Social media medical forwards are quite often advertorial in the garb of being educative
Social media is perhaps the most powerful communication tool of recent times. It empowers using a way that few others ever have. Given its all-pervasive presence, affordability (all it needs is a smart device with an internet connection) and the speed with which one can disseminate information, it has a rapid and profound impact on opinions about almost anything under the sun.
In medicine too, social media has a huge impact. Large bits of information are shared across the big six platforms of social media. This information is either educative or advertorial but is often advertorial in the garb of being educative. For an innocent lay person, the last is obviously difficult to differentiate from facts. Another enigmatic feature of social media is its proclivity for faster dissemination of disruptive messages, which are contrary to established scientific facts. When shared across multiple groups, these messages have a cascading effect, that too without verification.
Medical progress is often slow. Rapid path breaking advances are not the usual norm. Additionally, a new treatment modality often supplements an existing one and is hardly ever a total replacement.
Quite often, I receive forwards seeking comments on a particular health related information. Some of them appear so genuine that I am compelled to cross check their authenticity. This article deals with myths regarding cardiac health that are commonly propagated on various social media posts. I will only discuss three commonly forwarded messages and what, I perceive, is the truth about them.
LOVE-HATE RELATIONSHIP WITH STATINS
Social media posts often convey an impression that statins (a type of cholesterol lowering drugs) are among the biggest medical deceits. Some forwards even go to the extent of rubbishing the entire concept of high cholesterol being a risk factor of heart disease. Most posts only underline the financial aspects of statin usage without highlighting their benefits or the financial burden of disease that these drugs help mitigate.
Blockages in blood vessels of the heart (coronary artery disease) were identified to contain cholesterol many decades ago. Thereafter, it was scientifically proven that high cholesterol levels in blood predisposed to a greater incidence of heart attacks and strokes. Scientific evidence for this is so compelling that elevated cholesterol levels continue to be mentioned as a major risk factor of coronary artery disease by all scientific bodies.
The quest for a predictable, reliable and effective lipid lowering medication with minimal side effects led to the discovery of statins. These drugs act by inhibiting a liver enzyme. They also have an ancillary benefit of reducing inflammation, thereby making blockages more stable and reducing chances of heart attacks and sudden death. As a group of drugs, statins have been subjected to extensive and rigorous scientific scrutiny. Several published scientific trials and meta-analyses verify their benefits. Rarely, like most other drugs, statins too can have side effects. These are often minor and easily managed. Overall, their benefits far outweigh the risks.
IS EECP A PANACEA?
Many social media posts about enhanced external counter pulsation (EECP) convey an impression that this is the primary (if not the only) form of treatment for blocked arteries. It is proposed to be a replacement for coronary stenting or bypass surgery. Some forwards even claim that patients with angina can opt for this therapy directly, without undergoing any further evaluation. Nothing is farther from truth.
EECP involves tying inflatable bands to lower limbs of a patient. These bands get inflated during the relaxation phase of the heart at a frequency of the patients’ heart rate (80-90 beats per minute). A patient needs to undergo daily sessions of EECP (lasting approximately 1 hour each) for about 30-35 days. The proposed mechanism of benefit from EECP is due to enhanced blood return to the heart, improved blood supply and opening up natural bypasses
Currently available scientific evidence as well as guidelines still maintain that the best management for blocked blood vessels is to either open them or create new conduits. All other methods only have a supplemental role to this basic approach. In a rare minority of patients where it may not be possible to either open the blocked arteries or conduct a bypass surgery, EECP (like many other ancillary therapies) might have a limited role. Therefore, it is recommended to be used for a “no option” situation, and not as a replacement or primary mode of treatment for blocked arteries.
LASER TREATMENT FOR ALL BLOCKED ARTERIES
Another common message on social media is about the use of laser therapy to open blocked heart arteries. It has also been published in a few newspapers recently. The messages claims coronary laser treatment to be a revolutionary and new therapy, with a capacity to replace all other forms of coronary interventions such as angioplasty and stenting. This too, is incomplete at best, if not largely incorrect.
Laser therapy for blocked arteries has been available for more than two decades. It needs to be used prudently only when specifically indicated such as in patients with extremely hardened blockages due to calcium, totally blocked arteries or patients who have blocked stents. It is not a routinely recommended treatment for all coronary blocks as it carries its costs and complications rates. It is at best an adjunct to angioplasty and not its replacement.
The above-mentioned scenarios are only representative of the kind of inadequate or false information that can be rapidly and widely disseminated on social media. These could have serious implications for one’s cardiac health. We need not believe all medical information that is pushed to our smart devices. The devices might be smart but all forwards are not. Hence, it is good to follow a simple rule of authenticating the source, identifying the relevance and evaluating the implications before sharing.
Prof Hemant Madan is an Interventional Cardiologist and Programme Head, Cardiac Sciences for Narayana Health. He can be contacted at dr.h.madan@gmail.com