardiovascular disease. Log on to www.ama-assn.org for more information. - NU
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