Look Who it Was Random video

Blood Thinners and Stroke Prevention

1,635 views · Published 10 December 2017 · 8:19 · Indexed 30 October 2026

Channel: Dr. Ford Brewer MD MPH · 2017 · Science & Technology

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ABOUT THIS VIDEO:
Atrial Fib is the biggest rising cause of disability. High BP is a major cause of strokes as well, but we are managing BP better on a population basis. Anti-coagulants ( not antiplatelets) prevent stroke with Afib. Coumadin has been the big preventive until recently. But it has disadvantages: 35 days to effective levels, weekly blood test monitoring for effectiveness, and significant dietary restrictions re: vitamin K. Samples include collard greens, spinach, kale, turnip greens, broccoli, and even blueberries, blackberries, and tuna. 

The NOACs are now available. They are dabigatran ( Pradaxa), rivaroxaban (Xarelto), Apixaban ( Eliquis), and Edoxaban (Savaysa). NOAC advantages include: immediate effect, no weekly blood test requirement, fewer ( maybe no) food restrictions, and - most importantly - LESS BLEEDING THAN COUMADIN (including fewer hemorrhagic strokes). 

The only advantage for coumadin would be an immediate antidote ( Vit K). That's not much of an advantage compared to less bleeding in the first place. Also, Pradaxa already has an immediate antidote. And the other NOACS are scheduled to have immediate antidotes in less than a year.
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Read more about stroke/AFib here: https://prevmedhealth.com/how-to-prevent-stroke-manage-atrial-fibrillation.
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ABOUT DR. BREWER
Dr. Brewer started as an Emergency Doctor. After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine. While there, he went on the run the post-graduate training program (residency) in Preventive Medicine. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.

At PrevMed, we focus on heart attack, stroke, and cognitive decline. We serve patients who have already experienced an event as well as those who have not developed a diagnosis or event. Dr. Brewer provides services via telemedicine or in person if you're in the Lexington, KY area. We find a lot of undiagnosed prediabetes or insulin resistance. Treating unrecognized risk factors like prediabetes allows reduction of risk and prevention of disease.

If you are interested in becoming a patient, please visit our website: https://prevmedhealth.com.
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