Suzypenguin yikes I have a clotting autoimmune
condition well interestingly enough I'm gonna go ahead and give you the
punchline that clotting discussion
one of the things that's coming up and several people are considering you know
by the time we know that somebody's got
COVID-19 from coronavirus infection maybe we
should go ahead and start covering them with
uh blood thinners anti-clot mechanism well guess what I'm already on it why am
I on it I'm on Eliquis you know you see Eliquis Xarelto
you see some of those medicines here's why so many people are on it the
number one cause or the number one cardiac
dysrhythmia or arrhythmia is what people used to
call it but that arrhythmia means no rhythm you got to have rhythm
or you won't be alive dysrhythmia means not such a good rhythm
number one dysrhythmia is what
I've got it atrial fib and here's one of the things we used to think that
cryptic or stroke of unknown origin well then we're beginning to find all
those strokes of unknown origin and by far the
majority of strokes were used to be "unknown" origin we're finding out
are due to atrial fib atrial fib like I've got
which is called paroxysmal atrial fib fibrillation which means your heart's
beating at a normal pace on a regular basis but then it'll go
into atrial fibrillation on and you know it may go into 15 second run of
atrial fib well these unnoticed
runs of atrial fib appear to be enough to cause clots
so if you have paroxysmal atrial fibrillation
you probably don't know it just like that
90% of people that have prediabetes don't know it and if you have it
if you have atrial fib your probability of having a stroke has just gotten
multiplied by five to seven times
and again you don't know it now most people that have atrial fib
at least most baby boomers once you get to that age
probably need to be on one of these anti-clotting mechanisms so
like they're called NOACs new or novel oral anticoagulants again
the most common ones are Rivaroxaban or Xarelto and eliquis like I'm on so
again maybe i'm jumping around a little bit but it's an important concept
again another hugely neglected area in terms of health of baby boomers Dave
Murphy what are your thoughts on low dose aspirin
you know there was the ASPREE trial A-S-P-R-E-E
and a couple of others about 12 to 18 months ago and the
interpretation that came out of these free trials was a low-dose aspirin
is not indicated anymore it didn't really help well that
was wrong in my book I don't agree with it
and I think it's related to the fact that doctors for the most part
today tend to practice prevention from you know it's a cardiologist who's
primarily a cardiologist and remembers a few things about prevention and just
tries to apply that or a family practitioner or whatever I know I'm
being a preventive medicine snob but here's
the thing I think we do a lot of people a lot of disservice
not knowing and thinking through the details
I appreciate you bringing this up Dave so what you saw with this ASPREE trial was
this there was a lower amount of
benefit and obviously the same amount of risk
you know there's nothing that's risk-free especially aspirin
if our in the FDA I'd rather than go back and make
metformin non-prescription and especially the Freestyle Libre
non-prescription but then turn around and make aspirin
prescription because aspirin has some risks
now what they showed in this ASPREE trial is that
the benefits for people taking baby aspirin were not as
high anymore and that was because we've made
progress now despite the fact that heart attack and stroke is still the major
causes of death and disability even in the age
of COVID by the way that's what the early numbers prior to
the show mean even with that we've made progress we're better than we
were 10 years ago and 20 years ago when the original baby aspirin studies
were done so therefore the interpretation was
we don't think you need to take baby aspirin anymore well
here's the problem and here's where we weren't thinking
the standards committees I think we're not thinking
I know they're thinking but I don't agree with them the standards committees
before they were saying if you turn age what 55 60
you should start taking baby aspirin well i understand why they said that i
mean that's when you start getting into the risk age for heart attack and stroke
but what about the people that have no plaque if you have no plaque
why would you be taking baby aspirin where else do we see that question
we make the same kind of assumption if you have a
an LDL level over 120 or over 100 and some people are even saving over 70
then you need to be taking a statin if you've got no plaque you don't need
to be taking a statin and you know don't need to be taking a
baby aspirin so if you go back and you rewrite those standards and say
look unless you have plaque you don't take
that or baby aspirin then all of a sudden the vast majority
of the statin prescriptions would go away and
the vast majority of the aspirin prescriptions would go away the people
that are left are the people that have non-plaque
if you've got known plaque your risk for heart attack and stroke
is much higher than somebody that doesn't
at that point i do think you need to be taking baby aspirin
but the bottom line is this for people that have
plaque I think you need to be on a blood thinner either
low dose baby aspirin 81 milligrams daily you also
by the way are in that risk category at that point if you have plaque you're
also in the risk category to have the other chronic diseases like high blood
pressure and by the way unrecognized paroxysmal
atrial fibrillation so I think you need to rule that out
if you have atrial fibrillation aspirin doesn't work as well
you need at that point to be on one of the NOACs
novel oral anticoagulants like Eliquis or Xarelto
continue to get great feedback regarding the webinars
and here's why you know on the Internet when you hear a webinar you expect for
somebody to try to sell you something we're not doing that
we're trying to tell you something people are coming in with their labs
from Quest inflammation panel OGTT insulin survey
response and then they're finding out do I have
inflammation do I have insulin resistance and where does that fit in
terms of other folks we're getting ready to start one for
CIMT as well so again people are really excited about
finding out their own status looking forward to
seeing you there thanks