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The atherosclerotic-plaque burden among cops and firefighters is no higher than in a cohort of age-matched controls, suggesting that something else, possibly increased emotional and physical stress, is causing the increased risk of on-the-job cardiac-related events.
Atlanta, GA - The stereotypical image of the cop and the doughnut is challenged this week with new data from a group of researchers showing that police officers, as well as firefighters, do not have greater burdens of atherosclerosis compared with age-matched controls [1].
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Inside: Prevention
Accredited educational programs,
supported by industry, developed by theheart.org
Dyslipidemia is only one signal of cardiovascular disease (CVD) risk. Inflammation is a frequent precursor of cardiac-related events. Drs. Willerson, Ballantyne, and Ridker critically examine the mechanisms of atherosclerosis, elevated C-reactive protein and other risk factors, and statin therapy to preemptively address or ameliorate CVD.
Little success has been realized in achieving target levels for glycemic control, lipids, and blood pressure, as a result the number of patients with diabetes in the U.S. with these risk factors has increased. Drs. Davidson, Blumenthal, and Svec discuss appropriate treatments to guide the physician in the prevention of CVD.
Join Drs. Davidson, Sabatine, Sacks, Chapman, and Foody in an exciting discussion about the advances in genetic markers in assessing cardiovascular risk and targeting therapy.
The following test-and-teach case is an educational activity modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and will then read evidence-based information that supports the most appropriate answer choice. Please note that these questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the case, there will be a short post-test assessment based on material covered in the activity.
Genetic findings that affect the course of diseases have been increasing geometrically. Cardiology is one of the specialties that has benefited from recent discoveries. David Danar, MD, Scientific Director, MedscapeCME, interviewed John P. Kane, MS, MD, PhD, about the role of genetics in determining the risk for and management of heart disease.
New research from the UK has found that doctors are still prescribing ACE inhibitors and angiotensin-receptor blockers in women of child-bearing age, despite evidence that they are teratogenic. Reasons include a lack of awareness of the issue among GPs and obstetricians and ambiguity in hypertension guidelines, says the researcher.
In a group of nearly 1000 subjects told they had low vitamin D at baseline, those who managed to up their levels over follow-up were significantly less likely to die or to suffer a combination of cardiovascular end points.
A host of new analyses published in the Lancet journals, some of which were also reported at the ACC meeting, suggest that variability in blood pressure is a much stronger determinant of both stroke and coronary disease outcome than average blood pressure. And calcium-channel blockers have the strongest effect of all antihypertensives on reducing BP variability, say the researchers.
Diabetic patients whose systolic blood pressure was lowered to 130 to 140 mm Hg had a better outcome than those with systolic pressures over 140. But reductions below 130 did not appear to offer any additional benefit and had a higher mortality rate in this retrospective analysis.
Psoriasis patients should be considered at increased cardiovascular risk and prioritized for earlier medical risk-factor intervention for heart disease, the authors of a new study say.
The ACCORD BP study shows that there is no benefit to be gained from intensively lowering systolic blood pressure to less than 120 mm Hg in type 2 diabetics; for now, a goal of <140 mm Hg seems reasonable in this population, say the authors.
UPDATED // In a population with impaired glucose tolerance and CV disease or risk factors, the angiotensin receptor blocker had a slight effect and the short-acting insulin secretagogue had no favorable impact on progression to diabetes; neither drug prevented cardiovascular events.
Despite looking fit and healthy, a third of firefighters examined in a new study were at high risk of a thrombotic event, and improving their fitness is more likely to reduce this risk than tackling excess body weight, say the researchers.
The warning will inform clinicians that tests are available to predict whether a patient will convert the drug to its active form based on the genetic profile of a key liver enzyme.
Drinking four or more cups of java per day is associated with an 18% lower risk of hospitalization for arrhythmias, new research shows. While the data are observational and researchers don't advocate for greater consumption, they say it is good news that coffee doesn't appear to be harmful to the heart's electrical system.
The Heart of a Woman
Primary and Secondary Prevention of CVD and Stroke in Women
The role of lipids in women for primary prevention of cardiovascular disease is a challenging issue for all providers. Join Drs. Foody, Mora, and Welty as they discuss limitations to current risk stratification models, recent clinical trial data, and the changing paradigm in the management of lipids in women.
Primary and Secondary Prevention of CVD and Stroke in Women
We know there are sex and biological differences in the manifestation of CVD. How do these pathophysiological differences affect the diagnosis and treatment of our female patients? Drs. Hayes, Johnson, Manson, and Piña provide their insight.
Dr Valentin Fuster sits down with Drs Peter Berger, Anne Curtis, Tim Gardner, Tony Gershlick, Harlan Krumholz, Darren McGuire, Ileana Piņa, and Rita Redberg to discuss the lessons learned at the ACC 2010 Scientific Sessions, including why lower may not be better for blood pressure, why preventing diabetes does not necessarily reduce cardiovascular risk, and the future of the mitral-valve clip.
Do gender perceptions affect the way female physicians are treated in cardiology? Drs Melissa Walton-Shirley, Judith Hochman, Suzanne Oparil, and Lynne Warner Stevenson tackle this important question.