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High CAC, High Cholesterol Increase Heart Attack/Stroke Risk, UT Southwestern Cardiologists Find

Patients with both a high lipoprotein(a) and high coronary artery calcium score (CAC) face a more than 20% risk of heart attack or stroke over the following 10 years, according to findings from a multicenter study led by preventive cardiologists at UT Southwestern Medical Center. “We are hopeful that by making the connection between Lp(a) and CAC as dual risk drivers, we can raise awareness in the medical community and improve earlier heart attack prevention for these patients,” said cardiologist Parag Joshi, M.D., Associate Professor of Internal Medicine at UT Southwestern. “Our data may also expedite the development of treatments designed specifically for this high-risk population,” said Dr. Joshi, a member of the Clinical Heart and Vascular Center at UT Southwestern, which is ranked #11 in the nation and #1 in Texas for cardiology and heart surgery, according to U.S. News & World Report. Approximately one in six people in the U.S. have high Lp(a), a type of bad cholesterol whose levels are driven largely by one’s genes. Coronary artery calcium, known as CAC, is a marker of plaque deposits around the heart. The team of researchers, which included researchers from Emory University, found that participants with combined high Lp(a) and high CAC had a 22% 10-year risk of heart attack or stroke, compared with a 10-15% 10-year risk in patients who had either risk factor alone. Investigators identified three distinct risk-related trends: • High Lp(a), high CAC: These individuals face the highest 10-year risk of heart attack or stroke. • High Lp(a), zero CAC: 10-year heart attack and stroke risk is low when there is no CAC, even if

Lp(a) is high. • Low Lp(a), high CAC: 10-year heart attack or stroke risk is higher than average but lower

Cardiologist Parag Joshi, M.D., is a member of the Clinical Heart and Vascular Center at UT Southwestern, which is ranked #11 in the nation and #1 in Texas for cardiology and heart surgery, according to U.S. News & World Report

than with high LP(a) and high CAC combined. The findings are online in the Journal of the American College of Cardiology (JACC) and will appear in the March print edition. Read more at “What Can Lp(a) Add to CAC for ASCVD Risk Prediction? New Insights” at TMTMD. “Establishing the connection between Lp(a) and CAC means we can move to the important next phase of research, which will be defining and personalizing early screening protocols to identify patients at high risk of heart attack,” said Dr. Joshi, whose research focuses on assessing risk for heart attack and stroke, CAC, cholesterol, and coronary CT angiography. “With further research, this could mean selectively scanning patients with high Lp(a) for their CAC score, and studying therapies specifically designed to reduce Lp(a) among patients with high CAC.” Cardiology researchers confirmed the Lp(a) and CAC connection by comparing data from two landmark cardiovascular trials: • The Dallas Heart Study, an ongoing comprehensive study of 6,000 diverse and heart-healthy patients conducted by UT Southwestern from 2000 to present • Multi-Ethnic Study of Atherosclerosis (MESA): A 6,000-participant study investigating early-stage atherosclerosis (hardening of the arteries).

Heavy Cannabis Use by Female Adults Associated with Lower Incidence Of Diabetes

The Study Found No Association Between Diabetes and Cannabis Use For Female Adults Who Lightly Use Cannabis Nor For Male Adults With Any Level Or No Use

By Rae Lynn Mitchell

Anew study recently published in Cannabis and Cannabinoid Research found that women who heavily used cannabis had lower incidence of diabetes, a chronic condition that prevents the body from either making enough insulin (type 1) or being able to use insulin efficiently (type 2).

Approximately one in 10 Americans has diabetes, and the condition accounted for 87,647 deaths in the United States in 2019, making it the seventh leading cause of death for that year.

For the study, Texas A&M University School of Public Health graduate students Ayobami Ogunsola, Samuel Smith, Udeh Mercy and Olatunji Eniola, along with a colleague from Hofstra University, analyzed data from the National Health and Nutrition Examination Survey (2013-2018). From approximately 15,000 participants. The majority of participants were female, white (non-Hispanic), over 40, and had at least a college-level education. Cannabis use was estimated on the basis of exposure and frequency of use with smoking cannabis fewer than four times per month deemed “light use,” and “heavy use” defined as four or more times per month. Diabetes status was determined by physician diagnosis or meeting criteria for plasma glucose, fasting blood glucose or hemoglobin A1C levels.

Female participants who used cannabis heavily were less likely to be diagnosed with diabetes than female participants who did not use cannabis. Light cannabis use by female participants had no association with diabetes diagnosis. Researchers found no association in male participants between diabetes and any level of cannabis use.

Previous research has shown that the endocannabinoid system, a series of neurotransmitters and receptors in the nervous system involved in numerous biological processes, has different effects depending on sex. Cannabidol and delta-9-tetrahydrocannabidol, two key compounds in cannabis, stimulate receptors in the endocannabinoid system that result in improved glucose disposal. The authors note that this is one possible explanation for the sex-based difference found during their study.

Further research is needed to better understand the association observed in this study, especially to analyze the individual and contextual variables and mechanisms that may be responsible.

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In Caregiving for Elderly Adults, A Local Partnership Offers Help

By Ascension Texas

Anewccording The realities of aging and its impact on loved ones can be a tough realization. Witnessing a decline in the physical or mental abilities of parents or older relatives, many people may not know where to get help. Historically, women have assumed the role of caregiver. They take on physical, emotional and financial responsibilities, often at their own expense – a reality that will only expand as the population of older adults in Central Texas continues to grow. Confronted by new caregiving responsibilities, women’s own health and well-being can quickly become sidelined. But it’s critical for caregivers to prioritize their own mental health so that they, in turn, can better care for those they love. Through a partnership between Ascension Texas and AGE of Central Texas, caregivers in Central Texas can access help. “AGE of Central Texas has been a lifeline for both patients and caregivers,” said Gayle Ayers, DO, geriatric psychiatrist at Austin Ascension Medical Group Seton Behavioral Health, specializing in dementia and cognitive issues evaluation. “At Austin Ascension Medical Group Seton Behavioral Health, we evaluate individuals experiencing mental decline and often refer families and patients to AGE for further resources. Partnerships like this are so important for providing caregivers and communities the resources and support they need,” said Dr. Ayers. As part of its commitment to women’s health through all stages of life, Ascension Texas also supports AGE of Central Texas’s educational events, such as the annual She Thrives conference. This event connects women caregivers with support through a community of peers as well as practical tools and resources. “AGE of Central Texas recognizes how complex and challenging a caregiver’s role can be, and it’s our mission to provide care, resources and support for caregivers and patients alike,” said Jayden Beatty, chief development officer for AGE of Central Texas. “Our goal is to equip women of all ages and backgrounds with resources, information and community to validate and support them as they navigate life’s aging and caregiving journeys.” Among AGE of Central Texas’s robust programs, the largest