Healthy lifestyles and increasing risk

Cardiology Review

Cardiology Review

If you’re reading this, you’ve gotten through the holidays intact, but you may also be carrying a few extra pounds. It is appropriate, then, that this month’s features a study evaluating risk factor data to find out how healthy lifestyles can prevent the development of coronary artery disease in men who are either users or nonusers of lipid-lowering and antihypertensive medications. Drs Stephanie E. Chiuve and Eric B. Rimm prospectively monitored 42,847 men in the Health Professionals Follow-up Study. “Healthy lifestyles”—as defined by the authors and discussed by Dr Peter Jones in his commentary—had an additive effect for decreasing cardiac events above and beyond whatever medications were already being taken. In a combined report in the Diabetes and Hypertension sections, Dr Chin-Hsiao Tseng from Taiwan studied 5927 insulin users with Type 2 diabetes to see whether exogenous insulin use, along with insulin resistance, is associated with a higher risk for developing hypertension. Their observational data are commented on by Dr Rosemarie Pasmantier. This issue also features an article in the Stroke section that involves histological assessment of 526 carotid artery plaques in symptomatic patients in relation to the nature and timing of ischemic symptoms. Dr Jessica N.E. Redgrave and associates from the United Kingdom found a high percentage of “coronary-type” plaque instability in en­darterectomy specimens from patients with strokes and/or transient ischemic attacks. Our vascular surgical consultant, Dr John Ricotta, offers his thoughts on the significance of these findings in his commentary. Finally, this issue also features 2 articles that break custom with our usual format. The first, in the Diabetes section, is an overview by Dr Robin Mathews describing the mechanisms, diagnosis, and treatment of diabetic cardiomyopathy, a syndrome that is surprisingly common but still has many unanswered questions surrounding it. The second is a point-of view article by Dr Abe Friedman promoting the positive aspects of the (now) controversial use of intermittent inotropic therapy for patients with chronic congestive heart failure. If you’d like to weigh in (no pun intended!) on this controversy, or anything else you’ve read in , please send us your thoughts. Best wishes for a happy, healthy, and successful 2007!