{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:12:04Z","timestamp":1767165124120,"version":"build-2238731810"},"reference-count":23,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:p>Polypharmacy is common and associated with negative health outcomes in the elderly. We report the case of an 82-year-old man with a history of polypharmacy due to coronary artery disease, myocardial infarction, ischaemic cardiomyopathy, hyperlipidaemia, hypertension and persistent atrial fibrillation who presented with memory loss, cognitive impairment, fatigue and weakness. His treatment plan included an exclusively plant, whole-food diet and moderate physical activity which resulted in a rapid reduction of hyperlipidaemia and high blood pressure and the discontinuation of statin, antihypertensive and beta blocker drug therapy. The patient also reported reversal of impaired cognition and symptoms associated with atrial fibrillation and ischaemic cardiomyopathy, including light-headedness, fatigue and weakness. This case demonstrates that dietary and lifestyle modifications have the potential to improve symptoms of cardiovascular disease and reduce polypharmacy along with associated negative consequences in the elderly.<\/jats:p>","DOI":"10.1136\/bcr-2018-227059","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"e227059","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Exclusively plant, whole-food diet for polypharmacy due to persistent atrial fibrillation, ischaemic cardiomyopathy, hyperlipidaemia and hypertension in an octogenarian"],"prefix":"10.1136","volume":"11","author":[{"given":"Andrew B","family":"Beauchesne","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4120-3694","authenticated-orcid":false,"given":"Alan C","family":"Goldhamer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshia R","family":"Myers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,17]]},"reference":[{"key":"key-10.1136\/bcr-2018-227059-1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1517\/14740338.2013.827660","article-title":"Clinical consequences of polypharmacy in elderly","volume":"13","author":"Maher","year":"2014","journal-title":"Expert Opin Drug Saf"},{"key":"key-10.1136\/bcr-2018-227059-2","first-page":"i","article-title":"Polypharmacy: a global risk factor for elderly people","volume":"6","author":"Dagli","year":"2014","journal-title":"J Int Oral Health"},{"key":"key-10.1136\/bcr-2018-227059-3","first-page":"111","article-title":"Deprescribing: a new goal focused on the patient","volume":"16","author":"Machado-Alba","year":"2017","journal-title":"Expert Opin Drug Saf"},{"key":"key-10.1136\/bcr-2018-227059-4","doi-asserted-by":"crossref","first-page":"390","DOI":"10.5694\/mja14.00146","article-title":"First do no harm: a real need to deprescribe in older patients","volume":"201","author":"Scott","year":"2014","journal-title":"Med J Aust"},{"key":"key-10.1136\/bcr-2018-227059-5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-019542","article-title":"Deprescribing in primary care in Portugal (DePil17-20): a three-phase observational and experimental study protocol","volume":"8","author":"Sim\u00f5es","year":"2018","journal-title":"BMJ Open"},{"key":"key-10.1136\/bcr-2018-227059-6","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart disease and stroke statistics-2018 update: a report from the american heart association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"key-10.1136\/bcr-2018-227059-7","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.1161\/01.cir.0000437740.48606.d1","article-title":"2013 AHA\/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","author":"Eckel","year":"2014","journal-title":"Circulation"},{"issue":"25 Pt B","key":"key-10.1136\/bcr-2018-227059-8","doi-asserted-by":"crossref","first-page":"2889","DOI":"10.1016\/j.jacc.2013.11.002","article-title":"2013 ACC\/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"63","author":"Stone","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"key-10.1136\/bcr-2018-227059-9","doi-asserted-by":"crossref","first-page":"527","DOI":"10.7861\/clinmedicine.2-6-527","article-title":"Are preventive drugs preventive enough? A study of patients' expectation of benefit from preventive drugs","volume":"2","author":"Trewby","year":"2002","journal-title":"Clin Med"},{"key":"key-10.1136\/bcr-2018-227059-10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017723","article-title":"Effectiveness of blood pressure-lowering drug treatment by levels of absolute risk: post hoc analysis of the Australian National Blood Pressure Study","volume":"8","author":"Ho","year":"2018","journal-title":"BMJ Open"},{"issue":"8A","key":"key-10.1136\/bcr-2018-227059-11","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1016\/j.amjcard.2005.12.006","article-title":"Statin safety: an overview and assessment of the data\u20132005","volume":"97","author":"Bays","year":"2006","journal-title":"Am J Cardiol"},{"key":"key-10.1136\/bcr-2018-227059-12","doi-asserted-by":"crossref","first-page":"373","DOI":"10.2165\/0129784-200808060-00004","article-title":"Statin adverse effects: a review of the literature and evidence for a mitochondrial mechanism","volume":"8","author":"Golomb","year":"2008","journal-title":"Am J Cardiovasc Drugs"},{"key":"key-10.1136\/bcr-2018-227059-13","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/07315724.2008.10719702","article-title":"What do resident physicians know about nutrition? An evaluation of attitudes, self-perceived proficiency and knowledge","volume":"27","author":"Vetter","year":"2008","journal-title":"J Am Coll Nutr"},{"key":"key-10.1136\/bcr-2018-227059-14","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1177\/0884533610380057","article-title":"Barriers to providing nutrition counseling cited by physicians: a survey of primary care practitioners","volume":"25","author":"Kolasa","year":"2010","journal-title":"Nutr Clin Pract"},{"key":"key-10.1136\/bcr-2018-227059-15","first-page":"1671","article-title":"A plant-based diet for overweight and obesity prevention and treatment","volume":"14","author":"Turner-McGrievy","year":"2017","journal-title":"J Geriatr Cardiol"},{"key":"key-10.1136\/bcr-2018-227059-16","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.amjcard.2009.05.032","article-title":"Effects of plant-based diets on plasma lipids","volume":"104","author":"Ferdowsian","year":"2009","journal-title":"Am J Cardiol"},{"key":"key-10.1136\/bcr-2018-227059-17","doi-asserted-by":"crossref","first-page":"e256","DOI":"10.1038\/nutd.2017.3","article-title":"The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes","volume":"7","author":"Wright","year":"2017","journal-title":"Nutr Diabetes"},{"key":"key-10.1136\/bcr-2018-227059-18","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s11606-015-3390-7","article-title":"Vegetarian diets and weight reduction: a meta-analysis of randomized controlled trials","volume":"31","author":"Huang","year":"2016","journal-title":"J Gen Intern Med"},{"key":"key-10.1136\/bcr-2018-227059-19","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1079\/BJN19840066","article-title":"A vegan regimen with reduced medication in the treatment of hypertension","volume":"52","author":"Lindahl","year":"1984","journal-title":"Br J Nutr"},{"key":"key-10.1136\/bcr-2018-227059-20","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1097\/HJH.0000000000001068","article-title":"Vegetarian diet reduces the risk of hypertension independent of abdominal obesity and inflammation: a prospective study","volume":"34","author":"Chuang","year":"2016","journal-title":"J Hypertens"},{"key":"key-10.1136\/bcr-2018-227059-21","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1001\/jamainternmed.2013.14547","article-title":"Vegetarian diets and blood pressure: a meta-analysis","volume":"174","author":"Yokoyama","year":"2014","journal-title":"JAMA Intern Med"},{"key":"key-10.1136\/bcr-2018-227059-22","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1001\/jama.280.23.2001","article-title":"Intensive lifestyle changes for reversal of coronary heart disease","volume":"280","author":"Ornish","year":"1998","journal-title":"JAMA"},{"key":"key-10.1136\/bcr-2018-227059-23","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1159\/000365328","article-title":"Polypharmacy in the elderly: a marker of increased risk of mortality in a population-based prospective study (NEDICES)","volume":"61","author":"G\u00f3mez","year":"2015","journal-title":"Gerontology"}],"updated-by":[{"DOI":"10.1136\/bcr-2018-227059corr1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T00:00:00Z","timestamp":1548115200000}}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bcr-2018-227059","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227059","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T12:44:47Z","timestamp":1601037887000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12,17]]},"published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1136\/bcr-2018-227059"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227059","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]}}}