South Florida Vascular Associates South Florida Vascular Associates

Monday, November 26, 2012

Women with Diabetes Have Increased Risk for Peripheral Artery Disease (PAD)

Women with diabetes have an increased risk of developing peripheral artery disease, a thickening of the inside walls in the arteries of your legs. The excess sugar in the blood of women with diabetes damages the blood vessel walls, making them thicker and less elastic. As the arteries become progressively more damaged, it is more difficult for blood to flow through them. This can also lead to high blood pressure, another major risk factor for PAD.

Stiff and narrowed arteries reduce the flow of blood and oxygen to muscles and organs. In women with PAD in the legs, the leg muscles may not be able to get enough blood, causing leg pain that occurs when walking, but dissipates at rest. This is known as intermittent claudication, one of the major symptoms of PAD.

Along with smoking, diabetes is one of the strongest risk factors for PAD. PAD is up to 4 times as common in women with diabetes compared with non-diabetic women. The longer you have had diabetes, the more likely you are to develop PAD.

Diabetes can also cause problems that make PAD symptoms more difficult to recognize. Diabetes often causes nerve problems in the legs or feet that blunt pain signals, making the symptoms of PAD harder to detect. For this reason, it is especially important that women with diabetes get regular testing with an Ankle-Brachial Index test to identify PAD early so it can be properly treated. If left untreated, PAD can lead to critical limb ischemia and amputation of a lower limb may be necessary.

Diabetes also puts you at risk for heart disease, stroke, and kidney, nerve, and eye damage. The good news is that proper treatment and lifestyle changes can drastically reduce the risk of future problems.
If you have pain in your leg while walking and it subsides at rest, you may have PAD.

We invite you to contact our office to set up a consultation with one of our board certified endovascular surgeons to determine whether you have PAD and to discuss treatment options and lifestyle changes. Being proactive about your health can save your limbs and your life.

FDA expands use of Xarelto to treat, reduce recurrence of blood clots (DVT)

November 2, 1012- The U.S. Food and Drug Administration today expanded the approved use of Xarelto (rivaroxaban) to include treating deep vein thrombosis (DVT) or pulmonary embolism (PE), and to reduce the risk of recurrent DVT and PE following initial treatment.

Blood clots occur when blood thickens and clumps together. DVT is a blood clot that forms in a vein deep in the body. Most deep vein blood clots occur in the lower leg or thigh. When a blood clot in a deep vein breaks off and travels to an artery in the lungs and blocks blood flow, it results in a potentially deadly condition called PE.

Xarelto is already FDA-approved to reduce the risk of DVTs and PEs from occurring after knee or hip replacement surgery (July 2011), and to reduce the risk of stroke in people who have a type of abnormal heart rhythm called non-valvular atrial fibrillation (November 2011).

The FDA reviewed Xarelto’s new indication under the agency’s priority review program, which provides an expedited six-month review for drugs that offer major advances in treatment or that provide treatment when no adequate therapy exists.

“Xarelto is the first oral anti-clotting drug approved to treat and reduce the recurrence of blood clots since the approval of warfarin nearly 60 years ago,” said Richard Pazdur, M.D., director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research.
Other drugs approved by FDA to treat or reduce the risk of blood clots include Lovenox (enoxaparin), generic versions of enoxaparin, Arixtra (fondaparinux), Fragmin (dalteparin), Coumadin (warfarin), and heparin.

The safety and effectiveness of Xarelto for the new indications were evaluated in three clinical studies. A total of 9,478 patients with DVT or PE were randomly assigned to receive Xarelto, a combination of enoxaparin and a vitamin K antagonist (VKA), or a placebo. The studies were designed to measure the number of patients who experienced recurrent symptoms of DVT, PE or death after receiving treatment.

Results showed Xarelto was as effective as the enoxaparin and VKA combination for treating DVT and PE. About 2.1 percent of patients treated with Xarelto compared with 1.8 percent to 3 percent of patients treated with the enoxaparin and VKA combination experienced a recurrent DVT or PE. Additionally, results from a third study showed extended Xarelto treatment reduced the risk of recurrent DVT and PE in patients. About 1.3 percent of patients treated with Xarelto compared with 7.1 percent of patients receiving placebo experienced a recurrent DVT or PE.

The major side effect observed with Xarelto is bleeding, similar to other anti-clotting drugs.
Xarelto is marketed by Raritan, N.J.-based Janssen Pharmaceuticals Inc.

Monday, November 5, 2012

November is Diabetes Awareness Month. Do you know that people with diabetes are at an increased risk for Cardiovascular Disease?

According to the American Heart Association (AHA), diabetes affects nearly 24 million Americans (7.8 percent of the population). The AHA also considers diabetes to be one of the six major controllable risk factors for cardiovascular disease.

In the U.S., a new case of diabetes is diagnosed every 30 seconds; more than 1.6 million people are diagnosed each year.
  •  Forty-one children are diagnosed with type 1 diabetes each and every day.
  •  More than $174 billion is spent annually on healthcare costs related to diabetes in the United States.
  •  Diabetes kills one American every three minutes.
Why are people with diabetes at increased risk for Cardiovascular Disease?

Heart disease and  stroke are the #1 causes of death and disability among people with type 2 diabetes. In fact, at least 65 percent of people with diabetes die from some form of heart disease or stroke.

 Adults with diabetes are two to four times more likely to have heart disease or a stroke than adults without diabetes.

Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. People with diabetes, particularly type 2 diabetes, often have conditions that contribute to their risk for developing cardiovascular disease.

While poor health habits aren’t good for anyone, they’re especially destructive for people with diabetes, making it harder to manage the condition and increasing your risk for dangerous complications such as peripheral artery disease, critical limb ischemia, and loss of limbs.

Common Risk Factors
High blood pressure (hypertension)
-has long been recognized as a major risk factor for cardiovascular disease. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles.

Obesity- Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk.

Lack of physical activity- Exercising and losing weight can prevent or delay the onset of type 2 diabetes and  reduce blood pressure and help reduce the risk for heart attack and stroke. Studies show that exercise lowers blood sugar and keeps it down for several hours afterward.

Smoking can increase your risk of developing serious diabetic complications: coronary heart disease, stroke, and peripheral vascular disease Smoking puts individuals, whether or not they have diabetes, at higher risk for heart disease and stroke.

Diabetes can be well-managed if you implement a healthier lifestyle. By controlling your risk factors, diabetes patients may avoid or delay the development of heart and blood vessel disease which can ultimately save your life..