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 Edwin Y. Endo, OD

We are the leading Provider in Eye Care and highly regarded professional Optometry establishment in honolulu for the entire family where Quality eye exams are Affordable with Excellence. Diplomate, American Board Certified Optometrists, Eye Doctor

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Steve Jobs Said 1 Thing Separates Successful People From Everyone Else (and Will Make All the Difference In Your Life)

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// TOP TEN

Anti‐Inflammatory Effects of a Vegan Diet vs the AHA-Recommended Diet 
J Am Heart Assoc; 2018 Dec 12 
#Coronary Artery Disease #Coronary Heart Disease #Dietary Modification #Heart Health-Prevention and Rehabilitation

Commentary by David Rakel MD, FAAFP


Angiotensin Receptor Neprilysin Inhibitor for Functional Mitral Regurgitation 
Circulation; 2018 Dec 21 
#General Cardiology #Heart Failure and Transplantation #Mitral Regurgitation #Valvular Heart Disease 

Commentary by Gervasio Lamas MD, FACC, FAHA, FESC


Association of Estimated Sleep Duration and Naps With Mortality and Cardiovascular Events 
Eur Heart J; 2018 Dec 20 
#General Cardiology 

Commentary by Peter Lin MD, CCFP


2018 Top Stories in Cardiology: Are Omega-3 Fatty Acids Cardioprotective? It Depends…. 
Commentary; 2018 Dec 03 
#Coronary Heart Disease #General Cardiology #Metabolic and Endocrine Disorders #Vascular and Aortic Disease 

Written by Peter Libby MD


Artificially Sweetened Beverages, Stroke,and Dementia 
Stroke; 2017 Apr 27 
#Dietary Modification #General Cardiology #Heart Health-Prevention and Rehabilitation #Stroke or Cerebrovascular Accident (CVA) 

Commentary by David Rakel MD, FAAFP

Commentary by Deborah Wexler MD, MSc


Coenzyme Q10 Reduces Statin-Induced Myopathy 
J Am Heart Assoc; 2018 Nov 07 
#Cardiomyopathy #Myocardial Disease 

Commentary by David Rakel MD, FAAFP


Omega-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer 
N. Engl. J. Med; 2018 Nov 22 
#Coronary Heart Disease #General Cardiology #Metabolic and Endocrine Disorders #Vascular and Aortic Disease 


2018 Top Stories in Cardiology: Aspirin Primary Prevention Trials 
Commentary; 2018 Dec 03 
#Coronary Heart Disease #General Cardiology #Myocardial Disease #Vascular and Aortic Disease 

Written by Joerg Herrmann MD


Statins for Primary Prevention of Cardiovascular Events and Mortality in the Elderly 
BMJ; 2018 Sep 25 
#General Cardiology #Lipid Disorders #Metabolic and Endocrine Disorders 

Commentary by Om Ganda MD

Commentary by John Tayek MS, MD, FACP, FACN


Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease 
N. Engl. J. Med; 2018 Nov 22 
#Coronary Heart Disease #General Cardiology #Heart Health-Prevention and Rehabilitation #Lifestyle Modifications#Vascular and Aortic Disease 

Pillow as a Risk Factor for Glaucoma

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2018 Top Stories in Eye Care: The Relationship Between Obstructive Sleep Apnea and Eye Disorders

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The relationship between obstructive sleep apnea (OSA) and eye disorders is not yet well appreciated by the eye care community. However, in 2018, there were several papers published about a number of ophthalmic conditions associated with OSA. Because most are based on retrospective studies, it cannot yet be determined if there is a causative relationship between OSA and these specific eye pathologies. However, to highlight this potential relationship, as well as the need for eye care professionals to appreciate how we can help patients to either be aware of the need for a sleep assessment or to support sleep therapy, my story of the year is the review article, "Obstructive Sleep Apnoea,"1 which summarizes some of these relationships.

Sleep apnea is described as an “episodic upper airway narrowing during sleep,” which can be either partial or complete, and which is qualified as mild, moderate, or severe. It almost seems intuitive that a reduction in airflow, which can cause intermittent hypoxia, blood pressure surges, and heart rate increases, could contribute to retinal vascular compromise in the eye. It should, therefore, not come as a surprise that OSA is associated with vascular conditions like hypertension and diabetes, with possible retinal disease and optic neuropathy sequelae.

How can eye care professionals use this information? As primary healthcare providers, we can help preliminarily identify patients who may have OSA by including questions in our histories that relate to quality and quantity of sleep, especially for seniors and those who appear overweight. Depending on the patient’s responses, a recommendation to be seen by either the patient’s primary care physician or a sleep specialist for a sleep study may be appropriate. Additionally, special attention should be paid to sleep information for those patients with hypertension, diabetes (especially those with diabetic retinopathy), central serous chorioretinopathy (CSCR), glaucoma, age-related macular degeneration, and non-arteritic ischemic optic neuropathy. The relationship between certain systemic and ocular conditions and OSA should encourage information sharing between eye care professionals who are treating and monitoring these ocular pathologies and those clinicians who are treating OSA. And, finally, from a functional and public health perspective, making seniors aware of the effect of both fatigue and aging, a combination which could potentially increase the risk of motor vehicle accidents when response time is important, can be of benefit not only for the patient but also for the community in which the patient drives.

Currently, continuous positive airway pressure (CPAP) is the treatment of choice for OSA (along with weight loss). Importantly, this treatment has the potential to have both positive and negative effects with respect to some ocular pathologies. For example, for patients with CSCR, treatment of undiagnosed OSA “can lead to dramatic resolution of CSCR after treatment of OSA with continuous positive airway pressure therapy,” whereas, for patients with glaucoma, some studies suggest an increase in intraocular pressure for those using a CPAP. In the latter condition, a pre-assessment of intraocular pressure and visual fields may be of value in appreciating that effect, and should be considered.

Hopefully, as more studies are done, there will be a better understanding of the pathophysiological similarities between OSA and eye pathologies, with resultant overall positive therapies.

Association Between Sunlight Exposure and Risk of Age-Related Macular Degeneration

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TAKE-HOME MESSAGE

Omega-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer

Link   

TAKE-HOME MESSAGE

Coenzyme Q10 Reduces Statin-Induced Myopathy

Link   

TAKE-HOME MESSAGE

Anti‐Inflammatory Effects of a Vegan Diet vs the AHA-Recommended Diet

Link  

TAKE-HOME MESSAGE

2018 Top Stories in Primary Care: Were We Really That Off With Aspirin for Primary Prevention?

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Now, over 30 years later, we conduct ASPREE, ARRIVE, and ASCEND. The participants in these trials either had good blood pressure control on their own or they were treated. They either had good cholesterol on their own, or they were treated. They either had good glucose control, or they were treated. With much less damage to the blood vessel wall, plaque ruptures occur less often, and aspirin has less work to do—less damage, fewer plaque ruptures, and fewer clots to break up.

My take on this aspirin story is not that aspirin is not working but that we have managed the other risk factors so well that clot formation is no longer rampant. I don’t think that we were wrong for all these years recommending aspirin for primary prevention. Aspirin did provide a benefit, but now we are also taking care of the root causes of vascular damage. If a trial was conducted currently among patients who refused blood pressure medications, refused statins, refused diabetes medications, and were still smoking, then I think aspirin would shine again.

Artificially Sweetened Beverages, Stroke,and Dementia

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TAKE-HOME MESSAGE

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