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In This Issue of Archives of Internal Medicine
Arch Intern Med. 2002;162:971.
Low- High-Density Lipoprotein Cholesterol and Ischemic Cerebrovascular
Disease
Koren-Morag et al studied the occurrence of cerebrovascular disease
(CVD) in 11 177 patients with documented coronary heart disease. During
a 6- to 8-year follow-up period, 941 patients were identified with nonhemorrhagic
CVD, 487 of whom had verified ischemic stroke or transient ischemic attack.
Adjusting for clinical covariates, lipid values in the upper vs lower tertile
were associated with the following odds ratios (95% confidence intervals)
for the end point of nonhemorrhagic CVD: total cholesterol, 1.43 (1.20-1.70);
low-density lipoprotein cholesterol, 1.52 (1.27-1.81); high-density lipoprotein
cholesterol, 0.84 (0.70-1.00); and percentage of total serum cholesterol contained
in the high-density lipoprotein moiety, 0.69 (0.58-0.83). These findings clearly
support the role of total cholesterol and its fractions in prediction of ischemic
CVD among patients with established coronary heart disease.
(SEE ARTICLE)
Serum Potassium and Risk of Cardiovascular Disease: The Framingham
Heart Study
To determine the association between serum potassium and risk of cardiovascular
disease, Walsh and coworkers studied 3151 participants in the Framingham Heart
Study free of cardiovascular disease and not taking medications that alter
serum potassium level. Over 16 years of follow-up, there was no association
between serum potassium level and risk of cardiovascular disease (hazard ratio
per 1-mg/dL increment, 1.00; 95% confidence interval, 0.98-1.03) or death
due to cardiovascular disease (hazard ratio per 1-mg/dL increment, 1.04; 95%
confidence interval, 0.97-1.11).
(SEE ARTICLE)
Epidemiological Evidence of Increased Bone Mineral Density in Habitual
Tea Drinkers
Tea is the most popular beverage worldwide. Tea extracts contain high
concentrations of caffeine, fluoride, flavonoids, and phytoestrogen. These
compounds have all been thought to influence bone mineral density (BMD) and
fracture risk, but information about the effects of tea consumption on bone
mass is limited and equivocal. In this study, 497 men and 540 women 30 years
and older were enrolled. A dose-response effect between the duration of habitual
tea consumption and BMDs of 4 measured regions was found. In other words,
subjects who consumed tea habitually for more than 10 years had significantly
higher BMDs compared with the nonhabitual tea drinkers. After being analyzed
with all the covariates, tea consumption was still a significantly positive
variable on BMDs of all measured regions. These findings suggest that habitual
tea consumption might have a beneficial effect on BMD in both men and women.
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Dose-response effect between the duration of habitual tea consumption
(year) and bone mineral density (BMD) in 4 regions.
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(SEE ARTICLE)
Use of Cholesterol-Lowering Therapy by Elderly Adults After Myocardial
Infarction
To assess the use of cholesterol-lowering therapy and related beliefs
during 1999 and 2000, Ayanian et al surveyed 815 elderly Medicare beneficiaries
who had been hospitalized for acute myocardial infarction in California, Florida,
Massachusetts, New York, or Pennsylvania during 1994 and 1995. In this cohort,
59% reported they were taking a cholesterol-lowering drug, and in adjusted
analyses this treatment was significantly more common among women, younger
patients, and those who reported that a cardiologist was responsible for their
cholesterol management. Lowering cholesterol level was viewed as "very important"
by 77% of respondents, but only 33% of respondents knew their cholesterol
level. Use of cholesterol-lowering drugs was substantially greater than in
prior studies of elderly patients after myocardial infarction, but most patients
were unaware of their cholesterol level or the potential adverse effects of
cholesterol-lowering drugs, suggesting opportunities to enhance patient education.
(SEE ARTICLE)
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