guidelines

Guidelines recommend sleep test for obstructive sleep apnea

Obstructive sleep apnea is a common cause of daytime sleepiness. It occurs when the muscles in the back of the throat relax too much during sleep. This lets the tissues around the throat close in and block the airway. People with obstructive sleep apnea can wake up gasping for breath scores of times a night, usually without knowing it. Obstructive sleep apnea can boost blood pressure and increases the risk of stroke. New guidelines from the American College of Physicians recommends an overnight sleep test to diagnose, or rule out, obstructive sleep apnea for individuals with unexplained daytime sleepiness. These are usually done in a sleep center, but home tests can also be done using a portable monitor.

Cholesterol and statins: it’s no longer just about the numbers

Reena Pande, M.D.

Instructor in Medicine, Harvard Medical School

Updated cholesterol guidelines released yesterday by the American Heart Association and American College of Cardiology aim to prevent more heart attacks and strokes than ever before. How? By increasing the number of Americans who take a cholesterol-lowering statin. The previous guidelines, published in 2002, focused mainly on “the numbers”—starting cholesterol levels and post-treatment levels. The new guidelines focus instead on an individual’s risk of having a heart attack or stroke. The higher the risk, the greater the potential benefit from a statin. A statin is now recommended for anyone who has cardiovascular disease, anyone with a very high level of harmful LDL cholesterol, anyone with diabetes between the ages of 40 and 75 years, and anyone with a greater than 7.5% chance of having a heart attack or stroke or developing other form of cardiovascular disease in the next 10 years.