Analysis of JNC-7 and trends in diabetes management

This month’s edition of Cardiology Review features an article in the diabetes section by Dr. Richard W. Grant and colleagues, who assessed current trends in the office-based management of diabetic patients. Dr. Alton L. Steiner discusses the case study in his commentary and stresses the need to fix our current model of diabetes care.

In a combined article in the lipid disorders and heart failure sections, Drs. Tamara B. Horwich and Gregg C. Fonarow evaluated the effect of HMG-CoA reductase inhibitor (statin) therapy on survival in patients with ischemic and nonischemic causes of congestive heart failure. In a cohort of 551 patients with left ventricular ejection fractions less than 40%, statin therapy was associated with improved survival without the need for urgent transplantation. The therapeutic properties of statins that could lead to these favorable results are discussed by Dr. Steven Borzak in his commentary.

In the arrhythmia section, Dr. Heikki V. Huikuri from Finland assessed risk markers for sudden cardiac death following acute myocardial infarction. The era of beta blocking therapy has sig-

nificantly affected the importance of common risk factors and has made prediction and prevention of fatal arrhythmic events a continuing challenge. Dr. Frank Mazzola comments on this study for Cardiology Review.

The final article, in the hypertension section, is an overview of the JNC-7 recommendations by Dr. Henry R. Black. This comprehensive analysis of the JNC-7 guidelines prompted some further questions, which are answered by Dr. Black at the end of the article.