admin

Many of our patients have asked us about recent studies that have come out in the medical journals and have been summarized in the lay concerned as to whether aspirin is safe and whether they should be taking it.  This new information is not only confusing to  patients but even for doctors.  This New York Times Editorial also may help. Click here for the Aspirin Article

In short, any patient who has had a heart attack, stroke, stent, or bypass, should remain on aspirin.

It may help to understand the 2 terms that clarify the issue.  The the two terms are : Primary prevention and secondary prevention.

Primary prevention simply means a strategy  of preventing a specific problem if one does  not already have a  problem but are at risk for a problem…  An example is if someone is worried that they are at risk of having a heart attack because their father had a heart problem, primary prevention would mean what could that person do to prevent their own heart problem.

Secondary prevention refers to people who already have a condition and want to prevent a recurrence.  Someone who has a stent or who has had a heart attack wants to prevent further problems.  That is called secondary prevention.

The question of secondary prevention regarding aspirin has already been solved.  If someone has a history of coronary heart disease (had a stent, heart attack, angina), peripheral vascular disease, or prior stroke, they should be on aspirin unless they are allergic to it.

These new studies address the issue of  primary prevention: that is can you prevent heart disease if you don’t already have it  by taking aspirin.  The answer seems to be NO, even if you have diabetes or a family history of heart disease.  If you do not have a personal history of heart disease, stroke or peripheral artery disease you should probably not be on aspirin.  Even though we are talking about baby aspirin, this medicine is not harmless and these studies show that you are much more likely to bleed than get any benefit from the therapy.

Though you should talk to your doctor,  in summary: if you have a vascular problem (history of stroke, heart attack, stent, or peripheral vascular disease), stay on aspirin; but if you have none of these conditions, you no longer need to be on aspirin.

Is there anything you can do to prevent heart disease if aspirin is no longer recommended?  The answer is YES.

You can exercise; If you smoke, stop.  If your blood pressure is high, control it.  If you have diabetes, control your sugar.  If you have very high cholesterol consider a statin.

PLEASE DISCUSS THESE ISSUES WITH YOUR DOCTOR OR WITH ONE OF US, and  we hope this new information helps you understand this very important issue.

We’re excited to announce that Dr. Ambereen Quraishi will soon be joining the Woodholme team, serving patients from our new Lutherville-Timonium location! Dr. Quraishi received her medical degree from Albany Medical College in Albany, New York in 2001. She completed her Internal Medicine Residency and also served as Chief Resident at Mt. Auburn Hospital/Harvard Medical School in Cambridge, Massachusetts in 2005. She then completed her Cardiology Fellowship at St. Elizabeth’s Medical Center/ Tufts University School of Medicine in 2008.

Ambereen M. Quraishi, M.D., is board certified in Cardiology, Echocardiography and Nuclear Cardiology.

Dr. Quraishi’s areas of interest include preventive heart disease with a focus on lifestyle modification, women’s heart health and noninvasive imaging/echocardiography.

Dr. Ambereen Quraishi

• Medical Degree – Albany Medical College
• Residency – Mt. Auburn Hospital/Harvard Medical School
• Fellowship – St. Elizabeth’s Medical Center/ Tufts University School of Medicine

With locations in Pikesville, Ellicott City, and Westminster, and a new office opening in the Towson/Lutherville-Timonium area of Baltimore County, Woodholme Cardiovascular Associates provides comprehensive consultative and preventive care services throughout the greater Baltimore, MD.

New Woodholme Location Opening Soon

York Place Building, Suite 30A
1205 York Road
Lutherville-Timonium, MD 21093

Advances in mobile and digital technologies mean that more people now have access to real-time health information in the palms of their hands. Depending upon how they are used these tools can be both a blessing and a curse. To the extent that more people are taking an active interest in their health and becoming more encouraged to get up and move, heart rate apps can be a good thing. On the other hand, overreliance on technology and self-diagnoses can be dangerous.

Convenience

Heart rate apps can be a convenient way to keep track of your heart rate when at rest, walking, or exercising, with measurements for heart rate zones such as peak, cardio, fat burn, and warm-up. They can also provide you with information to share with your doctor during regular visits.

How Heart Rate Apps Work

Phone-based heart rate apps work by using your phone’s camera and lights to detect your heartbeat. When you place your fingertip against the camera lens, the camera detects the change in color and opacity as blood is pumped through your skin. Smartwatch heart apps use sensors on the back of the watch to detect electrical pulses generated by the heart.

Heart Rate App Reliability

Health monitoring app technologies are still in their infancy and reliability and accuracy can vary depending upon the program, mobile platform, and the quality of the device camera. At this stage, many of these tools are probably closer to the traditional “finger-on-the-pulse” method of checking your heart rate than to an actual EKG or heart monitor from a qualified physician.

Apple Watch

In addition to monitoring your heart rate, the Apple Watch Series 4 features an ECG (also known as EKG) measurement that checks how regular your heart rate is and can help spot issues like an irregular rhythm. The Apple product seems to be more reliable than many of the downloadable apps because the technology and device have been developed and tested together. The watch, however, is only meant to flag a possible problem. An actual EKG from your doctor will then provide much more data that will help pinpoint specific issues.

Apple, along with the Stanford University School of Medicine, recently completed an eight-month study on the Apple Watch heart rate and EKG technology to determine whether it would accurately detect atrial fibrillation. While there have been concerns in the medical community about over-notification, the study showed that only 0.5% of participants received irregular pulse notifications. When compared simultaneously to electrocardiography patch recordings, the Apple Watch showed a 71% positive predictive value, and 84% of the participants who received irregular pulse warnings were found to be in atrial fibrillation at the time of the notification.

In addition to over-notification, some physicians are also concerned that false positives generated by the Apple Watch and other apps might result in unnecessary and costly tests, emergency room visits, or even unneeded procedures. Others believe that when used properly, and as part of an overall health treatment program rather than a self-diagnosis tool, these new technologies might help detect heart problems and save lives.

See Your Doctor

While many of the available heart rate apps, watches, and fitness trackers seem to be reasonably accurate, they don’t take the place of visiting a doctor. If you have symptoms or concerns, regardless of what your device says, you should see a doctor. You may contact Woodholme Cardiovascular Associates at 410-469-4000.

The information presented here is for informational purposes only and are not intended to take the place of one-on-one advice from your doctor. Please follow your personal physician’s recommendations if anything found here conflicts with what your doctor has advised.