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Yahoo
05-08-2025
- Health
- Yahoo
This One Test Will Tell You More About Your Heart Attack Risk
A long list of Lynda Hollander's paternal relatives had heart disease, and several had undergone major surgeries. So when she hit her mid-50s and saw her cholesterol levels creeping up after menopause, she said, 'I didn't want to take a chance.' A cardiologist told Hollander that based on factors like age, sex, cholesterol, and blood pressure, she faced a moderate risk of a major cardiac event, like a heart attack, within the next 10 years. Doctors typically counsel such patients about the importance of diet and exercise, but Hollander, now 64, a social worker in West Orange, New Jersey, didn't have much room for improvement. She was already a serious runner, and although 'I fall off the wagon once in a while,' her diet was basically healthy. Attempts to lose weight didn't lower her cholesterol. Her doctor explained that a coronary artery calcium test, something Hollander had never heard of, could provide a more precise estimate of her risk of atherosclerotic heart disease. A brief and painless CT scan, it would indicate whether calcifications and plaque were developing in the arteries leading to her heart. When plaque ruptures, it can cause clots that block blood flow and trigger heart attacks. The scan would help determine whether Hollander would benefit from taking a statin, which could reduce plaque and prevent more from forming. 'The test is used by more people every year,' said Michael Blaha, co-director of the preventive cardiology program at Johns Hopkins University. Calcium scans quadrupled from 2006 to 2017, his research team reported, and Google searches for related terms have risen even more sharply. Yet 'it's still being underused compared to its value,' he said. One reason is that although the test is comparatively inexpensive — sometimes up to $300, but often $100 or less — patients usually must pay for it out-of-pocket. Medicare rarely covers it, though some doctors argue that it should. Patients with a CAC score of zero — no calcification — have lower risk than their initial assessments indicate and aren't candidates for cholesterol-lowering drugs. But Hollander's score was in the 50s — not high but not negligible. 'It was the first indication of what was going on inside my arteries,' she said. Though guidelines vary, cardiologists generally offer statins to patients with calcium scores over zero, and suggest higher intensity statins when scores exceed 100. At over 300, patients' risks approach those of people who've already had heart attacks; they may need still more aggressive treatment. Hollander has taken a low dose of rosuvastatin (brand name: Crestor) ever since, supplemented by a non-statin drug, a shot called evolocumab (Repatha). This is the way calcium testing is supposed to work. It's not a screening test for everyone. It's intended only for selected asymptomatic patients, ages 40 to 75, who have never had a heart attack or a stroke and are not already on cholesterol drugs. The test helps answer a pointed question: to statin, or not to statin. If a doctor calculates the 10-year risk of atherosclerotic cardiovascular disease at 5 percent or lower, drugs are unnecessary for now. Over 20 percent, 'there's no doubt the risk is sufficiently high to justify medication,' said Philip Greenland, a preventive cardiologist at Northwestern University and co-author of a recent review in JAMA. 'It's the in-between range where it's more uncertain,' he said, including 'borderline' risk of 5 percent to 7.5 percent and 'intermediate' risk of 7.5 percent to 20 percent. Why add another measurement to these assessments, which already incorporate risk factors like smoking and diabetes? 'A risk score is derived from a large population, with mathematical modeling,' Blaha explained. 'We can say that this score describes the risk of heart disease among thousands of people. But there are lots of limitations in applying them to one individual.' A calcium scan, however, produces an image of one individual's arteries. Alexander Zheutlin, a cardiology fellow and researcher at Northwestern University, shows patients their images, so that they can see the lighter-colored calcifications. Cardiologists tend to be fans of calcium testing, because they so regularly encounter patients who are reluctant to take statins. People who feel fine may hesitate to start drugs they'll take for the rest of their lives, despite statins' proven history of reducing heart attacks, strokes, and cardiac deaths. In 2019, a survey of almost 5,700 adults for whom statin therapy was recommended found that a quarter were not in treatment. Of those, 10 percent had declined a statin and 30 percent had started and then discontinued, primarily citing fear of side effects. An American College of Cardiology expert consensus report recently put the rate of muscle pain, statin users' most common complaint, at 5 percent to 20 percent. Researchers consider the fear of side effects overblown, citing studies showing that reports of muscle pain were comparable whether patients took statins or placebos. 'The actual risk is much, much lower than the perceived risk,' Zheutlin said. That may be little comfort to people who are in pain, but cardiologists argue that reducing doses or switching to different statins usually solves the problem. Some patients will do better on a non-statin cholesterol drug. Hollander, for example, suffered 'muscle cramps that would wake me up at night.' Her doctor advised fewer doses, so Hollander now takes Crestor three days a week and self-injects Repatha twice monthly. (Statins also carry a very low risk of a dangerous condition, rhabdomyolysis, that causes muscle breakdown, and they slightly increase the chance of diabetes.) Some caveats: No one has undertaken a randomized clinical trial to show whether calcium testing eventually reduces heart attacks and cardiac deaths. That's why, although several professional associations endorse calcium scans to help determine treatment, the independent U.S. Preventive Services Task Force has called the current evidence 'insufficient' to recommend widespread use. Such a trial would be expensive and difficult to mount, with many confounding variables. And pharmaceutical companies aren't eager to underwrite one, since a successful result could mean that patients with zero scores avoid cholesterol drugs altogether. But a recent Australian study of asymptomatic patients with family histories of coronary artery disease found that, after three years, those who had undergone calcium scans had a sustained reduction in cholesterol and a significantly lower risk of heart disease than those who had not been tested. The test 'leads to more statin prescriptions, better adherence to statins, less progression of atherosclerosis, and less plaque growth,' Greenland said of the study, in which he was not involved. Another concern: people age 75 and older. Most will have arterial plaque, making a scan's benefit 'less clear-cut,' said Zheutlin, lead author of a recent JAMA Cardiology article pointing out that CAC testing can be both overused and underused. Because older adults face more chronic diseases and medical issues, cholesterol-lowering may become a lower priority. A study now enrolling participants over 75 should answer some questions about statins, calcium scans, and dementia in a few years. Meanwhile, cardiologists see calcium scans as a persuasive tool. 'It's incredibly frustrating,' Zheutlin said. With statins, 'we have cheap, safe, effective drugs available at any pharmacy' that help prevent heart attacks. If CAC test results prove more influential than traditional risk assessments alone, he said, more patients might agree to take them. A calcium scan helped Stephen Patrick, 70, a retired tech executive in San Francisco, reach that point. 'For years, I was borderline on cholesterol, and I managed to beat it back with less cheese toast' and lots of exercise, he said. 'I was on no meds, and I took pride in that.' Last fall, with both his total and his LDL cholesterol higher than recommended, his doctor suggested a calcium scan. His score: 176. He's taking atorvastatin (Lipitor) daily, and his cholesterol levels have dropped dramatically. 'I might have tried it anyway,' he said. 'But the calcium score meant I had to pay more attention.' The New Old Age is produced through a partnership with The New York Times. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism. Learn more about KFF. The post This One Test Will Tell You More About Your Heart Attack Risk appeared first on Katie Couric Media.
Observer
27-07-2025
- Health
- Observer
This test can see a heart attack in your future
A long list of Lynda Hollander's paternal relatives had heart disease, and several had undergone major surgeries. So when she hit her mid-50s and saw her cholesterol levels creeping up after menopause, she said, 'I didn't want to take a chance.' A cardiologist told Hollander that based on factors like age, sex, cholesterol and blood pressure, she faced a moderate risk of a major cardiac event, like a heart attack, within the next 10 years. Doctors typically counsel such patients about the importance of diet and exercise, but Hollander, now 64, a social worker in West Orange, New Jersey, didn't have much room for improvement. She was already a serious runner, and although 'I fall off the wagon once in a while,' her diet was basically healthy. Attempts to lose weight didn't lower her cholesterol. Her doctor explained that a coronary artery calcium test, something Hollander had never heard of, could provide a more precise estimate of her risk of atherosclerotic heart disease. A brief and painless CT scan, it would show whether the fatty deposits called plaque were developing in the arteries leading to her heart. When plaque ruptures, it can cause clots that block blood flow and trigger heart attacks. The scan would help determine whether Hollander would benefit from taking a statin, which could reduce plaque and prevent more from forming. 'The test is used by more people every year,' said Dr. Michael Blaha, co-director of the preventive cardiology program at Johns Hopkins University. Calcium scans quadrupled between 2006 and 2017, his research team reported, and Google searches for related terms have risen even more sharply. Yet 'it's still being underused compared to its value,' he said. One reason is that although the test is comparatively inexpensive — sometimes up to $300, but often $100 or less — patients must pay for it out of pocket. Medicare rarely covers it, though some doctors argue that it should. Patients with a CAC score of zero — no plaque — have lower risk than their initial assessments indicate and aren't candidates for cholesterol-lowering drugs. But Hollander's score was in the 50s, not high but not negligible. 'It was the first indication of what was going on inside my arteries,' she said. Although guidelines vary, cardiologists generally offer statins to patients with calcium scores over zero, and suggest higher intensity statins when scores exceed 100. At over 300, patients' risks approach those of people who've already had heart attacks; they may need still more aggressive treatment. Hollander has taken a low dose of rosuvastatin (brand name: Crestor) ever since, supplemented by a nonstatin drug, a shot called evolocumab (Repatha). This is the way calcium testing is supposed to work. It's not a screening test for everyone. It's intended only for selected asymptomatic patients, ages 40 to 75, who have never had a heart attack or a stroke and are not already on cholesterol drugs. The test helps answer a pointed question: to statin, or not to statin. If a doctor calculates the 10-year risk of atherosclerotic cardiovascular disease at 5% or lower, drugs are unnecessary for now. Over 20%, 'there's no doubt the risk is sufficiently high to justify medication,' said Dr. Philip Greenland, a preventive cardiologist at Northwestern University and a co-author of a recent review in JAMA. 'It's the in-between range where it's more uncertain,' he said, including 'borderline' risk of 5% to 7.5% and 'intermediate' risk of 7.5% to 20%. Why add another measurement to these assessments, which already incorporate risk factors like smoking and diabetes? 'A risk score is derived from a large population, with mathematical modeling,' Blaha explained. 'We can say that this score describes the risk of heart disease among thousands of people. But there are lots of limitations in applying them to one individual.' A calcium scan, however, produces an image of one individual's arteries. Dr. Alexander Zheutlin, a cardiology fellow and researcher at Northwestern University, shows patients their images. 'When there's plaque, it's white,' he said. 'It's easy to see.' Cardiologists tend to be fans of calcium testing, because they so regularly encounter patients who are reluctant to take statins. People who feel fine may hesitate to start drugs they'll take for the rest of their lives, despite statins' proven history of reducing heart attacks, strokes and cardiac deaths. In 2019, a survey of almost 5,700 adults for whom statin therapy was recommended found that a quarter were not in treatment. Of those, 10% had declined a statin and 30% had started and then discontinued, primarily citing fear of side effects. An American College of Cardiology expert consensus report recently put the rate of muscle pain, statin users' most common complaint, at 5% to 20%. Researchers consider the fear of side effects overblown, citing studies showing that reports of muscle pain were comparable whether patients took statins or placebos. 'The actual risk is much, much lower than the perceived risk,' Zheutlin said. That may be little comfort to people who are in pain, but cardiologists argue that reducing doses or switching to different statins usually solves the problem. Some patients will do better on a nonstatin cholesterol drug. Hollander, for example, suffered 'muscle cramps that would wake me up at night.' Her doctor advised fewer doses, so Hollander now takes Crestor three days a week and self-injects Repatha twice monthly. (Statins also carry a very low risk of a dangerous condition, rhabdomyolysis, that causes muscle breakdown, and they slightly increase the chance of diabetes.) (END OPTIONAL TRIM.) Some caveats: No one has undertaken a randomized clinical trial to show whether calcium testing eventually reduces heart attacks and cardiac deaths. That's why, although several professional associations endorse calcium scans to help determine treatment, the independent U.S. Preventive Services Task Force has called the current evidence 'insufficient' to recommend widespread use. Such a trial would be expensive and difficult to mount, with many confounding variables. And pharmaceutical companies aren't eager to underwrite one, since a successful result could mean that patients with zero scores avoid cholesterol drugs altogether. But a recent Australian study of asymptomatic patients with family histories of coronary artery disease found that after three years, those who had undergone calcium scans had sustained a reduction in cholesterol and a significantly lower risk of heart disease than those who had not been tested. The test 'leads to more statin prescriptions, better adherence to statins, less progression of atherosclerosis and less plaque growth,' Greenland said of the study, in which he was not involved. 'It tips the scale.' Another concern: People over age 75. Most will have arterial plaque, making a scan's benefit 'less clear-cut,' said Zheutlin, lead author of a recent JAMA Cardiology article pointing out that CAC testing can be both overused and underused. Because older adults face more chronic diseases and medical issues, cholesterol-lowering may become a lower priority. A study now enrolling participants over 75 should answer some questions about statins, calcium scans and dementia in a few years. Meanwhile, cardiologists see calcium scans as a persuasive tool. 'It's incredibly frustrating,' Zheutlin said. With statins, 'we have cheap, safe, effective drugs available at any pharmacy' that help prevent heart attacks. If CAC test results prove more influential than traditional risk assessments alone, he said, more patients might agree to take them. A calcium scan helped Stephen Patrick, 70, a retired tech executive in San Francisco, reach that point. 'For years, I was borderline on cholesterol, and I managed to beat it back with less cheese toast' and lots of exercise, he said. 'I was on no meds, and I took pride in that.' Last fall, with both his total and his LDL cholesterol higher than recommended, his doctor suggested a calcium scan. His score: 176. He's taking atorvastatin (Lipitor) daily, and his cholesterol levels have dropped dramatically. 'I might have tried it anyway,' he said. 'But the calcium score meant I had to pay more attention.' This article originally appeared in
Associated Press
02-06-2025
- Business
- Associated Press
Grünenthal announces acquisition of the rights to Cialis® from Lilly in Mexico, Brazil & Colombia
Grünenthal today announced the acquisition of the commercial rights to Cialis® (tadalafil) in Mexico, Brazil and Colombia from Eli Lilly and Company. Over the next few years, Grünenthal and Lilly will work together to transfer the manufacturing to Grünenthal's production site in Santiago, Chile, that will supply Cialis® for Mexico, Brazil and Colombia moving forward. The transaction is expected to close in the third quarter of 2025, subject to the satisfaction of customary closing conditions. Grünenthal will finance the transaction using available liquidity. The financial terms of the transaction are not disclosed. Cialis® is indicated for the oral treatment of erectile dysfunction and signs and symptoms of benign prostatic hyperplasia in adult men[1]. The acquisition will expand Grünenthal's Latin American Men's Health product portfolio. 'Executing on our strategy of targeted acquisitions, Cialis® will expand our existing portfolio in the region and strengthen Grünenthal's Latin American business', says Gabriel Baertschi, CEO, Grünenthal. 'In 2022, we acquired Nebido®, a long-acting treatment for testosterone deficiency, and with Cialis®we can continue to serve our existing customer base and foster our growth in key Latin American markets.' Through the acquisition of Cialis®, Grünenthal continues executing its strategy of acquiring established medicines to expand its portfolio and increase its profitability. Since 2017, Grünenthal has invested over €2 billion in the acquisition of established medicines, including Nebido®, the European rights to Crestor® and Nexium®, as well as the global rights to Vimovo® (excluding the U.S. and Japan), Qutenza® and Zomig® (excluding Japan). In 2023, Grünenthal established Grünenthal Meds, a joint venture with Kyowa Kirin International, which manages a portfolio of 13 brands primarily focused on pain management and, in 2024, acquired the US company Valinor Pharma and the product Movantik®. About Grünenthal Grünenthal is a global leader in pain management and related diseases. As a science-based, fully integrated pharmaceutical company, we have a long track record of bringing innovative treatments and state-of-the-art technologies to patients worldwide. Our purpose is to change lives for the better – and innovation is our passion. We focus all our activities and efforts on working towards our vision of a World Free of Pain. Grünenthal is headquartered in Aachen, Germany, and has affiliates in 28 countries across Europe, Latin America, and the U.S. Our products are available in approx. 100 countries. In 2024, Grünenthal employed around 4,300 people and achieved revenues of €1.8 billion. More information: Follow us on: LinkedIn:GrunenthalGroup Instagram:grunenthal [1]In Mexico Cialis® is indicated for the oral treatment of erectile dysfunction and symptoms of benign prostatic hyperplasia in adult men.
Forbes
24-04-2025
- Health
- Forbes
How To Cut Pharmacy Costs As Tariffs Push Drug Prices Even Higher
Pharmacy visits can often feel like an expensive necessity. Between prescriptions, over-the-counter medications, and health-related products, the costs can add up quickly — especially as tariffs on pharmaceutical imports begin to impact drug prices. 'Tariffs on pharmaceuticals could increase the price of generic drugs by as much as 17.5%,' according to a report by the Brookings Institution, referring specifically to a proposed 25% tariff on drugs imported from India — a major supplier to the U.S. But even in a climate of rising costs and global trade uncertainty, there are practical ways to reduce your pharmacy bill. Here are expert-backed strategies to help you save money on your next visit to the pharmacy — without sacrificing your health or skipping essential medications. If you haven't tried a prescription discount card like GoodRx, you could be missing out on major savings—without even switching pharmacies. GoodRx lets you compare prices at pharmacies near you and shows you which one offers the lowest price for your medication. In many cases, you can stay at your preferred pharmacy and simply show the GoodRx coupon at checkout to get the discount. The price differences can be shocking. One pharmacy might charge $60 for a medication, while another just a few blocks away sells it for $15. GoodRx helps you cut through that confusion and pay the lowest price available. Other programs like RxSaver and SingleCare work the same way, giving you options and control over what you pay—whether it's a generic or brand-name prescription. Before you refill a prescription, take 60 seconds to check one of these tools. It's one of the easiest ways to stretch your healthcare dollars without sacrificing convenience. Over-the-counter staples like pain relievers, allergy medications, and vitamins might not seem expensive individually — but the cost adds up over time. One easy way to save is by buying in bulk. For products you use often, larger quantities can offer better value and reduce the number of trips to the pharmacy. Just make sure to check expiration dates before stocking up. Pharmacy prices can vary dramatically—even within the same chain. This variation often comes down to local pricing strategies, supplier contracts, and whether the pharmacy accepts discount programs. According to a report by PharmacyChecker, the price for 90 tablets of Crestor 10 mg ranged from $622.69 at a Houston pharmacy to $932.99 at one in Orlando, Florida. That's a difference of more than $300 for the exact same medication. That's why it pays to shop around. For longer-term prescriptions, mail-order pharmacies can sometimes offer a lower monthly cost—another option worth exploring. Pharmaceutical companies often provide coupons and rebates for brand-name drugs, especially for patients who are paying out of pocket. Websites like RxCoupons offer printable coupons that can give you instant savings at the pharmacy. Many drug manufacturers also have patient assistance programs that help people afford their medications. Be sure to check both the manufacturer's website and third-party coupon websites before your next visit. If you have a Health Savings Account (HSA) or a Flexible Spending Account (FSA) through your employer, you can use those funds to pay for eligible prescription medications and certain over-the-counter products. According to IRS Publication 969, these accounts let you set aside pre-tax dollars, which can lower your taxable income and help cover out-of-pocket healthcare costs more efficiently. Both HSAs and FSAs can be used for a wide range of qualified expenses—from prescriptions to allergy meds, pain relievers, and even menstrual care products. Leveraging these accounts for everyday health expenses is one of the easiest ways to stretch your healthcare dollars throughout the year. If you're uninsured or underinsured, there are still ways to save on prescription medications. Many pharmaceutical companies offer patient assistance programs that provide drugs at low or no cost to eligible patients. These programs aren't always widely advertised, so it's worth asking your doctor or pharmacist if you qualify. According to a report by the Congressional Research Service, patient assistance programs are designed to "provide free or discounted prescription drugs to low-income individuals who lack insurance coverage." The programs are typically offered by pharmaceutical manufacturers and are aimed at helping people access costly medications they might not otherwise afford." You can read the full report here. Your provider can help determine which programs are available and may even assist with the application process. Many pharmacies have programs that can save you money by offering lower-cost alternatives to your current prescriptions. With your doctor's approval, a pharmacist might recommend a generic version or a similar medication that's just as effective but far less expensive. If you're taking a pricey medication, don't hesitate to ask your pharmacist if there's a more affordable substitute available — it could make a big difference in your monthly costs. you're on a costly medication, ask your pharmacist if a substitution might be a good option for you. Many pharmacies offer a discount when you buy a 90-day supply of medications instead of filling them every month. A 90-day prescription can be up to 25% cheaper than buying monthly refills, according to the Centers for Medicare and Medicaid Services. If you take a maintenance medication that doesn't change often, consider switching to a 90-day prescription for long-term savings.
The Guardian
13-04-2025
- Health
- The Guardian
Trump is ‘fully fit' and manages high cholesterol, says White House physician
Donald Trump – the oldest person to ever be elected US president – controls high cholesterol with medication and has elevated blood pressure but is 'fully fit', White House physician Sean Barbella said in a report released on Sunday. The US navy captain's report was published two days after Trump underwent a routine physical. It also said he was up to date on all recommended vaccines – despite his national health secretary Robert F Kennedy Jr having spent years sowing doubt about the safety and efficacy of vaccination. Trump himself has previously spread debunked claims about links between vaccines and autism often invoked by Kennedy. Barbella's report is the most detailed information on the health of Trump, 78, since he returned to the White House in January for a second presidency. 'President Trump exhibits excellent cognitive and physical health and is fully fit to execute the duties of the Commander-in-Chief and Head of State,' Barbella wrote in his report. The report noted that Trump's high cholesterol is 'well-controlled' with two medications addressing it. The medicines are rosuvastatin and ezetimibe, generic names of the branded drugs Crestor and Zetia. They have improved Trump's cholesterol over time. Ideally, total cholesterol should be less than 200. At his physical in January 2018, his total cholesterol was 223. In early 2019, the reading came in at 196 and it stood at 167 in 2020. In Sunday's report, it was listed as 140. Trump's blood pressure was 128 over 74. That is considered elevated. And people with elevated blood pressure are likely to develop high blood pressure – or hypertension – unless they take steps to control the condition. The report also noted that Trump has scarring on his right ear, the result of a gunshot wound he suffered when a would-be assassin fired at him during a campaign rally in Pennsylvania last year. A secret service sniper killed the attacker, who fatally shot one spectator while wounding two others. Barbella's report also references Trump's history with Covid-19. Trump was hospitalized during a serious bout with the virus in October 2020 during a run for re-election that ended in defeat to Joe Biden. Amid questions about his age and mental acuity, Biden then dropped out of an electoral rematch with Trump in November 2024 and endorsed his vice-president, Kamala Harris, to succeed him. Trump won the popular and electoral votes against Harris to return to the presidency. Sign up to Headlines US Get the most important US headlines and highlights emailed direct to you every morning after newsletter promotion After the exam preceding the report, Trump told journalists on Air Force One: 'It went, I think, well ... Every test you can imagine, I was there for a long time, the yearly physical. 'I think I did well.' Trump also told reporters he took a cognitive test. Barbella's report gave Trump a 30 out of 30 on what is known as the Montreal Cognitive Assessment. The screening takes about 10 minutes to administer, according to information online. One version available online asks those undergoing the screening to draw a clock, repeat words, name animals and count backwards from 100 at intervals of seven, among other tasks. Trump's resting heart rate was 62 beats per minute, in line with previous tests. A normal resting heart rate for adults ranges from 60 beats to 100 beats per minute. And generally, a lower rate implies better cardiovascular fitness. Reuters and the Associated Press contributed reporting
