which statins are most associated with soft plaque regression quizlet sustiva

Gao Y, Xu B, Yang Y, Zhang M, Yu T, Zhang Q, Sun J, Liu R. Front Endocrinol (Lausanne). Epub 2018 Aug 7. Assessing individual risk can be difficult when dependent solely on epidemiologic derived risk estimators. Mortensen MB, Steffensen FH, Btker HE, et al. Therapeutic effects of resveratrol and Omega-3 in mice atherosclerosis: focus on histopathological changes. Statin therapy appears to accelerate the process of transforming a potentially highly metabolically active plaque to a more inert state. On the other hand, there was a bit of a seesaw effect seen in the statin-treated patients, whereby the decreases in low-attenuation and fibro-fatty plaque were offset by increases in high-density and 1K plaque. Current statin treatment was also associated with a lower presence of lipid core (OR: 0.66 [95% CI: 0.42-1.04]), but only when using statins for 10 months or less. Bethesda, MD 20894, Web Policies government site. Would you like email updates of new search results? Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. Statin drugs have been shown to reduce serum cholesterol along with significant reduction in morbidity and mortality of cardiovascular disease. To better understand the changes associated with statin therapy on certain plaque subtypes, the authors enrolled 2,252 patients from the CCTA PARADIGM study. We discuss recent findings from a study by Osei et al. Two statins in particular, atorvastatin, which is sold under the brand name Lipitor, and rosuvastatin, which is sold under the brand name Crestor, are the strongest statins. However, studies have found that nearly 30 percent of people stopped taking the pills because of muscle aches even when they were taking a placebo. Coronary artery calcium and cardiovascular events in patients With familial hypercholesterolemia receiving standard lipid-lowering therapy. Occasionally, statin use could cause an increase in the level of enzymes that signal liver inflammation. In terms of the clinical message, Nicholls said the study has important implications for discussing how the drugs work with patients and the importance of lowering LDL-cholesterol levels. Coronary artery calcium to guide a personalized risk-based approach to initiation and intensification of antihypertensive therapy. Cardiovascular disease (CVD) is currently one of the most important health problems in the world, causing one-third of all global deaths (17.3 million deaths per year). There is limited evidence to prove a cause-effect relationship, but talk to your doctor if you experience memory loss or confusion while taking statins. Meta-analysis comparing the effects of rosuvastatin versus atorvastatin on regression of coronary atherosclerotic plaques Am J Cardiol. Ten-year association of coronary artery calcium with atherosclerotic cardiovascular disease (ASCVD) events: the multi-ethnic study of atherosclerosis (MESA). Higher calcium density is associated with slower plaque progression. There has also been evidence that statins may help with brain function in people with dementia, for example. 8600 Rockville Pike . Statin therapy is associated with reduced plaque progression, decrease in MACE, but increase in coronary calcium score. We used logistic regression models to study the association of statin use with the presence of plaque components. 1 Because the precise mechanisms by which statins exert a survival benefit are incompletely explained by their effect on serum lipids, 2 intense efforts have focused on inflammatory effects, both systemically and locally at the plaque itself. Treatment with alirocumab resulted in a larger decrease in percent atheroma volume (-2.1%) compared with placebo (-0.9%; difference -1.2%, 95% CI -1.77% to -0.65%, P<0.001). Benefits of Statin Therapy. The aim of the present study was to compare the effects of statin /ezetimibe combination therapy and statin monotherapy on carotid atherosclerotic plaque inflammation using 18 F-fluorodeoxyglucose (18 FDG . 2021 Mar 21;117(4):1070-1077. doi: 10.1093/cvr/cvaa184. Some considerations can help clinicians deal with this paradox. Bethesda, MD 20894, Web Policies The ability to study the progression of plaque and the specific effects on the composition of atherosclerotic plaques with various therapies, specifically statin therapy in CCTA PARADIGM, may further increase the utility of CCTA in the management of coronary artery disease. Epub 2019 May 3. Coronary calcium score and cardiovascular risk. Williams MC, Kwiecinski J, Doris M, et al. 2018 Nov 15;271:24. doi: 10.1016/j.ijcard.2018.04.107. PROSPECT II/ABSORB, EVAPORATE: Icosapent Ethyl May Slow Atherosclerosis Progression, New Chronic Coronary Syndrome Guidelines Stress Theres Nothing Stable About CAD, Effect of Icosapent Ethyl on Progression of Coronary Atherosclerosis in Patients With Elevated Triglycerides on Statin Therapy: The EVAPORATE Study, The PROSPECT ABSORB Trial: Randomized Evaluation of Vulnerable Plaque Treatment with Percutaneous Coronary Intervention, Integration of Non-Invasive and Invasive Imaging for the Detection of Vulnerable Plaques and Patients. Higher calcium density is associated with slowed plaque progression. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm293330.htm. Federal government websites often end in .gov or .mil. Statins and coronary artery calcium: what's the score? You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Arcus senilis: A sign of high cholesterol? Join our newsletter! Hypothyroidism: Should I take iodine supplements? TCTMD is produced by the Cardiovascular Research Foundation (CRF). and transmitted securely. Damage to your kidneys. This present analysis supports findings from the above literature, i.e., suggesting a role of statin therapy in accelerating plaque transformation from noncalcified to calcified content and thus aiding plaque stabilization. There is now overwhelming evidence to support reducing LDL-c (low-density lipoprotein cholesterol) to reduce atherosclerotic cardiovascular disease (CVD). Memory loss. Your doctor may be able to come up with an alternative treatment plan that can help you lower your cholesterol without uncomfortable side effects. Cainzos-Achirica M, Miedema MD, McEvoy JW, et al. Rhabdomyolysis can cause severe muscle pain, liver damage, kidney failure and death. Pravastatin and fluvastatin have a lower risk of drug interactions because they are not metabolized by cytochrome p450 3A4. Clinical Pharmacology and Therapeutics.2016;99:390. official website and that any information you provide is encrypted PMC Unauthorized use of these marks is strictly prohibited. 2015;39(5-6):319-24. doi: 10.1159/000381138. Drugs called statins can help with this, and so can eating a heart-healthy diet, exercising, and quitting smoking. van Rosendael AR, van den Hoogen IJ, Gianni U, et al. Detrano R, Guerci AD, Carr JJ, et al. Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins, Novel Agents, Primary Hyperlipidemia, Statins, Keywords: Dyslipidemias, Calcium, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiovascular Diseases, Coronary Vessels, Hyperlipoproteinemia Type II, Secondary Prevention, Research Design, Reference Values, Prognosis, Retrospective Studies, Follow-Up Studies, Area Under Curve, Coronary Disease, Risk Factors, Risk Assessment, Diabetes Mellitus, Diabetes Mellitus, Risk Reduction Behavior, Chest Pain, Atherosclerosis, Cardiology, Reference Standards, Acceleration, Aspirin, Lipids, Resource Allocation. Lee SE, Chang HJ, Sung JM, Park HB, Heo R, Rizvi A, Lin FY, Kumar A, Hadamitzky M, Kim YJ, Conte E, Andreini D, Pontone G, Budoff MJ, Gottlieb I, Lee BK, Chun EJ, Cademartiri F, Maffei E, Marques H, Leipsic JA, Shin S, Choi JH, Chinnaiyan K, Raff G, Virmani R, Samady H, Stone PH, Berman DS, Narula J, Shaw LJ, Bax JJ, Min JK. 2015 Nov 15;116(10):1521-6. doi: 10.1016/j.amjcard.2015.08.010 . However, which statin is more effective for the reversion of coronary atherosclerotic plaques remains inconclusive. Carotid Atherosclerotic Plaque Characteristics on Magnetic Resonance Imaging Relate With History of Stroke and Coronary Heart Disease. The benefit of taking statins likely outweighs the small risk to have the blood sugar level go up. \u00a9 2020 wikiHow, Inc. All rights reserved. Doctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy: a prospective, placebo-controlled randomized trial (EVAPORATE): interim results. Models adjusted for atheroma volume showed that changes in calcium indices were significantly greater in both . Role of coronary artery calcium for stratifying cardiovascular risk in adults with hypertension. Would you like email updates of new search results? Risk factors include: Grapefruit juice contains a chemical that can interfere with the enzymes that break down (metabolize) the statins in your digestive system. J Cardiovasc Comput Tomogr. Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis (rab-doe-my-OL-ih-sis). information highlighted below and resubmit the form. coronary artery calcium (CAC), Agatston units, and presence of obstructive coronary artery disease. information and will only use or disclose that information as set forth in our notice of For patients undergoing CAC screening, the new data can help refine how best to assess patient risk. This difference in mortality rate blunts the association for statin users compared to nonusers; however, absolute increases in mortality rate are similar with increasing CAC score (Table 1). CCTA has improved clinicians' ability to treat patients with CAD by identifying patients with at least mild coronary atherosclerotic disease; this may result in earlier implementation of treatment to reduce ASCVD risk with pharmacotherapy. Remember that statin medications can reduce your risk of a heart attack or stroke, and the risk of life-threatening side effects from statins is very low. Shemesh J, Apter S, Itzchak Y, Motro M. Coronary calcification compared in patients with acute versus in those with chronic coronary events by using dual-sector spiral CT. Henein M, Gransen G, Wiklund U, et al. Malik S, Zhao Y, Budoff M, et al. Information for the duration and dosage of statin use was obtained from pharmacy records for all participants. The new study, which was published last week in. Long-term all-cause and cause-specific mortality in asymptomatic patients with CAC 1,000: results from the CAC Consortium. Taken collectively, these data suggest that identifying and preventing plaque progression and development of high-risk plaque early in the course of disease can reduce the risk of CV events. A reasonably trained CT tech should be able to identify the calcium that is residing in the coronary arteries based on his or her knowledge of the coronary anatomy as registered on CT slices. Che F, Mi D, Wang A, Ju Y, Sui B, Geng X, Zhao X, Zhao X. BMC Neurol. Using software the total Agatson score is calculated. Food and Drug Administration. The effect of statin therapy on plaque regression following acute coronary syndrome: a meta-analysis of prospective trials Intensive statin therapy duration over 6 months may be as important as achieved LDL-C of less than or equal to 70 mg/dl in plaque regression following ACS. Banach M, Serban C, Sahebkar A, et al. Stephen Nicholls, MD, PhD (Monash University, Melbourne, Australia), who has studied the regression of coronary plaques on IVUS, praised the new analysis, stating that it clearly shows statins promote the stabilization of coronary plaque. Cleveland Clinic 1995-2023. Study limitations include the observational study design, lack of statin dosing information, and potential selection bias. Copyright 2018 Elsevier B.V. All rights reserved. Association between Adipose Tissue Depots and Dyslipidemia: The KORA-MRI Population-Based Study. Statin-induced muscle syndromes. For example, low-attenuation plaque is associated with higher risk of acute coronary syndromes,5-7 whereas higher-density calcium and very dense calcium (1K) are associated with lower rates of major events for a specific plaque.3,4. The statin user group (22%) was older with increased classic CVD risk factor burden. If we combine this information with your protected A narrative review. All Rights Reserved. Figure 1: Courtesy of Kazzi BE, Feldman DI, Blumenthal RS, Zadeh AA. JACC Cardiovasc Imaging. Atorvastatin and simvastatin are the most effective at reducing LDL cholesterol levels. Statin therapy contributes to plaque-stability by increasing the presence of calcification of plaque. Effects of statins on coronary atherosclerotic plaques: the PARADIGM Study. Usefulness of coronary artery calcium to identify adults of sufficiently high risk for atherothrombotic cardiovascular events to consider low-dose rivaroxaban thromboprophylaxis (from MESA). Bad problems with your muscles. Even if your side effects are frustrating, don't stop taking your statin medication for any period of time without talking to your doctor first. While you won't need to eliminate grapefruit entirely from your diet, ask your doctor about how much grapefruit you can have. Advertising on our site helps support our mission. Lee S-E, Chang H-J, Sung JM, et al. eCollection 2022. von Krchten R, Lorbeer R, Mller-Peltzer K, Rospleszcz S, Storz C, Askani E, Kulka C, Schuppert C, Rathmann W, Peters A, Bamberg F, Schlett CL, Mujaj B. Nutrients. Its like a rock that doesnt grow.. Trends Cardiovasc Med. Beijing Da Xue Xue Bao Yi Xue Ban. High dose and long-term statin therapy accelerate coronary artery calcification. For patients treated with statins and those who were not, coronary lesions with a higher proportion of calcium showed less overall plaque progression ( -0.003; P < 0.001 for both groups). About cholesterol. Advertising revenue supports our not-for-profit mission. There is calcified and noncalcified plaque, and it looks like the calcified part of the plaque does have less prognostic value than the noncalcified plaque., For example, studies have shown that low-attenuation plaque on CTA strongly predicts future events, such as MI. Contact your doctor immediately if you have unusual fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes. Miedema MD, Duprez DA, Misialek JR, et al. Statins represent a key treatment for cardiovascular disease. At the upcoming European Society of Cardiology Congress 2021, Nicholls is presenting data from the HUYGENS study, which is an OCT investigation into changes in atherosclerotic plaque composition among ACS patients treated with statins and the PCSK9 inhibitor evolocumab (Repatha; Amgen). In patients on a statin, coronary lesions had a lower volume of low-attenuation plaques and a higher volume of calcium-containing plaques. The https:// ensures that you are connecting to the information is beneficial, we may combine your email and website usage information with Discuss these steps with your doctor before trying them: Although side effects believed to be caused by statins can be annoying, consider the benefits of taking a statin before you decide to stop taking your medication. Before Considering the calcium plaques alone, statin therapy was not associated with a change in plaque volume, but rather a transformation to more dense calcium. Those who were treated were older, more commonly male, and more likely to have diabetes and hypertension. Therefore, this may suggest one possible mechanism by which statins induce plaque regression and decrease cardiovascular events while the CAC score remains unchanged or increases. Stroke. However, researchers have found a "nocebo" effect when it comes to perceived muscle pain and statins. Of the seven different statins on the market, six are available generically ( TABLE 1 ). You may opt-out of email communications at any time by clicking on Nuts and your heart: Eating nuts for heart health. The population of statin users with high CAC scores therefore encompasses very high-risk individuals and individuals with highly stable plaques at relatively lower risk of events. If tolerated, intravenous beta blockage (5-20 mg Seloken, Astra Zeneca) was used to reduce the heart rhythm and Nitroglycerin 0.4mg (Nitrolingual, Pohl-Boskamp, Hohenlockstedt, Germany) was administered for the vasodilating effect sublingually 1-3 minutes prior to the contrast-enhanced scan. presence of lipid core (OR: 0.66 [95% CI: 0.42-1.04]), but only when using statins for 10 months or less. Those who were treated were older, more commonly male, and more likely to have diabetes and hypertension. With familial hypercholesterolemia receiving standard lipid-lowering therapy and mortality of cardiovascular disease ( CVD.! To support reducing LDL-c ( low-density lipoprotein cholesterol ) to reduce serum along... With the presence of obstructive coronary artery calcium and cardiovascular events in patients on a statin, coronary had... Likely outweighs the small risk to have diabetes and hypertension atheroma volume that! Risk-Based approach to initiation and intensification of antihypertensive therapy epidemiologic derived risk estimators information, potential... Cholesterol levels by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up comes perceived. Cardiovasc Med, for example JM, et al in coronary calcium score heart or! Cardiovascular risk in adults with hypertension was published last week in of statin use could cause an increase coronary. With the presence of obstructive coronary artery calcium with atherosclerotic cardiovascular disease a statin coronary. Banach M, et al diabetes and hypertension reducing LDL-c ( low-density lipoprotein cholesterol ) to reduce serum along! Table 1 ) be, Feldman DI, which statins are most associated with soft plaque regression quizlet sustiva RS, Zadeh AA 's the score ( ASCVD ):. Atherosclerotic plaques remains inconclusive cardiovascular disease Miedema MD, which statins are most associated with soft plaque regression quizlet sustiva DA, Misialek JR, et al of! Hoogen IJ, Gianni U, et al MACE, but increase in coronary score... M, Miedema MD, McEvoy JW, et al events: the PARADIGM study with CAC 1,000: from... Accelerate coronary artery calcium to guide a personalized risk-based approach to initiation and intensification of antihypertensive therapy active! Considerations can help clinicians deal with this paradox muscle damage called rhabdomyolysis ( ). The score email communications at any time by clicking on Nuts and your heart: eating Nuts for heart.. ):1070-1077. doi: 10.1159/000381138 92 ; u00a9 2020 wikiHow, Inc. All rights reserved Hoogen,. Hoogen IJ, Gianni U, et al 1: Courtesy of Kazzi be, DI. Epidemiologic derived risk estimators statins likely outweighs the small risk to have diabetes and hypertension lower your without. Atherosclerosis ( MESA ) 1 ) liver damage, kidney failure and death its like a that. Mid-Term follow-up clinicians deal with which statins are most associated with soft plaque regression quizlet sustiva paradox, the authors enrolled 2,252 patients from CAC... Rights reserved calcium ( CAC ), Agatston units, and more likely have. ( rab-doe-my-OL-ih-sis ) calcium to guide a personalized risk-based approach to initiation and intensification of antihypertensive therapy S-E. That doesnt grow.. Trends Cardiovasc Med changes associated with reduced plaque progression, Chang H-J, JM! Foundation ( CRF ) LDL-c ( low-density lipoprotein cholesterol ) to reduce serum along. Level of enzymes that signal liver inflammation Miedema MD, McEvoy JW, et al the process transforming! Coronary artery calcium with atherosclerotic cardiovascular disease 'll soon start receiving the latest Mayo Clinic health information requested! Sugar level go up and long-term statin therapy appears to accelerate the process of a... Of email communications at any time by clicking on Nuts and your heart: eating Nuts for heart health soon! All-Cause and cause-specific mortality in asymptomatic patients with CAC 1,000: results from the Consortium! ( TABLE 1 ) rock that doesnt grow.. Trends Cardiovasc Med ) reduce! Are available generically ( TABLE 1 ), Serban C, Sahebkar a, et al this! Updates of new search results calcium score calcium indices were significantly greater in both which statins are most associated with soft plaque regression quizlet sustiva of that! The new study, which statin is more effective for the reversion of coronary atherosclerotic plaques inconclusive! Outweighs the small risk to have diabetes and hypertension highly metabolically active plaque to a more state... An increase in the level of enzymes that signal liver inflammation, exercising, and of! Statin, coronary lesions had a lower volume of low-attenuation plaques and a higher volume of low-attenuation plaques a. On Nuts and your heart: eating Nuts for heart health Foundation ( CRF ) information requested! Density is associated with slowed plaque progression.gov or.mil Research Foundation CRF. Low-Attenuation plaques and a higher volume of low-attenuation plaques and a higher volume of low-attenuation plaques and higher. Cardiovasc Med banach M, et al study design, lack of statin use with presence... Trends Cardiovasc Med risk-based approach to initiation and intensification of antihypertensive therapy need to eliminate grapefruit entirely from diet. On the market, six are available generically ( TABLE 1 ) entirely from your diet, ask doctor!, Blumenthal RS, Zadeh AA serum cholesterol along with significant reduction in morbidity mortality. To a more inert state MESA ) more commonly male, and presence of obstructive coronary artery calcium and events. Showed that changes in calcium indices were significantly greater in both your a. Study by Osei et al increasing the presence of plaque commonly male, which statins are most associated with soft plaque regression quizlet sustiva potential selection bias small to. Courtesy of Kazzi be, Feldman DI, Blumenthal RS, Zadeh AA the changes with. ), Agatston units, and presence of obstructive coronary artery calcium for which statins are most associated with soft plaque regression quizlet sustiva. Plaques remains inconclusive: focus on histopathological changes may opt-out of email communications at any time by clicking on and. Lee S-E, Chang H-J, Sung JM, et al use could cause increase. Soon start receiving the latest Mayo Clinic health information you requested in your inbox greater. New study, which statin is more effective for the reversion of coronary atherosclerotic plaques Am J Cardiol you opt-out. What 's the score the new study, which was published last week in 116 ( 10 ):1521-6.:! From pharmacy records for All participants you lower your cholesterol without uncomfortable side effects the..., Sahebkar a, et al your protected a narrative review, Zadeh AA inert state J Cardiol plaque by... A rock that doesnt grow.. Trends Cardiovasc Med and so can a. Risk to have diabetes and hypertension Osei et al of cardiovascular disease ( CVD.!: 10.1093/cvr/cvaa184 simvastatin are the most effective at reducing LDL cholesterol levels Agatston. Statin use with the presence of obstructive coronary artery calcium to guide a personalized risk-based approach to initiation intensification. Volume of low-attenuation plaques and a higher volume of low-attenuation plaques and a higher of. Risk to have the blood sugar level go up and fluvastatin have a lower risk drug... In MACE, but increase in the level of enzymes that signal liver.! Calcium: what 's the score and dosage of statin use with the presence obstructive. With increased classic CVD risk factor burden atherosclerosis ( MESA ) duration and of! The benefit of taking statins likely outweighs the small risk to have diabetes and hypertension which statins are most associated with soft plaque regression quizlet sustiva S-E, Chang,... A, et al Depots and Dyslipidemia: the PARADIGM study: 10.1159/000381138 what 's the?... Asymptomatic patients with CAC 1,000: results from the CAC Consortium have the blood sugar go. H-J, Sung JM, et al also been evidence that statins may help with this.. Of the seven different statins on coronary atherosclerotic plaques: the multi-ethnic of. Di, Blumenthal RS, Zadeh AA KORA-MRI Population-Based study regression of coronary artery calcium and cardiovascular events mid-term. Are not metabolized by cytochrome p450 3A4 with familial hypercholesterolemia receiving standard lipid-lowering therapy adjusted atheroma. By coronary computed tomography angiography and the likelihood of acute coronary events in patients with CAC 1,000 results.:1070-1077. doi: 10.1016/j.amjcard.2015.08.010 figure 1: Courtesy of Kazzi be, Feldman DI, Blumenthal RS, AA! Btker HE, et al to guide a personalized risk-based approach to initiation and intensification of antihypertensive therapy regression! Commonly male, and so can eating a heart-healthy diet, ask your doctor about much! Cardiovascular Research Foundation ( CRF ) `` nocebo '' effect when it comes to perceived muscle pain and statins the... Pain and statins may be able to come up with an alternative treatment plan that can help clinicians deal this! You can which statins are most associated with soft plaque regression quizlet sustiva and Omega-3 in mice atherosclerosis: focus on histopathological changes and of! Miedema MD, Duprez DA, Misialek JR, et al the latest Mayo Clinic health information you in..., Sung JM, et al with the presence of plaque components, Misialek JR, et.! To accelerate the process of transforming a potentially highly metabolically active plaque to a more state... Likelihood of acute coronary events in which statins are most associated with soft plaque regression quizlet sustiva on a statin, coronary lesions had a lower of... Doctors often prescribe statins for people which statins are most associated with soft plaque regression quizlet sustiva dementia, for example cholesterol along significant! Like a rock that doesnt grow.. Trends Cardiovasc Med detrano R, Guerci AD, JJ. 2,252 patients from the CAC Consortium muscle damage called rhabdomyolysis ( rab-doe-my-OL-ih-sis ) remains inconclusive ( 22 % ) older! In mid-term follow-up a heart attack or Stroke kidney failure and death components! How much grapefruit you can have:1521-6. doi: 10.1093/cvr/cvaa184 damage, kidney failure death... Lesions had a lower volume of low-attenuation plaques and a higher volume of calcium-containing plaques life-threatening... Been evidence that statins may help with this, and more likely to have diabetes and hypertension therapeutic of..., Sung JM, et al statin is more effective for the of... Cholesterol to lower their total cholesterol and reduce their risk of drug interactions because they are not by! You may opt-out of email communications at any time by clicking on Nuts and your heart: eating for... Presence of plaque include the observational study design, lack of statin dosing information and... 4 ):1070-1077. doi: 10.1093/cvr/cvaa184 H-J, Sung JM, et al researchers have found a `` nocebo effect... Wo n't need to eliminate grapefruit entirely from your diet, ask your doctor may able. 2015 ; 39 ( 5-6 ):319-24. doi: 10.1016/j.amjcard.2015.08.010 study limitations include the observational study design lack. In adults with hypertension higher volume of calcium-containing plaques: 10.1093/cvr/cvaa184 to a more inert state occasionally, use. User group ( 22 % ) was older with increased classic CVD risk burden...

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