Talk:Coronary artery disease/Archive 1

Contradictory Information

The NIH website lists the factors for CHD and assigns them risk factors. According the NIH, age is the major risk factor for men, not cholesterol levels, anyone can look up the USA NIH web site and calculate their risk of CHD based on the data from the Framingham studies. If these studies are incorrect, then somone needs to give a definitive reference that clearly demonstates that cholesterol is the primary risk factor. Wiseoldowl (talk) 23:00, 13 December 2007 (UTC)

Link to the NIH info on Framingham risk scores. The five major clinical risk factors for CAD are (aside from age which is a given):

1. Family history (not included in Framingham). Because it is not a significant risk factor. There is an association with coronary artery disease but it is mostly due to "social inheritance" with common diets and unhealthy habits. The "migration" studies (e.g. Hawaiian Heart Study) proved that it is habits and lifestyle that is responsible for the high rate of coronary artery disease in Western societies.
2. Diabetes
3. Smoking
4. Hypertension
5. High cholesterol

Dlodge (talk) 00:31, 14 December 2007 (UTC)

Disputed neutrality of Preventive diet section

I've placed a tag on this section as it appears neither neutral nor at all comprehensive. The neutrality of the "main article" to which it links is also disputed (Talk:Diet and heart disease). For an issue as important as this, neutrality and the most up to date evidence should be essential. OccamzRazor 18:41, 6 November 2007 (UTC)

2003

About these yahoo-like hierarchy things:

Health Sciences > Medicine > Cardiology > Cardiac arrhythmias
or:
Health Sciences > Medicine > Cardiology > Heart attack

are these wanted or necessary?

What if I came to this CHD page via:
Health Sciences > Medicine > Clinical biochemistry > Hyperlipidaemia > Coronary heart disease.
or even:
Economics > Countries > Wealthy country > Diseases of affluence > CHD ???

I don't want to start an argument, but I vote to delete them on sight. What do others think? Tristanb 06:37 27 May 2003 (UTC)

Agreed. These category schemes are neither widely used nor consistent, and they wrongly assume that article categories form a simple tree, rather than a more general graph structure. The new category-scheme mechanism being discussed on the wikipedia-l mailing list will eventually let this sort of thing be done properly. I second your vote to delete them on sight. The Anome 06:55 28 Jun 2003 (UTC)

Two pages on this stuff???

The only distinction between ischaemic heart disease and coronary heart disease is in degree. I'm going to start merging the two articles together and have ischaemic heart disease redirect to this article (since this article has a better initial layout). This may take some time... Ksheka 02:11, Dec 6, 2004 (UTC)

Okay. It's pretty much done.Ksheka 15:49, Dec 11, 2004 (UTC)

RxMed ArticleTo further prove that you are right. Common Name: Coronary Artery Disease. Medical Term: Ischaemic Heart Disease. Goldy496 02:48, 16 January 2007 (UTC)

So, almost three years ago you said it was pretty much done. What happened? The ischaemic heart disease article is still there. --Skylights76 20:32, 3 August 2007 (UTC)

I agree

Nivanovic 10:38, 7 March 2007 (UTC)

Heart vs. Artery?

Is there any reason for preferring "coronary heart disease" to "coronary artery disease"? I realize both are used commonly, so it is difficult to differentiate on that basis alone. My personal preference is for "coronary artery disease", as "coronary heart disease" seems redundant. Any thoughts? — Knowledge Seeker দ 05:45, 12 May 2005 (UTC)

I would like to add a category of cardiac rehabilitation. This could be under the heading of risk factor modification. Essentially we would be describing 2 related (preferably combined in any disease management) fields of therapy and lifestyle change. Firstly, reduction of risk of MI (heart attack). Secondly, regression (return towards 'normal') of atheroma burden. Because atheroma burden is widespread in many populations and typically hidden, especially in early stages, cardiac rehabilitation shares risk factor modification (targets) with disease prevention, including the disease condition diabetes, particularly Type II, and the similar 'high risk'conditions of obesity / overweight, which are also remedial. The related condition of angina is also improvable (by combined cardiac rehabilitation therapy and techniques). Related but distinct progressive structural cardiac dysfunction, Heart Failure, while appearing essentially recalcitrant, benefits from the same approach.

Phil H

Everyone knows the disease as coronary heart disease... keep it as that

Nivanovic 10:36, 7 March 2007 (UTC)

Don't merge it!!! unless u say out the differences, causes and actual symptoms of the diseases.Because when you merge them, yes they are sometimes called the same, but what the person is diagnosed with, isn't necessarily as severe or about the same body part because one is a disease of the heart and one is of the artery... =]

65.10.207.219 15:42, 29 March 2007 (UTC) Tay =]

From a cardiologist's standpoint, coronary heart disease is a term that is essentially never used--old school. —Preceding unsigned comment added by 76.199.66.13 (talk) 03:45, 19 July 2008 (UTC)

Prevention

"advised to avoid fats that are readily oxidized (e.g., saturated fats and trans-fats)," I started to write that this is simply dead wrong. Then I thought to say instead that it is hopelessly ambiguous. The term, "readily oxidized," might refer to oxidation during storage, prior to consumption, or to oxidation during metabolism after consumption. Oxidation prior to storage results in rancidity. Fats are hydrogenated to protect against rancidity. The result of hydrogenation is saturated fats and trans fats. These are the fats that are not readily oxidized during storage. (Naturally occurring saturated fats, such as many animal fats and vegetable fats such as coconut oil also resist rancidity and are not hydrogenated.) But the text recommends avoiding fats that are readily oxidized: it must mean fats that are readily oxidized before consumption. So it is dead wrong. I'd like to see a lipid expert correct this glaring error. --user:joaquin Joaquin

The statement on Vitamin C caught my eye. I have never seen a cardiologist recommend vitamin C. The site http://www.emedicine.com/pmr/topic165.htm states that preliminary evidence supporting Vitamin C usage was not born out in later studies. It should be dropped. There are later sections in this article that are pushing Vitamin C. I believe that these will need to be modified. Kd4ttc 03:56, 6 March 2006 (UTC)

The section on preventive diets in this article is similar to the section on preventive diets in the Diet and heart disease article. The neutrality of that article is disputed. That section caught my eye in particular. There is no explanation of why the Cretan diet works; in fact, it seems to go against all consensus dietary recommendations. Could a knowlegable, neutral person please address this? --Skylights76 20:40, 3 August 2007 (UTC)

The last I checked, most people eventually die. If you reduce your odds of dying of heart disease, it means you are more likely to die of something else - like cancer or stroke (which is more common in Japan). A sudden death from heart attack is far from the worst way to go. I'd personally prefer that to cancer or being "half dead" due to stroke or dementia. Sure it's a good idea to avoid dying way too _early_ from a heart attack, and it's good to be fit so you can actually do fun stuff, but to go to great pains to avoid it seems silly to me. —Preceding unsigned comment added by 202.75.240.2 (talk) 07:53, 18 January 2008 (UTC)

IHD vs. CAD

Is there any difference between "ischaemic heart disease" and "coronary artery disease"? If not, why are they in different articles? If yes, why is it not yet explained?

I believe "coronary artery disease" is the broader term and is used to define accumulation inside an artery that may not have a tremendous bearing on the heart while "ischaemic heart disease" is where one starts to see symptoms as the CAD is severe enough to impact the heart.

merger with cardiovascular disease

• oppose merger Both are huge topics and deserve an article on their own. Cardiovascular disease is a broader topic and certainly not the same as CAD, but a superset. Anlace 18:44, 17 October 2006 (UTC)
• Keep - See talk:cardiovascular_disease for arguments similar to the above by Anlace. 87.78.151.16 00:40, 10 November 2006 (UTC)

I AGREE!!! Nivanovic 10:40, 7 March 2007 (UTC)

Regarding citations

Ok, I don't want to mess up the page, and because I'm new to how to edit articles, I won't add it in myself.

I found this, which could be used as a citation for the "single cause of sudden death".

http://www.nlm.nih.gov/medlineplus/ency/article/007115.htm

"Coronary heart disease (CHD) is the leading cause of death in the United States for men and women."

Is that something that could be used? Calvin 09:25, 18 January 2007 (UTC)

Removed a promotion

I removed the sentence about fish oil for primary prevention as it seemed to be a promotion to a newsletter at http://www.newsmax.com/blaylock/. The newsletters that I saw were unreferenced and not balanced. Please restore this sentence if someone disagrees.Badgettrg 03:37, 21 May 2007 (UTC)

Proposal: Vitamin D section under Prevention

I'd like to propose a section on Vitamin D under prevention (and maybe list it under Risk Factors?) that includes vitamin D deficiency. There seem to be some interesting studies that refer to the connection between being Vitamin D replete and not developing heart disease or heart disease risk factors.

Since supplements aren't exactly Diet, and since the best way to obtain vitamin D is through sun exposure, and that's controversial, it seems like the discussion would be best suited to its own section.

http://www.vitamindcouncil.com/researchHeartDisease.shtml

http://www.americanheart.org/presenter.jhtml?identifier=3002267

Chaveso 17:51, 5 November 2007 (UTC)

Bizzar reference

I don't do any wikipedia editing, but I noticed at the bottom the reference:

Sir Ben-dover Risk Assessment of having a heart attack or dying of coronary heart disease, from the American Heart Association.

Sir Ben-dover? That cannot be right, I had a quick look at the site and cannot see any reference to such a name. Could someone verify this? —Preceding unsigned comment added by 77.102.247.6 (talk) 18:01, 4 December 2007 (UTC)

I agree: There defintively is no "Sir Ben-dover" in all reports from the AHA! Thomasjst (talk) 14:36, 6 March 2008 (UTC)

CHD and women

I added a section about this important and very modern aspect of CHD.Thomasjst (talk) 11:26, 17 December 2007 (UTC)

CHD: Coronary or Congenital?

It is noted that both Coronary (Ischaemic) and Congenital Heart Disease are abbreviated on Wikipedia as CHD. Although this may be common practice, it could be confusing to some Wikipedia users. Could something be done to reduce confusion? —Preceding unsigned comment added by 194.81.255.254 (talk) 15:46, 22 January 2008 (UTC)

I've never heard CAD called CHD anywhere other than on wikipedia - CHD is congenital heart disease. Dlodge (talk) 00:41, 2 February 2008 (UTC)

I would like to strongly disagree: CHD is not at all a common & accepted abbreviation for Congenital Heart Disease (in fact, there is no one). Common is to use as synonymes "CHD" (= Coronary Heart Disease) and "CAD" (= Coronary Artery Disease) - both referring to ischemic heart disease. Thomasjst (talk) 14:41, 6 March 2008 (UTC)

I guess we'll all have to agree to disagree then. Dlodge (talk) 19:11, 7 March 2008 (UTC)

Syndrome X

Who put in all this syndrome X stuff? It's over half the article now and pervades every section. It should be limited to one paragraph!

Ayurveda

This "alternative medicine" section appears to have been written by someone who speaks English as a second language. Ayurveda already has its own wiki page, so I'd recommend yanking it, but at minimum it must be re-written to comply with wiki standards.

The very first sentence of this article is weird

The very first sentence of this article is pretty messed up by anyone's standards (weird-ass formatting, run-on sentence, multiple parenthetical statements, etc.) I would edit it myself (since I guess we're supposed to fix obvious things without protracted debate http://en.wikipedia.org/wiki/Wikipedia:Be_bold) but the last time I did that to fix a dangling participle my edit was reverted within hours. Someone with the proper wiki-credentials please fix. — Preceding unsigned comment added by 108.92.189.206 (talk) 08:22, 24 January 2013 (UTC)

Article tagged as needing more references

There are a lot of unverifiable and unreferenced claims in this article, particularly in the pathophys., angina, prevention, and prevention diets. Noting that many inline 'citation needed' tags have already been inserted, it seems sensible to tag the article in its entirety, in the hope that others might be able to supply some missing citations. Fortnum (talk) 00:08, 23 August 2013 (UTC)

PCI vs CABG

In multivessel disease, CABG is better even in people without diabetes doi:10.1001/jamainternmed.2013.12844 JFW | T@lk 17:21, 19 November 2014 (UTC)

This is an interesting reference, dear Jfdwolff. I'm afraid I have no access to the full paper though. In any case, according to both European and American guidelines, people with three vessel disease are better off undergoing surgery instead of percutaneous intervention, unless their lesions are of low anatomic complexity (e.g. Syntax Score ≤22).

Of course the section on management of coronary artery disease, and especially revascularization allows the reader to deduce none of the above and is in desperate need of rewriting. --NikosGouliaros (talk) 08:51, 22 November 2014 (UTC)

NikosGouliaros My suspicion is that on occasion the interventionalist will want to apply PCI to disease that should properly be referred for surgery. But perhaps I am wrong and overly cynical. JFW | T@lk 20:42, 22 November 2014 (UTC)

Prevention

One of the issues of this article is prevention. Many information on primary and secondary prevention is not found in the relative section, but in a lifestyle subsection of Treatement. This, in my opinion, is just inappropriate. I think some elements from this paragraph just need deleting (they don't need to be repeared), and others moved. Its inclusion there seems to be partially driven by the information that vegan diet can actually reverse CAD; this is supported by references containing primary research or comments on it, all by the same author (Esselstyn 2010, Esselstyn 2001, Esselstyn) - one of them calling modern CAD management "the radical mastectomy of the 21st century", a controversial statement, to say the least. This seems like a case of WP:UNDUE and needs some fixing. Just some thoughts, to explain some of the edits that will follow, and to call for more thoughts and contributions. --NikosGouliaros (talk) 21:27, 2 January 2015 (UTC)

Whole Food Vegan Diet

I add yesterday (02.01.15) a new Study to this Article.

In that version exist already 3 other studys about the benefits of a vegan nutrition in the case of CAD.

I want to link this article now for a friend and see, these studys are all deleted, even those one, who exist already before.

I read in the History: "Removed undue weight given on veganism, supported by references to primary sources and comments on them, all written by the same author"

Why undue weight, these are all serious studys ? Since when is a primary source something wrong ? And the last Part is simply wrong:

https://en.wikipedia.org/w/index.php?title=Coronary_artery_disease&oldid=640661746#Lifestyle

44 is from Esselstyn, 45 from the Mayo Clinic, where Esselstyn is even not in the Team: http://www.mayoclinic.org/about-this-site/meet-our-medical-editors 46 is from Esselstyn again and 47 is from 5 different Authors, where Esselstyn is one of them. http://www.ncbi.nlm.nih.gov/pubmed/25198208

And itself when all these articles would be just from one author, why is that a reason to delete entrys ?

I found some additional scientists, which recommend as well a plant based diet, in order to heal coronary artery disease, like T. Colin Campbell:

https://en.wikipedia.org/wiki/The_China_Study#Heart_disease_and_obesity

http://cardiovascres.oxfordjournals.org/content/73/2/326

https://en.wikipedia.org/wiki/Neal_D._Barnard

https://en.wikipedia.org/wiki/Michael_Greger

https://en.wikipedia.org/wiki/Joel_Fuhrman

https://en.wikipedia.org/wiki/Dean_Ornish

https://en.wikipedia.org/wiki/Michael_Klaper

http://www.jeffnovick.com/RD/Articles/Articles.html — Preceding unsigned comment added by ShalokShalom (talk • contribs) 11:43, 6 February 2015 (UTC)

3 study`s are still listed in this article, which confirm these results: (https://en.wikipedia.org/w/index.php?title=Coronary_artery_disease&oldid=640661746#Diet)

The most interesting study of these 3 is for me the seven countries study and this for several reasons: (https://en.wikipedia.org/wiki/Seven_Countries_Study)

1) "The seven countries study showed that the risk and rates of heart attack and stroke cardiovascular risk both at the population level and at the individual level was directly and independently related to the level of total serum cholesterol. It demonstrated that the association between blood cholesterol level and coronary heart disease (CHD) risk from 5 to 40 years follow-up is found consistently across different cultures. Cholesterol and obesity were associated with increased mortality from cancer."

a) There is practically no cholesterol in plants.

2) Objective data on CVD health in relation to the mediterranean diet originated from the seven countries study. Coronary deaths in the United States and Northern Europe greatly exceeded those in southern europe, even when controlled for age, cholesterol, blood pressure, smoking, physical activity, and weight. When investigated further, the importance of the eating pattern characterized as the Mediterranean diet became clear.

a) The mediterranean diet is clearly the most vegan like nutrition from all this seven. 
b) The united states and northern europe are clearly that areas with the highest amount of animal products in theirs nutrition.

Please check all these important studys and arguments, thanks a lot — Preceding unsigned comment added by ShalokShalom (talk • contribs) 03:34, 3 January 2015 (UTC)

Please read WP:MEDRS. We do not typically use primary sources. Best Doc James (talk · contribs · email) 03:41, 3 January 2015 (UTC)

These studys are tested in clinical trials and what is about the china study ? Campbell is one of the most experienced nutrition scientist in the world and his china study one of the largest realised nutrition studys so far. What is about the arguments with the seven countries study ? Shalok Shalom — Preceding unsigned comment added by ShalokShalom (talk • contribs) 03:51, 3 January 2015 (UTC)

The problem with this study [1] is that it does not take into account confoudners such as smoking. Doc James (talk · contribs · email) 04:07, 3 January 2015 (UTC)

OK, and what is about the other studys and arguments ? (This study is anyway just a vegetarian study and part of the current article) — Preceding unsigned comment added by ShalokShalom (talk • contribs) 04:13, 3 January 2015 (UTC)

We have good recent review articles. Thus we should use them. Yes vegetarianism appears to decrease the risk of CAD. And we already say that. Doc James (talk · contribs · email) 04:24, 3 January 2015 (UTC)

Then you might link me the wrong link above. // So, you want to ignore all the other studys and also my executions about the seven countries study ? // Here is one Reason more, why Humans might profit from a fruit based diet: http://imgur.com/Ya0B1mu — Preceding unsigned comment added by ShalokShalom (talk • contribs) 05:01, 3 January 2015 (UTC)

So what they do in a systematic review is look at all the available literature on a specific topic and sum it together to come to overall conclusions. This means all the primary sources are taken into account. Doc James (talk · contribs · email) 05:22, 3 January 2015 (UTC)

Dear ShalokShalom, happy new year and thanks for your input. Doc James has said everything better than I would have. Just to explain to you my point of view: There's not much doubt that a diet rich in fruits and vegetables is good for coronary artery disease; medical societies and well-known textbooks do say it, and it's included in the article. Mentioning specific diets is OK too, as long as it is supported by good sources. And by good sources one means mostly secondary ones; please read Wikipedia:Identifying reliable sources (medicine), and especially Wikipedia:Identifying reliable sources (medicine):Respect secondary sources. As you already see, Mediterranean and vegeterian diets are already mentioned. I did not think it is justified to mention veganism too (which is a different thing from "eating fruits and vegetables"; as far as I could search it is not adequately supported by the sources. And giving undue wight means that if we do mention it, we'll be somewhat partial unless we include every other dietary intervention that has a couple of studies in favor of it; however, this is not the job of an encyclopedia, but of a (very big) review article.

Citation no. 45, to the Mayo Clinic website, was removed because the specific URL did not contain info on diet and CAD; and because this very website has been discussed in Wikipedia talk: MEDRS and is not considered a reliable source. The fact that the other studies were written by the same person is not adequate reason to get them deleted, but it does show that their point of view was not very broad. Why don't you also read the editorial from the very journal one of the articles was published?

Just a question though: what do you mean by: "And the last Part is simply wrong"?

I'm not saying that the current information on CAD in the article (or the whole article indeed) is at the level that it should be. Why don't you give a hand? You can use the European guidelines on prevention of cardiovascular disease, which is a respected secondary source (though it does not include secondary prevention).

And a question to everyone, including Doc James. Harrison's does mention them in its treatment of CAD section, but is it really appropriate to include lifestyle modifications, which are really secondary prevention, in our treatment section? Isn't Coronary_artery_disease#Secondary prevention best, and enough? --NikosGouliaros (talk) 10:28, 3 January 2015 (UTC)

The medications we mention are also secondary prevention :-) Doc James (talk · contribs · email) 10:33, 3 January 2015 (UTC)

Hi NikosGouliaros, thanks for your friendly response. Studys are one possible source, logic and the logic evaluation of these studys are another possible source, at least for me.

Please respect the additional information, which i mentoin before: http://imgur.com/Ya0B1mu

The Human is a born Frugivore and PhD Melanie Joy and others explain, why we eat animals and animals products: Because we follow an invisible dispensation, that this is normal, native and necessary.

https://www.youtube.com/watch?v=7vWbV9FPo_Q&feature=youtu.be&t=1m47s

That means, the natural human nutrition is based on fruits, combined with legumes, berries and vegetables.

The Studys, which inspect a fruit based nutrition, result in a stronger reverse of CAD, than the Mediterranean and vegetarian Studys. It is apparently for me, why this is the case, as already mentoined:

Plants simply contain no cholesterol. 

Since only the vegetarian and the Mediterranean is currently mentoined, result the impression, that a vegan nutrition is possibly unhealthy in the case of CAD, therefore is it to be apparent a undue to less weight.

Please be aware of the circumstantial evidence, which i deduce from the well proofed and already accepted seven countrys study: Its clear, that the most vegan like nutrition results in the recommended one for CAD, while exactly the areas with the most unvegan nutrition show the highest quantity of CAD patients. It is clear, that a fruit based nutrition is healthy for these people, so please include this important information into this topic.

I add 4 secondary sources for the China Study, so please People: This Study is done by one of the most viewed nutrition scientist of the world and he is specialized for long-term health: ' CAD was 2012 the most common cause of death in the world. Find tons of references here: http://nutritionstudies.org/china-study-references/

Is there any serious reason to assume, that a pure plant based nutrition result in lower healthy effects on CAD as a vegetarian or mediterranean nutrition ? Shalok Shalom

Dear fellow editor, let's stay focused on veganism and CAD, not veganism in general.

I'm not familiar with the China–Cornell–Oxford Project, which is discussed in the book the China Study. However, it's still one study. From as far as I know, there's no scientific consensus yet on CAD and veganism; please prove me wrong if I am. I'm pretty sure that most vegans are healthier than the average non-vegan; but I'm not sure at all that this is because they don't eat animal products and not because they tend to lead a healthy life in general - how many vegan smokers do you know?

Your two links are interesting theories on veganism, but not scientific proof of anything.

Yes, CAD is a very serious problem of modern human race, and that's why we need to stick to the best and most thoroughly checked sources. I'm not saying there aren't any that could support your claims; I'm only saying I haven't seen them. --NikosGouliaros (talk) 19:37, 4 January 2015 (UTC)

Again: Plants contain no Cholesterol, which is one of the main reasons, as far as we know now, for CAD.

Do i miss something ?

The point is, that a omnivore nutrition is based on cultural decisions and that the human body is designed to process a fruit based nutrition, so is it clear, that such a nutrition should be recommended in general, of course especially in the case of diseases ?

This Study here (http://www.ncbi.nlm.nih.gov/pubmed/25198208) change just the nutrition, no one changed there lifestyle in any other Way and it is a clinical study.

Again: "Please be aware of the circumstantial evidence, which i deduce from the well proofed and already accepted seven countrys study: Its clear, that the most vegan like nutrition results in the recommended one for CAD, while exactly the areas with the most unvegan nutrition show the highest quantity of CAD patients."

Are there any serious reason to assume, that a pure plant based nutrition result in lower healthy effects on CAD as a vegetarian or mediterranean nutrition ? Shalok Shalom — Preceding unsigned comment added by 80.110.99.96 (talk) 00:02, 5 January 2015 (UTC)

Recommendations regarding dietary intake of cholesterol may soon be removed.

• [2]
• [3]

There appears to be no relationship between dietary cholesterol intake and serum cholesterol. Thus no concern. Doc James (talk · contribs · email) 20:27, 5 March 2015 (UTC)

So James you have a financial and or religious and or some other personal reasons for spreading lies here on wiki about whole food plant based diets, how much meat and dairy do you eat each day? A good doctor cares about their patients and would want to learn the literature to help their patients.

heres a few literatures for someone interested

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662288/

http://www.ncbi.nlm.nih.gov/pubmed/25755896

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854817/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048091/

http://www.ncbi.nlm.nih.gov/pubmed/17457340

http://www.ncbi.nlm.nih.gov/pubmed/19766762

http://www.ncbi.nlm.nih.gov/pubmed/24944170

http://www.ncbi.nlm.nih.gov/pubmed/14527636

Sellingstuff (talk) 03:44, 27 March 2015 (UTC)

My feeling is there should be no mention of veganism when discussing health topics. Veganism is NOT a diet nor is it a health issue. What SHOULD be on any health page that is serious about accurate and current info is info on WFPB diets. Anything less is blatantly ignoring the data and amazing scientific results of WFPB diet. It is our responsibility to provide info that may help people, even if the editors are uncomfortable with full committal to the accessible data. Statement such as:

A 2014 article in the Journal of Family Practice ‘A way to reverse CAD?’ depicts the results of a study in using a whole-foods plant-based diet in the prevention and treatment of CAD that demonstrated very promising results. While the article admits that wider controlled clinical trial is indicated to more conclusively evidence their findings, the medical community involved with the study felt “the data are sound and strong enough that patients should be informed of this option.” http://dresselstyn.com/JFP_06307_Article1.pdf

??? thoughts??

Still working on what sources are considered acceptable so feedback always welcome. Karyn Swaney (talk) 05:00, 8 December 2015 (UTC)

See above, secondary sources are very strongly preferred. This 2014 JFP article (http://www.ncbi.nlm.nih.gov/pubmed/25198208) is a primary study. TylerDurden8823 (talk) 06:03, 8 December 2015 (UTC)

I'm going to leave this list here, as no matter how many doctors or results I cite here it does not seem to meet criteria, but I am interested in health professionals being up-to-date, so I'll leave them here anyways.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662288/

http://ajcn.nutrition.org/content/78/3/544S.full

http://health.usnews.com/health-news/blogs/eat-run/2015/09/02/absence-of-meat-makes-the-heart-grow-stronger

http://www.forksoverknives.com/why-i-abandoned-traditional-cardiology-to-become-the-healthy-heart-doc/

The following page reproduces articles that were published in The Preventive Cardiology, The Am J of Cardiology, Cleveland Clinic, The Journal of Family Practice, Experimental and Clinical Cardiology, but again, was told were not valid: http://www.dresselstyn.com/site/articles-studies/

http://ajcn.nutrition.org/content/78/3/544S.full

http://www.jeffnovick.com/RD/Articles/Entries/2013/12/5_The_Specturm_Of_Health__The_Evidence_For_A_Whole_Food_Plant_Base_Diet_-_Pt_1.html

http://www.hindawi.com/journals/cric/2015/978906/

http://www.huffingtonpost.com/joel-fuhrman-md/heart-health-prevent-and-reverse_b_783565.html

http://www.pcrm.org/health/medNews/plant-based-diet-reverses-angina

http://business.inquirer.net/167214/genes-load-the-gun-lifestyle-pulls-the-trigger

http://wellandgood.com/2014/12/29/meet-the-new-york-doctor-who-prescribes-vegan-diets/

http://www.montefiore.org/cardiacwellnessprogram

http://www.losaltosonline.com/special-sections2/sections/your-health/48685-

http://health.usnews.com/health-news/blogs/eat-run/2015/01/28/plant-based-diets-a-prescription-for-optimal-health

http://nutritionstudies.org/reversing-heart-disease-diet/

Risks of eating meat but does not specify plant-based:

http://healthletter.mayoclinic.com/editorial/editorial.cfm/i/397/t/The%20risks%20of%20not%20going%20meatless/

Again, should not use the word vegan as ‘vegan’ is not health-related:

http://drjaygordon.com/in-the-news/the-president-of-the-american-college-of-cardiology-goes-vegan.html

Take care :) Karyn Swaney (talk) 19:01, 8 December 2015 (UTC)

what is cad characterized by?

What is CAD? The definition says that CAD is "a group of diseases," and gives examples. That's not useful. I suggest that at the least the definition should say what that "group of diseases" is characterized by, or what is common to every member of the group, to better give a description of what CAD actually is. Piratejosh85 (talk) 22:38, 1 October 2015 (UTC)

Two years later, Piratejosh85's issue remains unaddressed. When a user comes to this page, they expect the article to begin something like,

Coronary artery disease is a group of diseases characterized by insufficient blood flow to the heart muscle.

or something like that, saying what it is. The user could read the entire article and still not have an answer to that most basic question, although this answer is implied by the infobox (Causes) and by the section Pathophysiology. Would someone with basic knowledge of this subject please put a proper definition of this disease in the first sentence? —Anomalocaris (talk) 20:23, 12 December 2017 (UTC)

Well, I took a first crack (probably needs a bit of refinement) at providing a more straightforward definition/explanation of CAD in the beginning. Feedback is appreciated. This is a highly important article and I agree it's important that we define CAD well for our audience. TylerDurden8823 (talk) 06:08, 13 December 2017 (UTC)

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Use of word smoking as a risk factor

It is true that smoking is one of the important risk factors. But in many countries like India, tobacco is consumed in many forms. So the word 'tobacco' needs to be added as a risk factor apart from smoking alone. I was able to see that the word smoking is redirected to 'Tobacco smoking' only, so that should serve the purpose. But that gives an impression that smokeless tobacco is harmless which is not true. Hence I would request experienced editors to kindly look into it. Thank you. -- Abhijeet Safai (talk) 12:15, 21 June 2017 (UTC)

If there are WP:MEDRS sources that discuss other forms of tobacco consumption increasing risk of CAD, please bring them. Thanks! Jytdog (talk) 18:34, 21 June 2017 (UTC)

Interesting. I will surely try to find of these sources. I remember I had studied an acronym for cardiac poisons as TOAD. Which means Tobacco, Oleander, Aconitum and Digitalis. I will try find out the sources and would share here. Thank you. -- Abhijeet Safai (talk) 07:11, 22 June 2017 (UTC)

Statins versus lipid lowering agents

Ref says

"Sometimes lifestyle changes aren’t enough to control your blood cholesterol levels. For example, you may need statin medications to control or lower your cholesterol. By lowering your cholesterol level, you can decrease your chance of having a heart attack or stroke."[4]

Fibrates are not commonly used much. Ezetimibe is also somewhat controversial. IMO we should go with what the ref says. Doc James (talk · contribs · email) 01:08, 16 December 2017 (UTC)

James, I agree with your points. However, those other agents are still used. I goofed putting "lipid-lowering agents" before the ref (I didn't mean to attribute it to that ref). It's also important to consider PCSK-9 inhibitors. They're quite expensive and not nearly as cost-effective and data is still emerging on them, but they do have a role and I think that deserves recognition. Here a few reviews that discuss this [5], [6], and [7]. TylerDurden8823 (talk) 05:39, 16 December 2017 (UTC)

Text removed

Oral Manifestations of Coronary Artery Disease

Coronary artery disease does not directly induce oral lesions or oral complications. However, carotid calcifications can de detected on panoramic images in about one third of patients who have atherosclerosis. Also, an association between ischaemic heart disease and periodontal disease, poor oral health, chronic apical periodontitis and tooth loss has been documented. Drugs used in the treatment of ischaemic heart disease may produce oral changes such as dry mouth, taste aberrations, and stomatitis. Calcium channel blockers can induce gingival overgrowth when plaque control is less than optimal and is more prominent at anterior interproximal sites. Patients with angina or acute coronary syndrome may experience pain referred to the neck, shoulder, lower jaw or teeth.

Need to use secondary sources and integrate into the rest of the text. Doc James (talk · contribs · email) 02:12, 24 February 2020 (UTC)

Dental management

Treatment sequence should start with taking a complete medical history, followed by short morning appointments, premedication with anxiolytics or prophylaxis nitroglycerin, nitrous oxide-oxygen sedation, and slow delivery of an anaesthetic with epinephrine (1:1,00,000) coupled with aspiration.

If a patient has an angina episode in the dental chair, dental procedure is discontinued and patient is allowed to attain a comfortable position. Patient is reassured and restrictive garments are loosened. Patient is encouraged to have his own nitroglycerin (NTG) spray, up to 3 doses of NTG spray can be given in 15 minutes. If angina signs and symptoms do not resolve with this treatment within 2–3 minutes, administer another dose of nitroglycerin, monitor the patient's vital signs, call his or her physician, and be ready to accompany the patient to the emergency department. Oxygen is administered 4-6 lit/min. Dental procedure may be restarted if it is the usual type of experience for the patient. If no improvement within 3 minutes, myocardial infarction (MI) is suspected and patient is sent to the hospital

A 1983 reference is too old. Doc James (talk · contribs · email) 02:12, 24 February 2020 (UTC)

References